One of the benefits of a government based on the separation-of-powers — like that of the United States, in which two separate parts of a legislature as well as the executive must agree on a law — is that change usually occurs incrementally, and the country is generally stable as a result.
In such a system, major shifts in law rarely occur quickly (not counting actions by the judicial branch), and policy typically spans only from the center-left to the center-right (as compared to what happens in parliamentary systems in Europe and elsewhere). When change does occur, it usually happens bit-by-bit over several years or longer — and the political tactics used to implement such change are referred to as the Overton Window.
The benefit is that extremely-bad laws are rarely enacted since a law passed by one branch of Congress can be struck down by either the other branch or the president. However, the opposite side of the coin is that extremely-good laws can be easily blocked as well. The public can demand “change” on any given issue, but significant “change” rarely occurs easily in the U.S. government as a result of this process.
Take the debate over the recently-passed health-care reform (known by opponents as “Obamacare”). As a result of the political process, the resulting bill that was passed was a moderate compromise that satisfied neither the left (who wanted a single-payer system of universal health-care) nor the right (who wanted nothing at all).
According to Wikipedia, the health-care reform bill resulted in the following:
- 32 million additional citizens being insured by 2019, but an estimated 23 million would remain without coverage
- Insurers would be forced to cover more of a person’s health care costs by excluding lifetime and annual caps, covering first-dollar costs for screenings and immunizations, and preventing exclusions for necessary care.
- Mandate that no more than 15% of premiums would be used fo overhead expenses by insurance companies.
But as a result of political maneuvering and negotiations, the muddled bill that emerged may in fact do more harm than good:
The new health care law wasn’t supposed to undercut employer plans that have provided most people in the U.S. with coverage for generations. But last week a leading manufacturer told workers their costs will jump partly because of the law…
While it’s too early to proclaim the demise of job-based coverage, corporate number crunchers are looking at options that could lead to major changes.
“The economics of dropping existing coverage is about to become very attractive to many employers, both public and private,” said Gov. Phil Bredesen, D-Tenn…
“I don’t think you are going to hear anybody publicly say ‘We’ve made a decision to drop insurance,’ ” said Paul Keckley, executive director of the Deloitte Center for Health Solutions. “What we are hearing in our meetings is, ‘We don’t want to be the first one to drop benefits, but we would be the fast second.’ We are hearing that a lot.”
I can understand the economics. The primary function of a business is not to provide health-care coverage for employees or contribute to the community — it is to increase its value for its shareholders through maximizing revenue and minimizing costs. While some business owners will sacrifice a little value to give benefits to employees or donations to communities — and those who do should be praised — they are under no obligation to do so.
Health-care reform has been one area in which massive change is preferable to incremental change — for reasons that include benefits to business owners, aid to employees, and help for society in general. The nature of the U.S. political system prevented a major overhaul — a move to universal health-care — that would have benefited all parties in the long-term.
Shortly after moving to Israel in January 2008, I developed a case of bronchitis. My first experience with a universal health-care system was quite interesting at the time, and it piqued my interest on the societal implications:
Which is the best means to have a healthy population? In general, there seem to be two options (based on my experiences in the United States and Israel):
- Everyone receives health insurance, but the quality of service is moderate for everyone and prescriptions are a little expensive; or
- Those who acquire health insurance receive excellent care and cheap prescriptions, but those who do not have it receive nothing at all.
Which one would you prefer? The former is universal health-care, while the latter is a free-market system.
When debating a controversial issue like universal health-care, it is common for opponents of national health-care to resort to illogical arguments involving words like “socialism,” “communism,” and “Marxism.” And this is a deflection that reveals a lack of logical counterpoints.
As I wrote in a prior post on the sad state of U.S. politics, I would love to see a world in which words including “liberal,” “conservative,” “Democrat(ic),” and “Republican” were banished from political discourse. An issue of public policy should be judged solely on its merits (or lack thereof) and not on whether it is an opinion rooted in one of the adjectives listed above. A liberal can have a good or bad idea; a conservative can have a good or bad idea. But the idea is what matters. So ignore any partisan rhetoric on universal health-care.
My arguments, of course, are based on economics. While having healthy people is a moral good in and of itself, the fact remains that such a population will generally be more productive in all aspects of society. But the main argument against universal health-care is that it is expensive — this is a rational, valid point, but it is also one that ignores the greater context.
My last journalism job in Boston was serving as the executive director and publisher of Spare Change News, an alternative newspaper that covered social-justice issues including homelessness and poverty, after I had first arrived there as the editor of the publication in 2003.
When I became executive director and hired a new editor to replace me, most of my time involved administrative and financial duties including fundraising and bookkeeping. As a result, I knew from where the money was coming and to where it was going — and, from what I remember, the small, non-profit organization paid $2,000 to $3,000 a month for health-insurance for our full-time and part-time employees. (To benefit its workers, SCN paid 100% of the cost.) I am sure that the payments have increased since premiums have risen in recent years.
Here is the crux of the matter from an economic standpoint. If SCN would had not needed to pay for employee health-care coverage, I could have used that money to hire another staffer. And this is what opponents of universal health-care should remember:
- By relieving businesses of the need to provide health-care insurance, a universal health-care system would decrease unemployment
- Increasing employment would give the public more purchasing power, allowing them to buy more goods and help the economy since consumer spending is roughly two-thirds of U.S. GDP
- Increasing employment would increase payroll-tax revenue to the government
- Increasing employment would decrease unemployment-insurance expenditures by the government
- Increasing employment would make businesses more productive, increase their bottom-lines, and increase corporate-tax revenue to the government
The main argument against universal-health care — not including pleas to emotion involving words like “socialist” — is that it would vastly increase expenditures by the government at a time of large deficits and growing debt-burdens.
But the economic benefits of an increase in consumer spending, payroll taxes, and corporate taxes would likely offset the economics costs of a national health-care program. Since most of the opponents of universal health-care seem to be on the right, this is an argument that they could surely support. But the real question is whether such a massive overhaul could occur anytime soon in a political system that enforces stability and moderation.