Thursday, June 18, 2009

Suntan lotion and health care

Water is an efficient conveyor of sound. At a peaceful, four-star hotel pool, even more so.

Recently, in a departure from workaday toils at an education conference, I experienced at poolside how the nonworkaday world lives, and thinks.

Two suntanners, who definitely are not fans of our president, were talking health care policy. Both appeared alarmed at the prospect of change — though not frantic enough to change their bodily positions.

"They want what Canada has," said one.

"I hear Canadians come over here for procedures," said the other. "Where do we go if Canada's system comes here?"

Ducking my head under the chlorinated cool, I'd heard enough. It doesn't take long to hear it all from one side of the debate about health coverage. Basically, its members have health coverage, and that's enough.

Barack Obama is promoting a Canada-style health care system, they say. Yep. And he is converting the Washington National Cathedral into a juice bar.

Agreed, Obama covets the end result Canada has achieved — health coverage for everybody. But only a person addled with overexposure to sun, or to right-wing talk radio or Fox Spews, would compare his way to Canada's.

Obama seeks to create a hybrid in which government picks up where private enterprise poops out — 45 million Americans without health insurance.

So doing, he angers many on the left who advocate a single-payer system.

Bill Clinton's venture into this minefield had some of the same elements of intrigue and public-private intermarriage. Battered by the insurance industry, it ultimately fell under the weight of Rube Goldberg-style complexity.

Obamacare portends to be simpler, building on tried-and-true concepts like the Children's Health Insurance Program.

Those who spit nails as they deride this as socialist medicine will be seen swallowing their scruples soon enough when Medicare eases their health care dilemmas in retirement.

For Obama, the dilemma is getting enough votes, even in a Democrat-controlled Congress, to resolve that we won't continue to have increasing numbers of Americans among the uninsured.

We also can't continue to absorb the cost of caring for uninsured Americans the way we do — at the emergency room door.

That's the dirty secret of the current system. The other is the fiscal black hole we've created by putting middlemen's profits ahead of affordable preventive health care and coverage working Americans could have with a modest public subsidy, a la CHIP.

Anyone who worries about the cost of finding a new way needs to consider this: We'll spend $8,000 per person on health care this year. The French with their single-payer system? $5,000 per person.

France's system, as with Canada's, has its own problems — particularly rising costs. But both spend their money more intelligently — at the front end of the health care drama.

We use our money in the most ill-advised fashion, sandbagging it in a dance of individual and collective false economy. We wait until catastrophe forces our hands.

It's very much open to question whether Obama's hybrid approach based on preventive care can work in the face of an entrenched system based on profit.

Unfortunately, to a vast number of Americans the specter of 45 million without health insurance is of no concern. They have health plans. They can meet the deductible.

Thinking of the poolside think-tankers reminds me of the late Eddie Chiles, who owned the Texas Rangers before a certain U.S. president-to-be got a minority share.

Chiles' oil-services company had a slogan: "If you don't have an oil well, get one."

If you don't have a four-star swimming pool, get one.

If you don't have health insurance, get some.

Pass the suntan lotion.

John Young's column appears Thursday and Sunday. E-mail:

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