The Terminator just announced sweeping new plans to offer health insurance to every single Californian, legal and illegal. "Everyone in California must have health insurance," Gov. Arnold Schwarzenegger announced this week, in a tone that, according to the New York Times reporter, "seemed as much a threat as a promise."
Schwarzenegger thus joins former Massachusetts Gov. Mitt Romney as the second Republican governor to make expanding healthcare coverage his signature reform initiative. Karen Davis, president of the nonprofit Commonwealth Fund, praised ArnoldCare to The New York Times as "a very significant proposal. I think this shows health care is going to be a major issue in the 2008 presidential campaign," she said.
I think so, too.
In the 1990s, Republicans helped defeat HillaryCare, a bureaucratic national health insurance scheme (and for reasons I'll share another time, I'm glad they did). They touted at the time something called "managed care" as the private solution to the crisis of rapidly rising healthcare costs. What this means in practice to ordinary people like me is that instead of a government bureaucratic system rationing care in inexplicable and irritating ways, the private healthcare system is doing it for us.
Republicans who applaud themselves for trashing '90s-style HillaryCare need to think hard about what's ahead -- for the good of the country, and also in case they want a prayer of winning an election next time around. I offer here a primer on just what I hate about health care, in case it's useful.
Mind you, I'm aware that the problems of Yale-educated, nationally syndicated columnists making a (low) six-figure income are not what the country is worried about. I offer them anyway on the grounds that if Yale grads making six figures are this disenchanted, what must the rest of you be feeling?
After about a decade of ignoring my health issues (diabetes), last July I finally found a good doctor I could work with. My A1C level (the primary measure of long-term blood sugar control) dropped from more than 10 percent (catastrophic) to less than 6.5 percent (close to normal). I know it's not just me, because my doctor had recently calculated his office-wide A1C average for diabetics: It, too, was under 6.5 percent.
Three days ago, I received a letter from my insurance company. My doctor had been removed from the provider network. Clearly it's not because of his medical skill at treating diabetics. I suspect it is because he orders too many prescriptions for the latest expensive diabetes drugs, which (under a New York diabetes mandate) the insurance company is required to cover. The terrible thing about national health insurance is the government gets forced into healthcare rationing. The terrible thing about "managed care" is that private insurance companies do exactly the same thing.
Meanwhile, this fall a dear friend and (uninsured) former baby-sitter of mine was diagnosed with bladder cancer. I offered to pay for the surgeon. She launched on an intensive search to find the resources to pay for the hospital expenses. The doctor who diagnosed her told her there was something called "emergency Medicaid" for which she qualified. The Medicaid bureaucrats told her there was no such thing. Finally one of them confessed that emergency Medicaid does exist, but you have to be an illegal alien to qualify.
Here's the warning for "limited government" folks: Over the long haul (and I think we are close to being hauled), public support for government health care is going to grow on the grounds that the tortured system you don't know can't be worse and might be better than the torturer you do. If we want a better alternative, someone is going to have to do some hard thinking, fast.