Bowdoin faculty members of the government, economics, sociology and history departments weighed in on the raging health care debate and largely came out on the side of a government-regulated system. Three out of four professors argued forcefully for a government-run model, though the finer points of their positions varied.
Tuesday marked the latest defeat for Democrats in the struggle to revamp the country's health care system when the Senate Finance Committee voted down two proposals to establish government-run, or public option, health insurance plans.
Liberal Democrats in both houses hope a government-run insurance program will provide uninsured Americans with more affordable coverage. The more conservative members of both parties counter that a public option will threaten private insurance companies.
The liberal Democrats in both houses who are struggling with consensus building have the sympathy of the Bowdoin faculty.
Associate Professor of History Patrick Rael expressed deep frustration with the current health care system and with conservative legislators who are opposed to reform. Assistant Professor of Government Michael Franz also criticized the Republicans involved in the health care reform debate and their dogma of deregulation.
Professor of History and Political Science Emeritus Daniel Levine agreed with Franz in his approval of the systems of Germany and France, but also likes the single-payer systems of Great Britain and Denmark.
Despite these diverse opinions, the three professors might agree with Franz's final statement: "It's about time that we look to our friends and allies for help on some policy-making."
Michael Franz
Professor of Government
Health care is not easy. Across the industrialized world, different nations struggle with keeping costs low and offering affordable, quality care. In the United States, we spend more per capita than any other industrialized country, and we leave tens of millions uninsured. I'm convinced that the reason for sky-rocketing costs is the for-profit model of health insurance. France and Germany maintain a private system of insurance where employers and employees pay premiums but insurance providers keep costs lower by operating as non-profits. The government operates as a strict referee, further controlling the overall cost of the system.
In many ways, then, the "public option" discussed in Congress is a conservative change to the model of health insurance we currently have. It maintains the for-profit model, for example. I've never understood why Republicans are worried about a public option. It would operate as a competitor to private insurers, and competition is good in a free market. Republicans also complain that a public option will drive health insurers out of business. But doesn't competition always pose a risk to businesses in a free market? In many ways, the opposition to a public option by Republicans in Congress is akin to a preemptive bailout of the health insurance industry.
In general, I'm a bit wary of the British or Canadian [single-payer models], if only because of the long waiting lines that characterize their coverage. I would argue for a privately-run, government-regulated, non-profit model of insurance. The unemployed would have their premiums covered by the government, and costs would be lower by covering everyone and eliminating much of the administrative waste in our current system (a lot of which goes into the denial of claims). Put simply, I would borrow from France, Germany and Japan. It's about time that we look to our friends and allies for help on some policy-making.
Craig McEwen
Professor of Political Economy and Sociology
The current debate over options to provide adequate and affordable health insurance coverage to most or all Americans misses a set of larger issues that shape health in the United States and around the world. Indeed, the almost exclusive focus in the debate over health care on treating illness after it appears misses the fact that inadequacies in health care can account for only about 10 percent of premature deaths and debilitating illnesses in the U.S. According to a 2007 Report from the John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health (Reaching for a Healthier Life: Facts on Socioeconomic Status and Health in the U.S.), "the emergence of disease in the first place is less a matter of medical care and more a function of environmental exposures, toxic stress, neighborhood quality, poor diet, smoking, and other conditions that are unequally distributed throughout our society."
There are steep gradients in premature death that relate to income and education in the U.S. —the lower the income and formal education, the lower the life expectancy and the greater the chance of chronic illnesses such as asthma, diabetes and heart disease. The stresses of poverty and overcrowding build into the bodies and brains of children greater vulnerability to later disease and disability. Thus, the fact that 23 percent of children under 18 were poor in 2007 has significant short and long-term health consequences. As a result, a broad look at improving health in the U.S.—and at reducing the costs we pay for health care—would recognize that virtually all policies are health policies if they affect the quality of life of individuals.
Patrick Rael
Associate Professor of History
I admit to keeping my head low during most of the debate over health care. I lack the expertise to comment on specific plans, and I lack the patience to acquire it. So I heed the larger issues.
The notion that the government should not be in the business of ensuring that all Americans have health care is strange. Markets are very good at providing some things to society, but they, and particularly the unregulated ones called for by conservatives, will never be able to solve the nation's health care crisis. They haven't in any other country, and in the face of last year's fiscal meltdown, which was caused by evading market regulation, they seem even less capable of doing so.
Government is not a market, and that is precisely its value in a market society. Government can provide what the market cannot. Government does much: educate the public, adjudicate disputes peacefully, secure the safety of the public, defend the nation from attack, and provide innumerable other critical functions—including protecting the legal environment in which markets and market society can flourish. Yet no one levels the "S" word (socialism) when these are considered. But when someone suggests a government role in providing decent health care for all, and in the process threatens the profits of a health-care industry grown fat on the current system, watch out!
How did this debate produce such an atrocious public dialogue? It's not as if President Obama advocated, say, unleashing the world's most powerful arsenal on a rogue but non-belligerent member of the community of nations (oh, and doing it unilaterally, and on the basis of falsified evidence, to boot). Nor is it as if he installed his own corporate cronies into positions of government power to undermine the very regulatory regimes they were supposed to enforce, or to politicize an array of critical government offices ranging from the Justice Department to the Central Intelligence Agency.
Instead, Obama simply asked for the nation to deliver on its promise to invest in minimum security for all, and in the process help ensure the well-being of the whole. So why the vitriol and spite—the Hitler mustaches and guns and conspiracy theories, all the simple, mind-numbing dumbness of this debate? How have the corporate lobbyists and insurance PACs so effectively manipulated the conservative and libertarian base?
Regardless of where one stands on the political spectrum, the selfishness and greed evident in the discussion is disheartening. In a society as affluent as ours, do not the "haves" have some obligation to reach out to the "have nots"? And aren't there times when all must sacrifice some short-term self-interest to achieve the long-term shared interest? It seems especially strange to me that those who most consistently invoke "values" seem least willing to contribute to the common good.
Daniel Levine
Professor of History and Political Science Emeritus
My family and I have lived in four countries where they have a national health insurance system: Great Britain, Denmark, Germany and France. The systems all work reasonably well, with some problems here and there, but reasonably well. No one lacks for health services, no one goes bankrupt because of medical expenses. The earliest of these systems started in Germany in 1883, so they are not some new experiment. T.R. Reid has recently published a book describing various systems, some public, some privately administered, some a combination, but all essentially "single payer." We are going through such contortions to avoid this tried and true solution, that we may end up with little or no progress. There is a simple solution, with premiums payed for via taxes. Let's use it!