Conservative commentator David Frum describes the American health care system: "The U.S. health care system costs too much, delivers too little and excludes too many. Americans pay 60 percent more per person for health care than any other nation. Yet Americans rank only 41st in life expectancy and live with the paralyzing fear that the loss of a job means the loss of coverage."
Frum doesn't think much of the bill that was passed, but then he is Canadian, as am I, where we have rather good health care, job mobility, universal coverage and our businesses have a nice competitive advantage. Another big benefit of the government paying the bills is that it gets really concerned about the health of its citizens. For example, where I live, the government banned junk food in schools, smoking just about anywhere, and removed taxes on bikes, all in the interest of a healthier citizenry and lower health care costs.
In the American bill, a 10% tax on tanning salons was tacked on; it sounds silly, but skin cancer experts compare it to taxes on cigarettes- it acts as a disincentive to a dangerous practice.
Certainly we have complained before that government policies have historically gone in the other direction, that The Government Makes You Fat. Michael Pollan has noted that Government policy determines what we eat and why. "The reason the least healthful calories in the supermarket are the cheapest is that those are the ones the farm bill encourages farmers to grow." When the government is paying the health care bill, it may encourage the farmers to grow leafy green vegetables.
No cost control through gun control
There are all kinds of preventative measures that can be taken to reduce health care costs; that's why the gun lobby wrote in a provision protecting "the lawful use, possession, or storage of a firearm or ammunition by an individual."- 30,000 Americans are killed each year and 80,000 wounded by gunfire, so no guns would mean lower health care costs.
So don't look to gun control for cost control, but do look for exercise and weight loss programs to help control diabetes. As Senator Al Franken says:
"To me, this is just a no-brainer, If we can intervene before these Americans develop full blown diabetes we'll save billions of dollars and not incidentally avoid the burden of diabetes for millions in our country. It's really a win-win."
Other things we like, found in a post by Peter Jacobson of the O'Neill Institute for National and Global Health Law:
Healthy Communities: there is a section of the act that creates "a grant program for state, local, and tribal health departments to implement, evaluate, and disseminate evidence-based community prevention initiatives to reduce chronic disease rates, address health disparities, and develop stronger prevention programs." Funding activies include ""creating healthier school environments..., promotion of healthy lifestyle..., and prevent[ing] chronic diseases."
Prevention Section 4001 "establishes the National Prevention, Health Promotion and Public Health Council within HHS to "provide coordination and leadership at the Federal level, and among all Federal departments and agencies, with respect to prevention, wellness and health promotion practices...." A related Advisory Group would develop a "national prevention, health promotion and public health strategy"
Swedes Put First Carbon Labels On Food
Food Labelling: "Section 4205 would apply uniform, national nutritional labeling standards to all standard menu items in a restaurant that is part of a chain with 20 or more locations offering a standard menu. Among other requirements (and subject to certain exceptions), the covered restaurants would be required to disclose the nutrient content and suggested daily caloric intake in close proximity to the menu item."
By international standards it is a lousy act, leaving the private insurance companies in control and a huge burden on business. But it will give the Government a real incentive to improve the American diet, to deal with traffic injuries, obesity, air quality, water quality and all of those causes of illness, injury and death that were previously externalities. They aren't anymore.