The Middle Way
One of Buddhism’s central tenets is the doctrine of the Middle Way. Most of us would agree that avoiding extreme positions, emotions, and actions seems eminently sensible, at least most of the time.
In the U.S. national debate over health care reform, we are led to believe that the status quo and a single-payer plan represent the two extremes. The current situation leaves millions of Americans uninsured, and the number keeps rising as economic conditions worsen (or do not improve quickly enough) and as health care costs, particularly those borne by already stressed employers, keep rising. The single-payer plan transfers all costs to the government or a quasi-governmental entity created for the purpose of ensuring universal access. It guarantees coverage for all, but does not necessarily mean the elimination of private plans or mandates to limit costs.
Most of the developed world already has some form of single-payer plan. In those countries, no one goes without some form of basic coverage, which almost always includes an emphasis on preventive care. Health outcomes in single-payer countries are generally better, even much better, than in the U.S. Although costs of care per capita are lower, often much lower, private health insurance plans still flourish as a way of gaining preferential access to elective or off-plan procedures. Even the best private health plan in these countries costs about the same for a year of coverage as most employers here pay for a single month.
Opponents to single-payer health plans would have us believe that such proposals are the slippery slope to Socialism. In light of the evidence that single-payer plans not only provide better access and improved health outcomes while allowing private markets to operate successfully, why do Americans find it so hard to see them as the Middle Way to economical, ethical, and equitable health care for all Americans?