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Brace yourself for an historic national battle

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By Jim Flynn

In 1945, President Harry Truman urged Congress to create a health care system which would provide hospitals for 1200 counties which had none, and make medical care accessible to 15 million people in rural areas. The American Medical Association attacked the idea as creeping communism.

Twenty years later, during the Presidency of Lyndon Johnson, federal money financed the building of hundreds of hospitals and paid for the education of hundreds of doctors. Nobody com-plained.

At the same time, Congress passed the Medicare supplement to Social Security. Mr. Truman received the first Medicare card. Despite mumblings about socialism, hospitals and doctors have treated millions of elderly patients and happily accepted billions of socialistic federal dollars for their work.

Where are we now? Sixty-four years later, we spend more than 16% of our total national income on health care. That’s $2.5 trillion dollars, and rising rapidly! We spend more than $8,000 per citizen per year, which is more than double the next highest industrialized nations, most of which have health care for everyone. And millions of citizens are still uninsured.

Where does all that money go? Some 25% to 30% goes to insurance company administration and profits. That doesn’t buy any health care. It pays for salaries, forms, regulations, dividends, and bonuses.  

On the public side, Medicare and Medicaid have much lower costs for administration (around 5%), but the programs are rife with fraud and theft. Sleep-walking administrations result in periodic headlines that Medicare is overcharged by billions and Medicaid is too busy to audit its books and programs.

The Repubican plan to improve health care availability is to give individuals a $2,500 tax credit and families a $5,000 credit so they can buy health insurance –if they can find a company willing to sell it to them.  Based on current costs for group health insurance, the prices for individual policies would be at least double and more probably triple the amount of the tax credits.

Medicare, Medicaid, and children’s health programs came about because insurance companies want to insure selectively and charge different prices for different ages and health conditions. That’s sound business practice, but lousy social policy.

Republicans cling to a persistent misrepresentation that there is a “free market” for health care. Give folks a few bucks in tax credits and they’ll shop until they find the best coverage for their needs.  It’s a phony fantasy they’ve been selling to dumb politicians for years.

President Obama has a small window of opportunity to do what Presidents Truman and Johnson could not accomplish – universal access to health care at reasonable cost to individuals and employers, and substantial public expense. 

Mr. Obama has seized one of two best options, either require employer provided health insurance for all employees or open existing government-run programs to the uninsured. Unfortunately, execution is in the hands of a quirky Congress.

Some liberal members of Congress insist on opening an expensive new federal program at huge expense, no matter what. Republican members are already talking to a consultant about strategies to block an Obama health plan which doesn’t even exist.

There was elation in the White House when health insurers told Mr. Obama they could go along with a plan that requires all citizens to buy health insurance, with subsidies or tax breaks for those who can’t afford the cost. They even suggested they would offer insurance to everyone.

Another seemingly positive development was a delegation of health industry officials proposing to reduce their costs by $2 trillion over the next ten years. That suggests the health financing people believe Congress may actually create a universal health care plan. They want to block it, or at least exercise some control over what’s in it.

Mr. Obama has three goals for health care financing: Lower costs; provide more choices; and make health care affordable for all. How he’ll get lower costs and affordability into the same package is a mystery which will require a miracle

In a logical world, the $2.5 trillion we already spend on health care should be enough to in-sure every American without spending another dime, but that’s not how the game is played in the political world of big business health care.

If the Obama Administration gets a national health care bill through Congress in these uncer-tain times, it will be a bigger social change than Medicare.

We think he’s going to succeed, despite a mighty uproar from those in opposition.

Jim Flynn was formerly a corporate counsel, served in military intelligence during the Korean War and once aspired to be a newspaper columnist.