Forum Addresses
Health Care Crisis

n Tuesday, May 30^th, the New York Metro Chapter of Physicians for a National Health Program held a public forum on "The Health Care Crisis and What To Do About It." The noted economist and New York Times columnist, Paul Krugman, was the featured speaker. As he has done consistently in his column, Krugman addressed the urgent need for health care reform in the United States, analyzing the deep problems with the current health system, why it doesn’t work, and what should be done about it.

Krugman began by stating that the US has a history of failed attempts to introduce universal health insurance. This has left it with a system in which the government pays directly or indirectly for more than half the nation's health care. However, the actual delivery both of insurance and of health care is undertaken by a crazy quilt of private insurers, for-profit hospitals, and other players who add cost without adding value. "A Canadian-style single-payer system, in which the government directly provides insurance, would almost surely be both cheaper and more effective than what we now have," Krugman declared.

Describing the steady unraveling of this country's employer-based health system, Krugman explained that in 2004, for example, 63.1% of Americans under 65 received health insurance through their employers or family members' employers. This was down by 4.6% from 2000. He said that the true dimensions of the deterioration of the current health care system have been masked by the rapid growth in Medicaid, which absorbed many cast-offs from the employer-based system by covering eight million more people in 2004 than it had in 2000.

Krugman also discussed some of the political obstacles that must be overcome in order to achieve national health insurance. He said that even liberal economists and scholars at progressive think tanks shy away from proposing a straightforward system of national health insurance. Instead, they propose fairly complex compromise plans, like that in Massachusetts, that try to achieve universal coverage by requiring everyone to buy health insurance - the same way everyone is forced to buy car insurance - and deal with those who can't afford insurance through a system of subsidies. He noted that the main reason for not proposing a single-payer plan is political fear: reformers believe that private insurers are too powerful to cut out of the loop and that a single-payer plan would be too easily demonized by business and political propagandists as "big government."

But Krugman rejects this line of thinking. He believes that these compromise plans would run into the same political problems, and that it would be politically smarter as well as economically superior to go for broke: to propose a straightforward single-payer system and try to sell voters on the huge advantages such a system would bring.

"Whatever else," Krugman concluded, "universal health coverage should be brought about on moral grounds. "We should not let people suffer and die because they can’t afford health insurance."

Among the others who spoke briefly at the forum was Dr. Ayodele Green, a Resident Physician at Harlem Hospital. "Residents all over the country are on the frontlines in seeing the impact of people being uninsured and under-served," she stated. "We see the social devastation caused by people not having access to health care. Because they don’t have a private doctor, people with only mild illness wait until their condition becomes so severe that they end up in the emergency room."

Attending the forum was Katura Massie, a Medical Assistant, who commented, "I believe that everyone deserves health care. How are you going to have a productive society if when people get sick – and everybody does get sick at one time or another – they can't get decent health care?"

Edline Jacquet, whose family is from Haiti, said that she believes the US should move towards a universal health care model like Canada's because having 49 million Americans without health insurance is a public health crisis. She agrees totally with the motto of Physicians for a National Health Program: "Health care is a human right."