The United States is the only one of all industrialized nations that does not have some kind of system providing health care to all of its citizens. How can we ignore upwards of 45 million people and growing who do not have access to affordable health care. There are many things on our collective plate that need attention and if ignored will result in grave consequences. We have been discussing this dilemma for many years. Other issues of war and the economy have cast a shadow over the political campaign and now over tackling the challenges ahead. There are few things more fundamental than health, food, shelter and education. We can no longer set aside these issues and ignore their importance or urgency.
Different nations have found a variety of ways to provide universal healthcare to their citizens. Nonetheless they all ended up with similar results. If we are to rebuild America it cannot be done without providing for the health security of our citizens. All health care systems are imperfect but all came from the necessity of circumstances. The health care needs of wartime Great Britain drove them to the obvious and desirable solution of the National Health Service. Although one of the most socialized in the world, health care in United Kingdom has enjoyed a large measure of success and satisfaction over the last 50 years while continuing to thrive. France evolved a similar system starting from a different basic healthcare structure. The end result was access to quality health care of for the entire population in a system which considered by some to be the best in the world. Although the United States may be a leader in medical innovations, we rank 37th in overall services among other countries.
In a recent article in the New Yorker magazine by a practicing physician Dr Atul Gawande, he described the successes of universal health coverage in Massachusetts since its adoption in 2007. The majority of people who had satisfactory coverage in place remain largely unaffected while a sliding scale fee program was established making health care coverage available to all who are uninsured. Choices still have to be made regarding cost containment and most necessary services. However any system has to have oversight and requires difficult decisions be made to continue providing quality and needed services. Overall the Massachusetts plan has been a satisfactory if not entirely perfect success insuring over 97% of its citizens with a very high rate of satisfaction.
We can learn from all of these examples that a change in our health care policy is not only needed but inevitable. History has taught us that issues such as this are path dependent. The most recent Nobel Prize in Economics was given to Paul Krugman for demonstrating how this very phenomenon drives trade patterns and geographic location. It all harkens back to the idea that necessity is the mother of invention. Circumstances and initial steps in our history literally drive the subsequent direction of the outcome. Even if you are ignorant of history you cannot escape its viral influence. The path during this journey has become narrow. We too have reached a point in our history where change must come. The choices are more diminished but are not without merit. They must be bold. But like others before us, we can build on what we have now that works. We can repair what does not work and add choices where there are none. The cost will be an investment that will reap dividends for all of us who share this third rock from the sun.