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Health care is both simple and complex.  The simple part is that we need to ensure that everyone gets affordable health care.  Progressives and people that call themselves pro-life should agree that being poor and sick is not a capital crime.  The complex part is how to make that happen.

In years past many people were miserable or died and nothing could be done.  Today we can help these people, but the high tech treatments are costly.  It’s not acceptable that people fail to get treatment for readily curable conditions because they can’t afford it.  We cannot have people missing preventive care due to cost.  Yes, access to health care is a human right, but like all human rights there have to be limitations.  There are not enough health care workers to test for all known diseases every time someone comes in with a sniffle.  We can’t afford treatments where one person needs $1 million per month to live confined to a bed for many years.  Where those limitations should be has to be decided by political debate relying heavily on expert medical, ethical, and economic advice, and I don’t have all the answers.  But in my opinion not enough people get the care they need and care needs to be cheaper for patients.  

I used to do research for a drug company.  We spent huge sums on projects that never yielded a useful product.  Drug costs reflect lots of things: cost of manufacture, cost of drug research and clinical trials, cost of projects that failed, marketing, and return on shareholder investment.  Paraphrasing a line from the TV show “The West Wing”, the second pill costs 50 cents to make, but the first pill costs $500 million.  Drugs aren’t cheap and the cost must be paid by a combination of taxes, insurance premiums, and patients.  How to divide up the cost is another topic for debate.  But some things are totally unacceptable.  We shouldn’t pay 2-10 times more than people overseas for the same medicine.  Companies should not be allowed to prevent competition by paying generic drug makers to not make generic versions.

Part of the high cost of health care is the complex and costly maze of insurance.  European health care costs roughly half what ours does and care is just as good, largely because government controls health insurance.  Health insurance in the U.S.  is unlike other kinds of company for two reasons: 1) it is exempt from anti-trust laws and 2) it makes money by NOT providing a service, that is by delaying and denying payment of claims.  Free markets are fantastic if the customer is free to make choices and can clearly see which choice is better.  But insurance companies can divide up markets and fix prices.  And health care is hard for the average person to understand. Doctors need many years of education for good reason, and the Obamacare law was over 2000 pages long. 

Health insurance is largely a national issue, but the Iowa legislature can and should reverse the privatization of Medicaid.  Private insurance has shown that it is not better than government run insurance.  It has denied legitimate claims and it costs more to pay high executive salaries and greedy shareholders.  Health insurance should be provided as a public service rather than by employers.  That would save businesses lots of money and headaches, and it would allow workers to change jobs without losing coverage.

Putting Medicaid back together will be complicated, but I am well qualified for a task like that.  I have a Ph.D. in molecular biology from Harvard University.  I do complicated for fun.  The 48 page rulebook for a very complex military game called Russia Besieged says in part “The size and scope of the pages and pages of information contributed by Jim was incredible and extremely beneficial to making the final product an amazing piece of work.”  I’m a fighter too.  I won the world championship in this game, coming from behind in the final turn of a  9 hour game.

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