I like where Jonathan Gruber is going with this, but don’t think he’s going far enough.
Given the present need to address the economic crisis, many people say the government cannot afford a big investment in health care, that these plans are going nowhere fast. But this represents a false choice, because health care reform is good for our economy.
As the country slips into what is possibly the worst downturn since the Depression, nearly all experts agree that Washington should stimulate demand with new spending. And one of the most effective ways to spend would be to give states money to enroll more people in Medicaid and the State Children’s Health Insurance Plan. This would free up state money for rebuilding roads and bridges and other public works projects — spending that could create jobs.
Health care reform can be an engine of job growth in other ways, too. Most proposals call for investments in health information technology, including the computerization of patient medical records. During the campaign, for example, Mr. Obama proposed spending $50 billion on such technology. The hope is that computerized recordkeeping, and the improved sharing of information among doctors that it would enable, would improve the quality of patient care and perhaps also lower medical costs. More immediately, it would create jobs in the technology sector. After all, somebody would need to develop the computer systems and operate them for thousands of American health care providers.
Gruber’s thinking about this in terms of how to direct a part of a stimulus package that will likely run around $500 billion. I agree that health care should be a part of that, but when its relegated to the realm of pie-yet-to-be-divvied-up, it’s hard to envision enough being done to make both the necessary economic difference and substantively make peoples’ lives better. What I want to see is unabashed argumentation that goes along the lines of this: Companies like GM, Citigroup, and AIG exist with the presumption that they must continue to exist, regardless of how poorly they have been run. The response to the economic crisis has run over $7 trillion. There is no reason that these large, poorly managed corporations are more entitled to health and prosperity than the citizens of the United States. Don’t just ask for expanding state children’s health care programs — go whole hog. Now is the time for health care for all, paid for by the US government. Gruber lays out the economic benefits of health care spendingas a response to economic troubles. But just as the bailouts are stop-gap, single-payer health care is long-term. Businesses can’t plan on the next government bailout (well, maybe Citigroup was), but they can plan on the reduction of their costs by 15-20% permanently by not having to pay for their employees and retirees health care.
The Wall Street crowd in New York and the shock doctrine crowd in DC get the fact that now is the time to go big. It’s time for those of us who are working for all Americans to do the same.