[T]here is no universal definition of health care. Everyone is shouting for universal health care but I haven’t heard anyone define what that means.…That is a harsh reality that any politician trying to institute a national health care system will have to face. How do you devise a plan that satisfies enough Americans to be politically viable, yet which is small enough to remain manageable?
I do believe that it is objectively possible but politically perilous to define what is basic health care.… I also know that if basic health care is accurately defined based on scientific evidence, there will be great wailing and gnashing of teeth as people find out their favorite medical option is not included in a taxpayer funded medical plan.
In the United Kingdom, a national health care system was established early, as health care technology and cost first began to increase. The national health care provider network and the government system that paid for it grew together organically, and that is reflected in the way its citizens look at health care.
In the U.S., we look at health care a bit differently. There has never been a baseline standard, but rather a spectrum: at one end, no insurance, followed by sickness and accident plans, high deductible plans, and various PPOs and HMOs. At the far end of the spectrum lie comprehensive plans, some of which pay 100% of the cost of services.
If I put on my idealist's hat, I might say that a panel of experienced physicians and former hospital administrators with absolutely no conflicts of interest -- including no membership in professional organizations that have the ear of Congress -- would sit in a room, isolated from public opinion, and devise a baseline plan. Even a person wholly innocent of cynicism can see that this is not possible, in part because in a physician, "experienced" and "no membership in professional organizations" are mutually exclusive conditions.
We will not be able to ensure affordable yet universal access to minimum health care until we begin an honest national conversation on what it should cover. And with the number and power of lobbying groups that exist in the health care industry, I wonder whether such a conversation is even possible.
Toward establishing a baseline for universal health care