Feeling Better

Richard Quinn

“I SORELY MISS the peace of mind that comes with universal health coverage.”

Those are the words of a 32-year-old woman from Canada, who is currently a PhD student residing in the U.S. When I read them recently in the comment section of a blog, they changed my thinking about health care.

I’ve been involved in health benefits, health insurance and health plans of various types since 1962. I’ve designed employer plans. I was on the boards of four health maintenance organizations. I negotiated physician contracts and health benefits with five unions.

I lobbied Congress for changes during Hillary Clinton’s attempt at health care reform, and keenly observed the Obama-era changes. I was shocked by some of the unrealistic promises made—and the spurious claims opposing—the Affordable Care Act.

Wherever we travel, I embarrass my wife by asking people about their health care. I’ve asked people aboard the ocean liner QE2, on a tour bus in Costa Rica, pretty much anywhere—it doesn’t matter.

I’m aware of the issues and claims regarding cost, rationing, waiting times, freedom of choice and all the rest. I know that no system is perfect. Every system struggles with costs, and some systems can’t deliver care in the timely manner we might expect.

But I also know from my interviews that many people in other countries are satisfied with their health systems. Why? From their perspective, the low or minimal costs they’re charged when they receive care provide them with “peace of mind.”

My retired friend in the U.K. now pays no premiums or copays for his care. He’s convinced his health care is free. That isn’t accurate. Still, he enjoys peace of mind about his health care costs.

In the U.S., 34% of the population is currently covered by a government-run system. Yet, if I mention universal coverage—even Medicare—there’s instant controversy. It makes you wonder, what do Americans want?

There will never be a perfect system—one that has no out-of-pocket costs, unlimited and immediate access to care, and no taxes paid to support it. But there’s also no logical reason the U.S. can’t have some form of universal coverage with a public-private partnership. Nudged by the Canadian PhD student’s comment, I think it’s time we provided peace of mind to every citizen.

Sometimes, when I discuss the idea of universal coverage with people who are adamantly opposed to changes, I’ve taken to saying, “Give me your ideas for something better.” I’m still waiting.

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