Public Investments in Health

Today’s post is based on a Robert Reich video about Public Investments being the biggest deficit you’ve never heard of. While he describes the need to invest in infrastructure and basic research, this short post extends that to healthcare.

https://youtu.be/wYU1aP2FmOM

I am huge a fan of former Labor Secretary Robert Reich. I support his call for strategic public investments in infrastructure. I also support investments in public health and a skilled and productive workforce. That workforce needs to be paid well enough to create market demand for the goods and services they create. As Reich claims, the economy grows from the bottom up, not from the top down. The American people have been hoodwinked by the debunked trickle-down theory of economics.

Trillions can be Saved with Focus on Public Health

The U.S. could save some $2 trillion per year by focusing on public health and expanding healthcare to everyone. It could also improve longevity and health outcomes. What makes that possible is the fact that we now spend twice as much as other rich nations, yet we live sicker and die younger. And these other nations offer universal healthcare as a right. And they generally rank higher in measures of population health.

We already spend over $4 trillion/year (~20% of GDP) on healthcare. That’s up from $3.65 trillion in 2018 ($11,212 per capita). Half of that amount is $2 trillion, which will only increase if we don’t slow the rate of spending.

At current pace, our yearly healthcare spending could reach $13 trillion by 2030. That’s a huge problem that could bankrupt the nation if not addressed. Likely, some people will question these estimates, but don’t take them as gospel. My point is trillions of dollars in savings is possible with health reforms, even if we only match the average of other advanced nations spend. But why not set a goal to do even better and match the spending and outcomes of Singapore, the current world leader? I’m convinced we could do that if not for resistance from a medical-industrial complex that spends three times as much on political influence as the military-industrial complex.

Health Care versus Sick Care

America’s broken healthcare system has been compared to a sick care system, where the financial incentive is diagnose and treat and patients are seen as paying customers. But, fixing it and improving costs and care can all come from getting the incentives right.

Unfortunately, greed has driven corporate behavior in America to the point where it’s sociopathic. The profit motive has been spreading like a disease at epidemic proportions. But there’s still hope with a change of focus, new priorities, and wellness incentives.

As Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.“

Trillions More can be Saved from Increased Productivity

$2 trillion/year is just the savings from reduced healthcare spending and increased health span that reduces end-of-life care costs. No one seems to be talking about the downstream benefits of a healthier and more productive workforce, or increased corporate profits and GDP. So I will.

A single-payer system like Medicare-for-All would not just reduce costs and administrative overhead. It would likely also lead to higher wages as workers no longer would depend on employer group insurance. They could more easily seek better jobs elsewhere or start their own businesses.

The downstream benefits don’t stop there. Once our nation moves to a tax-funded universal healthcare system and sees trillion dollar savings and productivity gains from a healthier workforce, I’d expect to next see other policy changes aimed at further reducing costs and increasing productivity. That might include greater investment in public education, including college and medical school; basic research; infrastructure, including broadband for telehealth, distance learning, and telework; environmental protection; and programs to reduce poverty. That’s exactly what President Biden is proposing in his American Infrastructure and Jobs Plan, even without first seeing benefits from health reform.

Once politicians gain confidence in their ability to stand up to political pressures from medical industry lobbyists, I believe they will be more willing to stand up to oil and banking industries and the NRA, gradually moving us toward representative government that works better for all of us, rather than just catering to wealthy special interests. But it seems Republican non-legislating legislators are hell bent on preventing any such positive changes from the Biden administration. It would make reelection so much more difficult.

Extreme Inequality and its Effect on Policy

As I’ve written here before, one problem with extreme inequality is that it lies beneath almost every issue our society faces today, including healthcare, immigration, infrastructure, the environment, women’s rights, social justice, foreign relations, and more. To gain political influence, wealthy special interests have invested for decades and poured millions into conservative think tanks (Kato Institute, American Enterprise Institute, Heritage Foundation, Federalist Society, American Legislative Exchange Council) and media (AM talk radio, Fox News, One America News, NewsMax).

The uber-wealthy, often described as American oligarchs, have successfully divided our nation along partisan lines. One of the best examples of that is the documentary, “The Brainwashing of My Dad.” The film helps explain why voters can convinced into supporting radical policies and vote against their own best interest. Its storyline chronicles grandpa’s severe change of personality when he got hooked on conservative talk radio and Fox News. Surprising, was how quickly grandpa returned to his friendly, fun-loving, and accepting self after his radio broke and grandma programmed their new TV without Fox on the favorites list. Grandpa then started watching NPR, PBS, BBC News, and National Geographic instead.

Another example of the partisan divide is how Conservatives and Progressives seem to have the same complaint — “I work hard, so why should some lazy asshole get all my money?” They just disagree on who the asshole is: the family on food stamps trying to get by, or the dude paying cash for a third mega yacht.

And finally, AMERICA BROKEN is my critique of our Capitalism, Healthcare, and Politics. The article concludes, “There’s no such thing as Free Market Capitalism without rules governing Property, Monopoly, Contracts, and Bankruptcy.” But who makes the rules? And who enforces them?

Capitalism today has been distorted by wide disparities of wealth, influence and opportunity. Our laws and political systems have become rigged against all but the wealthiest among us who can buy influence. They seem to oppose any strategic public investments in our nation’s health and infrastructure if it means paying higher taxes.