Sheriff of Nottingham Medicine

The idea of universal health care is simple and elegant. Make sure no one is denied access to doctors, hospitals, clinics or treatment simply for lack of money.

Back before Medicare and Medicaid, medical costs for the poor were covered (inadequately) by charity and what was called “Robin Hood Medicine,” that is, doctors and hospitals overcharged wealthy patients to subsidize poor folks.

Today, Medicare, Medicaid and large private insurers use their clout in the market place to get favorable rates from hospitals, nursing homes, pharmacies and physicians. Providers contract to charge insurers less per procedure or pill than they do individual out-of-pocket payers.

Instead of soaking the rich to pay for the poor, these providers soak those who lack insurance to subsidize those who have it—what I call “Sheriff of Nottingham Medicine.” Middle-income families without employer-subsidized insurance end up paying more in medical bills because those with insurance pay less.

The correction is obvious and simple—have the government cover everyone’s bills for preventive and necessary medical expenses, spreading the cost across the entire gamut of taxpayers while eliminating their current, out-of-pocket payments. This would not only assure universal access to health care, it would provide welcome relief to American companies and workers burdened by medical insurance costs. U.S. companies would become more competitive overseas and at home, putting more people to work. Medical providers would have guaranteed payment and a single set of forms and regulations to plow through when filing for reimbursement.

What business calls a win-win solution and G. W. B. called a no-brainer.

Of course Republicans oppose public, single payer health care, or even a "public option". If implemented successfully, it could provide congressional Democrats with a political edge like  the one they enjoyed following the New Deal and the Great Society.

But why does a Democratic Congress produce "Health Care Reform" legislation that provides neither universal coverage, nor relief to business, nor reduction in the paperwork that is a major component of the high cost of medical care in the United States?

The answer is left to the student. (Hint: consider medical insurers’ and drug companies’ budgets for advertising, lobbying and campaign contributions.)