A RECENT DISCUSSION OF INCREMENTALISM
Part Two - Comments from Ida Hellander, M.D.
Executive Director of Physicians for a National Health Program
These comments were made following the initial interchange
between Don and Ron Back to Original interchange
If you define the problem as the uninsured (and decide that you can't confront the power of the insurance and drug lobbies), you end up with a solution like that proposed by the HIAA and Families USA. Buy more insurance, especially from companies represented by the Health Insurance Association of America.
This solution won't work, however. Ron Pollack's quote about the status quo being everyone's second choice comes from a lecture by Princeton economist Uwe Reinhardt to the US Chamber of Commerce. Reinhardt's lecture focused on the failure of incrementalism -- and specifically tax policy changes -- to ever achieve universal coverage, and concluded with the statement along the lines of "even Mother Theresa couldn't make incrementalism work."
We at Physicians for a National Health Program (and most Americans) define the problem as a greater health care crisis caused by market-based medicine and for-profit health care. 80% of Americans say the US health system is driven by "greed". They are right. The uninsured are a tragic symptom, along with rising costs and rapidly deteriorating quality, of a greater problem. The solution is not simply "universal coverage" but not-for-profit national health insurance with a ban on Wall Street/investor-owned providers (e.g. for-profit HMOs, hospitals, managed mental health firms, etc.).
There is a myth that single payer national health care activists are
asking for "too much" in a "single leap". This is nonsense. The US
health system has evolved in several stages, and the passage of Medicare
and Medicaid in 1965 could be said to be the largest necessary leap.
Government spending is already a majority of all health spending, and
new bills pass every year for coverage for one serious disease or
another (e.g. AIDS, breast cancer, etc.). The next leap -- eliminating
insurance firms from the coverage of the relatively healthy, wealthy,
and young -- is simply one of the last leaps to resolving the health
Back to original interchange