As the debate over a Congressional health reform bill enters what may be its final lap, Republican opposition has focused increasingly on the “dangers of a public option” – a state-managed medical care program to compete with private insurance firms.
“Here we are a few weeks before Christmas, with Democrats trying to squeeze every single one of their members to swallow a pretty bitter pill for the American people,” said Senate Republican leader, Mitch McConnell.
The reasoning behind these warnings – trumpeted daily in Washington and on conservative talk radio nationwide – is that any public program inevitably means a loss of economic vitality and personal freedom. The implications of a public option are “downright evil,” said 2008 G.O.P vice-presidential candidate Sarah Palin. “Nationalizing our health care system is a point of no return for government interference in the lives of its citizens.”
Yet surveys of the world’s leading economies, all of them staunchly free market democracies – and all offering longstanding public programs in health, transportation and education – find scant evidence to back up such claims.
On the contrary, a blizzard of data suggests that there is a direct relationship between key public services and an efficient and productive private sector.
WELCOME TO COUNTRY X
Consider the nation I’ll call “Country X.”
Each year, One-twelfth of its total GDP is directed to public health care programs and services, 20 percent more than the U.S. budget currently allocates.
Country X spends half of its per capita GDP on public support for each student pursuing a college or university education – a figure twice the level in the United States, which ranks 89th worldwide in this category. Country X also subsidizes a rail system that carries its average citizen four times as many miles annually as the average American.
By the logic of opposition to health care reform, a nation with this statistical profile ought to be a Stalinist hell, groaning under the burden of an oppressive state, a stagnant economy and severe restrictions on personal freedom.
In fact, at nearly $50,000 in purchasing power, the 2008 per capita GDP of X is among the highest on earth. In real terms, adjusted for inflation, it has doubled since 1980, and now stands at $7,000 more than the GDP of the United States. Last year, it grew at a rate almost five times that of America’s recession-bound 0.2 percent,
Country X is Norway, the envy of the affluent West, where efficiently managed programs in the public interest are regarded as a government’s duty. The results speak for themselves.
In 2007, according to research by the Ottawa-based Center for the Study of Living Standards (CSLS), Norway ranked number one among 14 of the world’s wealthiest nations in overall economic well-being. The United States ranked 13th, barely edging out last-place Spain.
Americans did finish number one in consumption – but dead last in economic security and equality. By considerable margins, the study found, the United States also ranked last in life expectancy at birth and first in the percentage of its citizens under the poverty level.
LET FREEDOM RING
It would be one thing if Norway were an anomaly, a prosperous exception explained by its North Sea oil reserves and small population. But the well-being gap that distinguishes Norwegians from Americans is as blatant in other free-world nations, big and small alike, as it is in Country X.
“What we cannot, and must not do, is the ‘public option,’ which is really the government option,” Senator John McCain, the 2008 Republican presidential candidate, declared at a rally in Arizona. “Look at it in Canada, look at it in England…”
This is what you actually see if you look at Canada, England and other favorite settings in Republican parables about the dangers of a public option:
Like Norway, Denmark, Belgium, the Netherlands, Sweden, France, Germany, Finland, Canada, the United Kingdom, Australia and Italy outshine America in the CSLS study – and each of them, regardless of size or natural resources, offers comprehensive public health care options.
They all finish above the United States in World Health Organization rankings, as well as in statistical measures of economic well-being.
Public options are not about an abstract conflict between critical liberties – personal or economic – and the ghost of Josef Stalin. The 14 countries examined in the CSLS study are, without exception, defenders of freedom of the press, of intellectual and religious belief, of political choice and assembly.
What public options are about, rather, is something very material: the infrastructure a society depends upon to prepare its children for productive and fulfilling careers, to remain healthy at home and on the job, and to reach its work or leisure destinations quickly and safely. They are about a social contract, observed by our closest international allies, requiring that government do everything possible to optimize the possibilities of liberty.
They are about the basic rights of citizens, not heavy-handed interference in their lives.
WORLD LEADERS
Neither liberty nor well-being come without cost. The same dozen nations that outdistanced the United States in economic performance paid, on the average, 43 percent of their GDP in taxes, 13 percent more than the United States.
But the evidence suggests that extra money in American pockets buys little more than extra consumption – mostly of foreign-manufactured goods – while endangering the national health and welfare, and neglecting the infrastructure that is crucial to a vibrant economy.
With 80 million people, Germany is the West’s second largest nation, and boasts no oil or gas resources to distort GDP statistics. Its economic success is beyond question. The U.S. trade deficit in 2007 was a stupefying $731 billion. Germany, by stark contrast, is the world’s number one exporter, with a trade surplus of $252 billion.
The average German pays just 8 percent more per year than Americans in overall taxes – a few thousand dollars, which is less than the deductible on a typical U.S. family’s medical insurance. Those taxes buy one of the world’s best health care systems, high-speed public transit and generously subsidized schooling.
Germans spend 2.5 percent of their GDP on privately-funded health care, in the same under-four-percent range as virtually all other western democracies. Americans spend around 9 percent, making them the world leaders in private health costs. Among other nations at the top of that category – our peers in the delivery of decent medical care to those who can afford it, with minimal provisions for the rest – are Lebanon, Argentina, South Africa, Uganda, Paraguay, Jordan, Cambodia, Gambia and Haiti.
Republicans, it would appear, are delighted with that picture, and adamantly against any Congressional action that might alter it.
“As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress,” says Palin, “our collective jaw is dropping, and we’re saying not just no, but hell no!!”
It is worth noting, however, that the current economic crisis has led residents of many Republican-governed states to say “hell yes!” to existing public options. No fewer than 15 of the 18 hungriest clients of the Supplemental Nutrition Assistance Program (SNAP), better known as “the food stamps program,” are states that voted for John McCain in the presidential election.
The nation’s single most avid food stamp client is Alaska, home state of former governor Sarah Palin.
Frank Viviano – barganews staff reporter – World View CBS5