European, and Against Health Care Reform

Health Care Reform is now on the lawbooks in the US, barring the unlikely event of a successful Constitutional challenge. As Europe reacts to this unexpected development – everyone thought that it couldn’t be done, particularly back in January – the prevailing attitude seems to be “Welcome to the club of states who don’t turn their back on the sick and the poor.” This new legislation does insert the US government more into the national health care business, in good European style, partly in order to finally enable (mandatory) insurance coverage for the 40 millions or so who are presently not covered.

But it’s always useful to remember that European opinion is never monolithic, even when it comes to the universal health coverage which has been the general rule there, in one form or another, since at least the 1960s. Not everyone in Europe opposed George W. Bush’s 2003 invasion of Iraq, for example; sure, the British even joined in with their own troops, but so did the Poles. And for one contrary view on America’s new Health Care Reform – one that is doubtful, not welcoming, but presumably intellectually palatable nonetheless – we have Czech commentator Radek Palata writing in the business newspaper E15 (USA: Savings don’t come for free).

First of all, Palata mentions the important aspects of the US health care system that remain unchanged. There has been no real break from the usual American free-market philosophy; health care provision there remains overwhelmingly centered around private insurance, usually provided by one’s employer. Even as things have remained unchanged in these aspects, the new measures at the same time raise the prospect of increased costs to the government that threaten to accelerate the already-enormous federal budget deficit – by an additional half-trillion dollars, for example, according to calculations Palata cites from the Cato Institute.

Now, the Cato Institute is well-known as a right-wing think-tank, and therefore in league with the Republican Congressional minority which supplied no votes at all towards the passage of the health bill, as it railed against (among other things) the supposed national bankruptcy which such a reform would bring. Palata is sympathetic to their point-of-view; the $100 billion in health cost-savings promised by the bill’s proponents over the next ten years (followed by a further $1 trillion in the ten years after that) don’t really seem credible, especially when you recall (as he does for us here) the explosive growth in Medicare/Medicaid costs seen since those programs’ establishment 45 years ago.

Naturally, Palata is writing from out of the context of his familiarity with the Czech health system, which stands at the polar opposite to the American: not high-quality, but fairly cheap – and truly available to all, in good socialist style, but also with private treatment facilities available for those who can and want to pay for them when the need arises, together with private insurance to help them do so. More to the point, though, the Czech State is also busy piling up a big budget deficit (although hardly on American scale, naturally), and at the same time seems so shot through with corruption when it comes to public spending that it would be impossible for any knowledgeable observer to begin to believe cost-savings promises of the sort accompanying the new American health legislation.

But that’s just the particular problem of the Czech government. If billions in health cost-savings were promised in that legislation, then they’ll turn up, and on schedule. Right?

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