http://www.youtube.com/watch?v=3OgcKGWwWlEThat video was posted here a few days ago, and I was more impressed by Biden after watching it than I already was.
Incrementalism in health coverage. I think he's right.
Here's the voice of Canadian experience.
Canada did not acquire a universal single public payer health insurance system overnight.
http://www.healthcoalition.ca/History.pdfA Brief History of Canada's Health Care System
1947 -- The Saskatchewan Government, led by leader Tommy Douglas, introduces the first provincial hospital insurance program In Canada.
1957 -- Paul Martin Sr. introduces a national hospital insurance program. Doctors, insurance companies and big business fight against it.
1960 -- The Canadian Medical Association opposes all publicly funded health care.
1962 -- Saskatchewan's NDP government introduces the first public health care program. Doctors walk out but the strike collapses after 3 weeks.
1965 -- A Royal Commission headed by Emmett Hall calls for a universal and comprehensive national health insurance program.
1966 -- Parliament creates a national Medicare program with Ottawa paying 50% of provincial health costs.
1977 -- Trudeau Liberals retreat from 50:50 cost-sharing and replace it with block funding.
1978 -- Doctors begin "extra-billing" to raise their incomes
1979 -- Canadian Labour Congress convenes the SOS Medicare conference to fight extra-billing and joins with community groups to form the Canadian Health Coalition.
1984 -- Canada Health Act is passed unanimously by parliament. Extra-billing is banned.
(And of course we continue on with ups and downs.)
Started, both provincially and nationally, with hospital coverage -- kinda like "catastrophic" coverage.
Started locally in one province, spread to others, was adopted nationally.
Was bitterly opposed by special interests, had to endure and win out over tough tactics and keep refining the system when attempts were made to undermine it.
The process Biden describes in that video is virtually a mirror image of the process that Canada went through to get our current system.
To me, as an outsider, it looks simply unrealistic to think that the US could go from its present system to the ideal system during one presidential term.
The present US system is obviously much more deeply entrenched than what Canada was dealing with in the early days, since insurance companies never had a chance to get hold of the health care market as has been done in the US, for instance. There are other barriers in the US today that are greater than what Canada was dealing with, in terms of public attitudes -- we just didn't and don't have quite as many voices clamouring against being taxed for someone else's benefit or losing their holy freedom of choice.
Moving toward universal coverage and public funding step-by-step is likely going to be your best bet. One understands how galling it must be to look at all the similar countries that have them now and think
why the hell not us? But obviously there are reasons why you don't have it now, and those reasons are still operating. They won't disappear the moment someone says
let's do it!I'm a huge fan of Biden's, and have been since I was glued to the tube during the Clarence Thomas hearings on cable here. He is one damned smart cookie. And he appears to be profoundly decent.
I don't think he doesn't want people in the US to have good, affordable health care. I think he knows what it will take to get it.
So speaking as a foreigner who would be absolutely delighted beyond measure to see Joe Biden as your next president, I urge y'all to look at his incremental health coverage plan not as cowardly or uncaring, but as a realistic plan for getting where you want to be.