Forget kindness, helping our fellow man and personal stories of tragedy from people who can’t afford to get well. It’s a valid discussion, but it takes the healthcare focus off logical issues and tries to tap into emotions.

Here’s the big thing no one admits in the healthcare debate: The U.S. healthcare system is screwed up. It was screwed up before Obamacare, during Obamacare, and it will be screwed up under current Republican proposals. It’s a matter of degree.

Drug prices increase 500% at the whim of a CEO’s balance sheet; insurance companies increase co-pays for a drug overnight; and the insane prices negotiated between insurers and hospitals for a specific procedure not only vary by thousands of dollars, they’re still like 50% cheaper than the cost uninsured patients pay. If an insurance company sends Hospital X $210 as “payment in full” for a one-night hospital stay, why is a non-insured patient charged $550 for that same night? In what world does this make sense?

Second point: Every healthcare system in the world has some sort of problem, including countries that offer universal coverage. It’s like looking into the ocean and asking which fish is least ugly. Suggest any other nation’s healthcare system as a model for the U.S., and critics won’t have to look far to create their “world is coming to an end” sound bite. And everyone dies. No healthcare system can change that.

We must pick the least ugly fish.

Skip compassion – go with logic

Only some kind of universal healthcare makes sense to A) minimize administration fees, and B) do the most people the most good. Forget arguments about compassion and taking care of neighbors we don’t know. From a bottom-line, spend-money-to-make-money vantage point, it’s better than the private system the U.S. has now, and it’s better than Obamacare’s mysterious prepaid-from-next-year’s taxes magic.

Not everyone is good; not everyone wants to spend money on strangers; not everyone cares more about emotions more than profits. You can’t prove God exists to an atheist by quoting the Bible, and you can’t convince someone to pay for other people’s healthcare with a PowerPoint presentation.

Would the federal government screw up universal healthcare? Of course. Will a few doctors pocket ill-gotten gains the way some do now with Medicare? You betcha.

The key advantage to a government-backed program, however, is that the American people have the power to prosecute and the ability to look behind the curtain. In a private healthcare system, the decision to increase the cost of a drug by 1,500% is done behind closed doors, and even bad press won’t slow that down. People who need to take a drug usually need to take a drug.

Arguments for universal healthcare

• It empowers type-A movers and shakers. A top-notch speechwriter may work at Company A to get health insurance benefits. With universal coverage, she could freelance for six companies. She’ll earn more money overall, and six companies, rather than just one, will give great speeches.
• It would require higher taxes – but isn’t that semantics? If Bob pays $600 per month for healthcare now and his insurance rate with universal coverage is $400 per month, Bob gets better coverage and saves $200 overall. Is that a tax increase or an insurance premium? In fact, don’t call it taxes. People who have national flood insurance pay a yearly premium for flood – and only flood – coverage. Older adults with Medicare do the same thing. If universal healthcare is $400 per month paid directly, Bob will see it as a health insurance bargain compared to the $600 he paid last year. But if that same $400 is a “tax,” he’ll see it as part of the giant federal slush fund.
• Government-run healthcare, for better or worse, can be – should be – cheaper if they do it right.
• Corporations with top-notch health plans to retain the best workers many times use part-time workers today – and a lot of them – because they don’t have to pay for their healthcare. These companies are legally gaming the system, and it’s making the poor poorer and the rich richer. Universal care should translate into better jobs.
• Thanks to a few years of Obamacare, Americans now expect a plan that covers pre-existing conditions, but that’s impossible to achieve unless a lot of non-sick people are also covered. Not just difficult – impossible. Imagine getting car insurance after an accident, and your new $1,500 yearly premium immediately covers the $150,000 damage and hospital bills. Why would anyone pay for car insurance every year when they can get coverage on the fly if they “just didn’t see that red light”?

So far, universal healthcare looks like the prettiest ugly fish in the pond.

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