U.S. UNIVERSAL HEALTH INSURANCE

I know he is charming, but President Obama did not really fix the health insurance and health accessibility situation for most Americans. Sorry to burst anyone's bubble on this.

Yes, it is still screwy, as anyone who actually gets sick and isn't a billionaire or government employee will agree. There isn't enough red tape in The Universe to chart how complicated it all is. So, the solution lies in getting a huge scissors to cut away the red tape that we can. It really isn't as complicated to fix it as it is to maintain the mess it is in. 

Obama bowed to those in Congress who were in the pocket of private insurance. That is just about all of them. Insurance companies, like banks, have massive political influence. Some health insurance companies are wedded to other forms of insurance in the morass of corporate webs. Those webs are not really like people, despite what Citizens United folks may think. They are monsters, morphed into existence by financial expedience.

The treatment should fit the disease, which has been made more acute by governmental mistakes. The U.S. Government, let's say Health and Human Services, should never be allowed to actually run health insurance programs. That would be akin to handing a drunk the keys to a bulldozer in Manhattan. I agree with Republicans on that point. 

The health insurance infrastructure in the U.S. is massive and relatively functional. The infrastructure of private insurance is not the problem. It could be maintained with reform and innovation under a universal health insurance system. 

Think of corporate mergers and buyouts. When Corporation A assumes control ... buys out or merges with ... Corporation B, the effects on the ground of Corporation B can be minimal. Business as usual for those who do the hands-on work and those who consume Corporation B's services. We have all had some experience with this as consumers, often without even being aware it is happening.

In the case of universal health insurance, there needn't be a single-payer at the vendor and consumer level. That is a bogey man created by health insurance panic-mongers and those who are trying to sell something that could be a disaster.

What happened when General Motors nearly died in 2008? The Federal government invested to keep it from happening. Now Chevrolet is actually making a comeback. There is precedent for the Federal government to work with corporate business to benefit the general economy of the nation.

Two models strike me as doable in the health insurance sector.

The top-down model would entail the U.S. government doing a buyout of existing health insurance companies. Again, the interface between providers of insurance and consumers would be relatively unchanged. Insurance companies would maintain their current infrastructure. Consumers would pay premiums which would be managed by the current infrastructure. 

The difference would be simple. After a period of adjustment, premiums would be drastically reduced as corporate profits and inflated executive salaries came under the control of the government. The government would become the controlling shareholder of all health insurance companies. Payment rates to medical providers would be standardized nationally. Co-insurance between government and private insurers would simply go away. 

Under this model, the consumer-taxpayer would benefit in several ways. Premiums would be drastically reduced over time. Insurance would become seamlessly portable nationwide. Providers could streamline billing costs. Insurance company employees would have job security. The executive and public relations aspect of the insurance industry would be drastically reduced and reformed at great savings to consumer-taxpayers. These savings would offset some necessary price-cutting on the medical provider side.

In the alternative bottom-up model, the U.S. government would become the sole super-consumer of all private health insurance. In this system, every legal citizen in the U.S. from birth would be issued a government insurance number which would guarantee lifetime medical insurance. The U.S. government would set a yearly or monthly premium for that coverage, similar to the premium which retirees pay monthly from their Social Security checks. 

All private health insurance companies would serve the U.S. government as their sole customer. They would have to reform their business practices to maintain their operations based on the premiums collected by the U.S. government through employment and income taxes. This would inevitably lead to corporate reform, since the super-consumer, the U.S. government, would have tremendous negotiating power. Likewise, medical providers would also have to reform their billing rates and costs. 

This all boils down to one thing: Corporate executives, shareholders, medical executives, some doctors are all making too much money from providing a necessary human service. 

Will the U.S. be a nation which prizes common health (common good) over individual profits ultimately? Will the U.S. sacrifice a fraction of its attempt to dominate world politics at tremendous cost in military budgets to provide a foundation of health and well being for all its citizens? Is this really a partisan issue for debate? 

The free market has never provided universal medical care in human history. It cannot. The sick and disabled are not able consumers, capable of picking and choosing the most economical and most qualified providers. Believing otherwise is a naive (but convenient) fantasy of the healthy or the extremely wealthy. In some aspects of society, we have evolved beyond the free market due to science and the philosophy it inspires. 

One thing is certain: Compassion is not a commodity.