The Wake

What’s one of the major differences between the United States and other industrialized countries? Healthcare. It’s not just that most other first-world countries provide healthcare to their citizens under a universal system. In the United States, healthcare is tied to employment in a way that cripples the unemployed.

“The U.S. is unique [because] we have an employer-based system,” says Steve Parente of the U’s Medical Industry Leadership Institute at The Current and Citizens League’s presentation, “Policy and a Pint: Healthcare Handcuffs.” And it’s not as if this issue hasn’t come up before,” adds Chris Farrell, MPR’s chief economics editor on stage with Parente and 89.3. The Current’s Steve Seel, moderator for the evening at the Varsity Theater on Wednesday, Mar. 7. In fact, Farrell explains, it’s come up about every 15 years for the past several decades. “Why is it going to be different this time?” he asks.

Because “you’re paying for 46 million uninsured,” Parente says. Medicare and Medicaid were created to assuage health care crisis’s similar to the current one. But “the middle class was largely covered” those times, Parente says. Not so this time around. In this “hypercompetitive economy,” employers are cutting benefits and extending probationary periods for new employees as premiums and co-pays skyrocket.

Many wonder if universal healthcare is even possible. Farrell says there are two kinds of feasibility to take into account: economic and political. Farrell wonders if our economy can support universal healthcare, especially during the transition, and if anyone can get the votes to institute a change. It’s possible, Parente thinks, but it’s going to take a lot of time, effort and money.

The ever-deteriorating situation is spurring legislators to take action. 2008 presidential hopeful John Edwards already has a universal healthcare plan designed and many in Congress are drawing up plans and calling for change. Fifth District Congressman Keith Ellison campaigned on support for a single-payer system of universal healthcare throughout last year’s elections and would likely vote yes on any such legislation.

But a single-payer system, which would mean the government provides healthcare for all citizens through tax increases, is controversial. Farrell thinks a “fee for service” system might work better. “The price should be based on improvement,” he explains. That way, you’d only have to fork over the cash after your condition improves. Such a system would encourage doctors to focus on chronic illnesses instead of the temporary bug at hand as well.

Parente, on the other hand, thinks there are some benefits worth noting under a single-payer system. “All the single-payer systems come out ahead,” Parente says, if you consider all the results we’re looking for, such as increased life expectancies and low infant mortality rates. “Universal healthcare doesn’t mean you have to give up choice,” he says, addressing one of the system’s biggest controversies.

So what to do? Examine how we got into this mess and consider our options, the speakers explain. “How did it get tied to employment?” Seel says.

“These are policies that were put in place [before World War II],” Farrell says. They were war policies that were never updated, he explains.

“We need to separate this link between employment and health insurance,” Parente says. “The issue can’t go away.”

About time.