Democrats often take it as an article of faith that universal health care would be a good thing. We see it as an issue of moral justice.
Freedom from want and freedom from fear are fundamental Democratic values, and making sure that every American has the right to adequate medical care has been a Democratic goal ever since Franklin Roosevelt proposed a
Second Bill of Rights in 1944.
We don't need to be convinced, but we're only half of the country. The other half of the country are Republicans, and many of them do need to be convinced.
Many smart people
have written before about the success of single payor health care across the rest of the civilized world. But "it works in France" is not an argument that wins over wavering Republicans.
A few weeks ago, the Pew Research Center released a fascinating report on American voting trends. They divided the voting public into nine segments, including three Democratic and three Republican groups. Not surprisingly, the Democratic coalition strongly backs universal health care: liberals by 90-8, conservative Democrats by 73-23, and the disadvantaged poor by 65-29.
More surprising, though, is the general support in the GOP coalition. Social conservatives support universal health care 59-37, and pro-government conservatives support it 66-33. Americans overall favor a government-guaranteed right to health care by an overwhelming margin of 65-30.
One faction in the GOP tent is steadfastly opposed to universal health care, though, by a 23-76 margin. Pew calls them the "enterprisers":
The staunchly conservative Enterprisers have perhaps the most consistent ideological profile of any group in the typology. They are highly patriotic and strongly pro-business, oppose social welfare and overwhelmingly support an assertive foreign policy. This group is largely white, well-educated, affluent and male; more than three-quarters are men.
The enterprisers are the folks who run the Republican Party. If I wanted to be rude, I would call them believers in supply-side Jesus. They represent roughly one-third of the Republican base. They agree with Calvin Coolidge that the business of the American people is business. I don't want to argue with that contention right now; I want to argue that universal health care is good for business and good for economic growth.
Good companies should not be punished for playing by the rules.
General Motors recently posted a $1.1 billion loss, because of spiraling health care costs. $1500 of every car they sell goes to pay for health care for current and past employees. General Motors has been doing the right thing for fifty years. They've been honoring the social contract, they have been looking after employees in their retirement. And because they are playing by the rules, they are at a competitive disadvantage with those companies that don't.
Japanese manufacturers don't pay that $1500, because Japan provides universal health care to all of its citizens. German auto-makers don't pay that $1500, because Germany provides universal health care to all of its citizens. They are free to concentrate more of their energy and effort into designing and building cars, instead of spending time and money dealing with an out-of-control health care system.
American companies should have a level playing field, and they shoud have the same freedom of action as their international competitors.
The converse is that bad companies that don't play by the rules should not be rewarded for doing so. Jay Bullock recently wrote about how Wal-Mart's miserly, Ebenezer-esque benefits package costs Wisconsin's BadgerCare program almost three million dollars a year. Wal-Mart employees are the largest group of Wisconsinites enrolled in BadgerCare. Wisconsin's taxpayers, including those who own businesses that compete with Wal-Mart, are subsidizing their competitor because Wal-Mart isn't doing the right thing.
It shouldn't be this way. It is an accident of history that health care became the burden of responsible employers. The Roosevelt Administration imposed wage and price controls during the war, and businesses wanting to attract the best employees, and wanting to differentiate themselves from competitors, began offering generous benefits packages and health care provisions as way around wage controls. In 1943, the IRS ruled that health benefits would be tax free, and so the practice slowly became the tradition.
This system worked in the old days of the old economy, but it's not the best-suited system for today. Too many people are trapped in their current jobs because they need to maintian the health coverage for themselves and their families. The current system reduces the elasticity of labor capital, which is a Republican way of saying that people are often forced to choose between advancing their career or affording their children's doctor visits.
The new economy is, as the Thomas Freidmans of the world never tire of telling us, based on knowledge and movement. We switch jobs a lot, we change careers, the job-for-life of the 1950s is a thing of the past. The modern economy has many upsides. Productivity is higher than ever, corporate profits are higher than ever, and more people than ever are climbing into the ranks of the upper middle class.
But the new economy also has downsides. Risk that was once widely-distributed ("what's good for General Motors is good for America") is now borne far more directly by the individual himself. The career gamble sometimes doesn't pay off. The new start-up company goes under. The factory is forced to close because of cheap labor from the Third World.
Some Republicans try to convince us that "old-economy" programs like Social Security are not suited for the "new economy". They get it exactly backwards, of course. In an economy with less security and greater risk, it becomes all the more important to provide a guaranteed minimum, to protect against the pitfalls of the new economy. That way, everyone can more easily participate in, and have the opportunity to succeed in that economy.
Why should the same not be true of universal health care? By removing an accidental burden that puts American companies at a disadvantage in the global marketplace, we can at the same time free the indomitable spirit of the American worker to participate fully in the new global economy.
Government cannot solve all of our problems, and it's not the silver bullet. But the greatness of America is not defined only by our individualism. There is more to the American story than that. We are all connected to each other, we are all Americans. And surely all of us -- Democrats, Republicans, and those in the middle -- can come together to demand, as Franklin Roosevelt demanded, that every American have "the right to adequate medical care and the opportunity to achieve and enjoy good health".