Dukakis talks health care

In the first of eight colloquia to be sponsored by the Connell School of Nursing, Michael Dukakis spoke at Boston College on Monday on the necessity of universal health care coverage in America.

Dukakis, a native of Brookline and graduate of Harvard Law, boasts an impressive political résumé: He has served four terms as a Massachusetts state legislator, served as Massachusetts governor in 1974, 1982, and 1986, won the Democratic nomination for the presidency in 1988 but lost to George Bush, and since 1991 has taught as a political science professor at both Northeastern and UCLA.

In his current position as a researcher for national health-care reform, Dukakis has taken on some pressing questions.

The first emotion he expressed on the subject was outrage and wonder at the United States' lack of universal health care. "For this nation to be the only advanced, industrialized nation not to guarantee health coverage to every resident is outrageous. The countries we like to compare ourselves to and compete with do so on average at half the cost per capita as we do, with better health outcomes, as best measured by life expectancy and infant mortality," Dukakis said.

In a similar vein, Dukakis noted that countries on the same economic tier as the United States are able to provide substantially broader health care packages for a significantly smaller price.

Dukakis maintained that the situation has not gone unaddressed. Throughout American history, many a prominent politician has attempted to win universal health care coverage for the United States.

In 1912, Teddy Roosevelt became the first presidential candidate to propose universal health insurance, but he was unsuccessful.

Harry S. Truman, who served as president from 1945 to 1953, proposed to introduce universal health insurance every single year of his presidency. Debates and failures followed, with opponents of the program crying socialism at every turn. It wasn't until 1951 when Lyndon B. Johnson proposed coverage only for those ages 60 and over that a fledgling Medicare program was created. And even this proposal didn't succeed until 1964, when Medicare, as it is now known, was finally made available for people 65 and over.

In doing so, however, LBJ had to make two very important compromises: "He agreed not to fix the rates of health care, and agreed to allow insurance companies a position as fiscal intermediaries. And the bill passed," Dukakis said.

However, there still remain "47 million uninsured Americans," Dukakis said.

"What is it about the American political system that makes it impossible for us to provide reasonably comprehensive coverage for everyone, even though we're spending half of what everyone else is spending?" Dukakis said.

Dukakis believes the answer to this question lies in prices.

"In Japan, a blood test costs $12. Here, a blood test is $85. The cost of living isn't different. The difference in all these countries when it comes to cost is that none of them indulge themselves by saying the market works in health care. It never has and it never will … who the hell wants competition among hospitals?" Dukakis said.

Dukakis pinned the concept of a market where people can "shop around" for health care as ridiculous.

"Shopping around is preposterous. Absolute nonsense. Speaking as just one consumer of health care service, what I want is a primary physician in who I can give great confidence and trust. Shopping around, creating a market, is absolute foolishness," Dukakis said.

Dukakis also stressed the need to regulate prices: "You have to treat health care as a public utility. You have to regulate prices. No one likes to, no one wants to, but you have to," he said.

The only feasible path toward achieving universal coverage, then, is through either the Truman or Nixon system.

This, said Dukakis, will take two things: (1), a president absolutely committed to universal coverage and (2), a congress that's ready to step up and make tough decisions.

The last factor stressed in the seminar was the importance of building coalitions. "It doesn't matter what political party they're from, you have to bring people to the table," Dukakis said.

In conclusion of his speech, Dukakis addressed the issue of presidential elections, sure that the argument against universal coverage will be more cries of socialism.

Dukakis argues, "If universal health care is socialist, what is Medicare? Is that socialist? Should we just repeal Medicare?"