May 5th 2017

Trumpcare is the best Advertisement for Nationalizing Insurance

by Juan Cole

Juan Cole is the Richard P. Mitchell Professor of History and the director of the Center for South Asian Studies at the University of Michigan. His latest book, Engaging the Muslim World, is just out in a revised paperback edition from Palgrave Macmillan. He runs the Informed Commentwebsite.

The sadism and greed of the American Republican Party was on full display Thursday, as the House GOP voted to destroy Obamacare and remove the coverage for pre-existing conditions (50 million Americans suffer from them). Oh, this sabotage is camouflaged, but the way Trumpcare would work would make health insurance too expensive again for the 40 million people who were uninsured in 2008. People will be shifted into pricey high-risk pools. Ending the individual mandate would ensure that healthy young people were exempted from having coverage, making it impossible to establish pools so private insurers can cover pre-existing conditions or chronic ones and still remain in business.

Apparently what the old white men of the GOP minded most of all about Obamacare was that it removed from the more racist states in the union the ability to shield rich white taxpayers from paying to keep the children of minorities alive. (Their image of the situation is anyway false; half of those living below the poverty line are white).

Here are some of the countries that are better than the US Republican Party:

President Hassan Rouhani of Iran has pledged universal health coverage in Iran by 2018. The GOP is always going on about how Iran is the world’s major sponsor of terrorism (this is not true), but even these bloodthirsty ghouls apparently are better than US Republicans inasmuch as they want to make sure poor children don’t have to just die for lack of money to pay for treatments.

Then there is China, where the government has successfully covered all 1.3 billion citizens. The Republican Party has made its way in the world by promising that if some businessmen are allowed to get fabulously wealthy that will lift all boats. What they said Thursday is that there are 40 million boats they won’t be lifting. But now the Chinese Communist Party has shown that it really can lift all boats.

Given the serious commitment of the Chinese Communist Party to green energy and meeting the goals of the Paris Accord, and the way in which it has lifted over a billion people out of poverty and given them universal health care, it seems obviously a superior party to the American GOP if you don’t happen to be a billionaire. It used to be boasted by the US Republicans that they provided an increased standard of living as well as democratic freedoms, but they don’t seem nearly as committed to either of these goals as Beijing is.

It is not clear why there is private health insurance. There are some things that the market does poorly and should be nationalized, as is the case in most advanced countries. The electric grid is another. The American myth that all government enterprises are inefficient and monopolistic ignores the fact that most large corporations in the US are de facto monopolies and are not particularly efficient.

The one percent who profit from health insurance will also try to tell you that government health care takes forever to see you. America’s privatized system also can take a long time to see you. Anyway, nationalizing health insurance would not stop people from going to a private hospital and paying out of pocket if they wanted to.

Here are the countries with a single payer system, which is defined this way “The government provides insurance for all residents (or citizens) and pays all health care expenses except for co-pays and coinsurance. Providers may be public, private, or a combination of both.”

Norway 1912 Single Payer
Japan 1938 Single Payer
United Kingdom 1948 Single Payer
Kuwait 1950 Single Payer
Sweden 1955 Single Payer
Bahrain 1957 Single Payer
Brunei 1958 Single Payer
Canada 1966 Single Payer
United Arab Emirates 1971 Single Payer
Finland 1972 Single Payer
Slovenia 1972 Single Payer
Luxembourg 1973 Insurance Mandate
Italy 1978 Single Payer
Portugal 1979 Single Payer
Cyprus 1980 Single Payer
Spain 1986 Single Payer
Iceland 1990 Single Payer

None of these countries is bankrupt. In fact, health care costs in these states are lower than in the United States and in many of them health statistics are superior to those of the US. Spain, Iceland, the UK, Portugal and Italy all have a life expectancy higher than the US.

Over a dozen other advanced countries have a two-tier system: “Two-Tier: The government provides or mandates catastrophic or minimum insurance coverage for all residents (or citizens), while allowing the purchase of additional voluntary insurance or fee-for service care when desired.”

Many two-tier countries also have lower health care costs and better health statistics than the US.

The US is the only advanced economy where millions are left without health insurance and are one illness away from bankruptcy and one paycheck away from dying or seeing their children die.

Even developing countries like Ecuador have quadrupled spending on health care and have markedly improved the lives of those living under the poverty line.

Raw American capitalism hasn’t increased the average wage of the average worker since 1970. It apparently can’t provide universal health care insurance to Americans. It is time for the American public to realize it is being taken for a ride. There are several industries that need to be nationalized. The electrical grid and some utilities are on the list, in order to fight climate change. But really, the only proper response to the vicious brutality that is Trumpcare is to punish the insurance companies who bought and paid for the congressmen that voted it in, by just having the government take over their industry.

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