Years ago, private insurance companies — many of them nonprofits — spent about 95 cents out of every dollar reimbursing policy holders. Today, that figure is often as low as 80 cents. Why? Because Wall Street demands higher profits from publicly traded companies. If consumers get screwed, well, that's 21st-century capitalism in action.
In a very real way, the Wall Street that almost destroyed the international financial system, wiped out retirement accounts, and triggered punishing unemployment is bleeding the health-care system.
Then there is the issue of the high cost of technology and advanced pharmaceuticals. These are already rationed. Since the nation is in very real danger of going broke, the likelihood that rationing will increase is pretty much unavoidable.
It may not be spiritually rewarding to shift the terms of this debate from the plight of the uninsured to the problems of the already insured, but it is practical.
Obama is in the politics business. Politics is the art of the possible. It seems that Obama's only hope of achieving anything in terms of health-care reform is contingent upon him radically rethinking his approach. Let's hope he does so. The Vineyard should be conducive to contemplation.
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