Ah! But they love 'em in the womb!
Alan: It is a hard, garish truth that many Americans prefer the sort of austerity and pay-as-you-go "free market" capitalism that would rather see people dead (or at least suffer unnecessarily en route to an early grave) than to conceive cost-effective healthcare as a human right.
***
In 1963,
when Martin Luther King, Jr. gave his “I Have A Dream” speech, America spent
5.5 percent of gross
domestic product on health care . Today we
spend 18 percent, while most other wealthy nations
spend 10 to 12 percent through systems that deliver equal or better health
outcomes. In a $16 trillion economy, our excess health-care spending — that is,
money we devote to health care that plainly isn’t needed for quality care —
thus comes to a staggering $1 trillion a year.
Call this
a trillion-dollar “diversion” or “opportunity cost.” Call it a “rip-off.” Or
even “theft.” Whatever the label, the point is the same: No leader
commemorating the March on
Washington and urging the nation to pursue our unfinished progressive agenda
will draw a link between our out-of-control medical-industrial complex and the
price of justice. They should.
Matt Miller
A senior
fellow at the Center for American Progress and the host of the new podcast
“This...Is Interesting,” Miller writes a weekly column for The Post.
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In 1963,
Dr. King said, “the Negro is still languishing in the corners of American
society.” Half a century later, if you want to know why too many Americans of
every race and creed are still languishing, our outsized health-care costs, and
the way they divert public and private resources from more urgent uses, are a
big part of the explanation.
Why?
Because there’s no money.
Millions
of poor children lack access to the high-quality preschool that would give them
a better chance in life. We can’t give them such access because “there’s no
money.”
Millions
of poor children are warehoused in schools across the United States today with
unqualified teachers. Still, the United States won’t invest in making teaching
an attractive career for our most talented young people, which is what nations
with high-performing school systems, such as Finland, South Korea and
Singapore, do.
Why not?
Because, we’re told, we don’t have that kind of money.
Average
wages have been stagnant for years, in part because in our employer-based
health-care system, soaring health-care costs have devoured all the cash
businesses might otherwise have had available to give workers a raise.
“America
has given the Negro people a bad check,” King said in 1963, “a check which has
come back marked ‘insufficient funds.’ But we refuse to believe that the bank
of justice is bankrupt. We refuse to believe that there are insufficient funds
in the great vaults of opportunity of this nation.”
What
would King have made of this needless overpayment of a trillion dollars a year?
A trillion dollars not available for higher wages and better teachers. A
trillion dollars we can’t use for gleaming new infrastructure and world-class
preschools. A trillion dollars that could dramatically lower the cost of
college for every young American working to build a better future.
If the
mob told us to hand over a trillion a year in protection money, we’d call the
police.
If a
conquering foreign power tried to extract a trillion a year in tribute, we’d
revolt.
But when
respected doctors in white coats and local worthies on hospital boards
essentially hold America up for the same aggregate sum, we say nothing. We do
nothing.
It’s not
as dramatic as Bull Connor
and the hoses. The martyrs to excess health-care
costs are less visible, and the links between cause and effect seem more
attenuated. But in a world of scarce resources and trade-offs, every new merger
lets hospitals hike prices helps deny poor children a fair start in life.
Our
radically inefficient health-care system isn’t a matter of accounting for the
budget. It’s a question of justice for the pulpit.
It will
take creativity to frame these issues in ways that make the tumblers click and
mobilizes voters to demand new answers. Advocates for young people, workers and
the poor will have to give up their traditional unwillingness to meddle in
other people’s sandboxes when it comes to public funds. You can’t play nice or
“stay in your lane” when the stakes are this high.
Yes, I
know, we’ll never get a thundering MLK refrain here, but even a wonky columnist
can have a dream.
“Cost-effective
at last, cost-effective at last, thank God almighty, our health-care system is
cost-effective at last!”
Fifty
years on, with King’s economic vision so far from being fulfilled, there’s no
choice. Getting serious about justice means getting serious about health-care
costs.
