By Jeremy Lott on 11.20.02 @ 12:48AM
Al Gore's championing of Canadian health care is not exactly new.
Al Gore thinks he's found the solution for what ails his party
--north of the 49th parallel. Last week, as part of the tour for
his and Tipper's new
pair of
books, Gore announced to an audience in New York's Upper West
Side that he has now "reluctantly" decided that single-payer health
care is the way to go.
For non-wonks, ABC's
The Note has a pretty good explanation of what that means.
"Single payer" it turns out, is one of those euphemisms (like
"affirmative action") meant to soothe, confuse and paint opponents
in the worst possible light. Under a single payer regime, all money
spent on medicine "is collected by some public agency or trust
fund, which then pays for comprehensive coverage, delivered
privately and publicly, for all citizens." Slate's
Mickey
Kaus headlined this "policy bombshell," "Gore moves to
Canada."
Some have expressed shock over Gore's change of mind but they
must not have been paying close attention. Gore was more cautious
than the early Clintonites, whose enthusiasm for socialized health
care got Newt Gingrich installed as Speaker of the House. However,
during the 2000 election, the former vice president made no bones
about wanting to expand the role of government in funding and
regulating prescription drugs. He even went so far as to expound on
the virtues of, yes, Canada's jury-rigged, highly regulated
prescription drugs industry.
This frame of mind was not lost on the cast of
Saturday Night Live. Near the end of their mock up of the first
Bush-Gore match-up -- the infamous "lock box" debate -- Darrell
Hammond (as Gore) held up a picture of 94-year-old widow Etta
Munsen. This woman, Hammond explained, was a one-kidneyed
Tennessean who suffered from "polio, spinal meningitis, lung,
liver, and pancreatic cancer, an enlarged heart, diabetes, and a
rare form of strychnic acne" and who was paralyzed by several
strokes and "an unfortunate shark attack."
With prescription drugs bills of roughly "$113 million a day"
("staggering!"), Etta had to choose some weeks between food and
"treating her Lyme Disease." The punch line was pretty good, even
by SNL standards: "Now, under my plan, Etta's prescription drugs
would be covered. Under my opponent's plan, her house would be
burned to the ground. And that is wrong. That is just wrong!"
One hates to explain a joke but the reason that that caricature
worked was that it had a counterpart in reality. Gore, like most
congressional Democrats, really did believe that the problem with
health care is that, without universal coverage, citizens are left
to the ravages of cruel fate and/or greedy insurance companies.
To Gore and company, large numbers of uninsured or so-called
"under insured" Americans are intolerable. These people are
evidence that "the system" -- a somewhat free market in medicine --
has failed and needs to undergo drastic government-ordered repairs
in order to meet basic standards of fairness. It is unsurprising
that those who think the solution to medicine is more government
would think that even more government will make for even better
medicine.
Only a fool would argue that the American medical system is
perfect, but its own admitted imperfection and incompleteness may
be its greatest strength. No, the U.S. doesn't have a single
medical system overseen by a national or provincial government.
Instead, it has a patchwork of independent medical providers,
insurance companies, charities, individuals and government
subsidies that serve as an excellent safety net. (Members of my
family, for instance, have been "under insured" for a few necessary
procedures and the hospitals/doctors have always offered the right
mix of discount and delayed repayment to see us through.)
The fairly unrestricted pricing of medical goods and services in
the U.S. allows some people to get rich, but its more important
contribution is the feedback loop generated by price signals.
Procedures, equipment and drug usage are directed much more by the
individual than by the state to a degree that occasionally shocks
outsiders. In the U.S. you can always get another opinion, and
another, and another. In Canada, that's a waste of taxpayer
money.
While many Canadians are indeed happy with their health care --
or at least not so unhappy that they protest -- thousands flee
across the border every year to receive life-saving medical
treatment such as chemotherapy or surgery to remove cancer. Because
Canadian medicine is ultimately driven by the government and not
the demands of individuals, shortages of workers and materials are
common and lead to rationing.
As things stand now, Canadians can crow about their egalitarian
system while counting on U.S. health care to bail them out in a
pinch. But one wonders where they would go if Al Gore ever became
president.
topics:
Health Care, Books