…is that in America you can´t sell health care reform by telling the truth. The truth would be something like this.

“We live in a country that has 50 million people without insurance. This is unfair and immoral. The right thing to do is for all of those who have insurance to get slightly worse medical care, so everyone can be insured. And that is what people do in other countries. And that is what we should do here.”

But solidarity does not sell well in a country where the 80% of people who have insurance don´t really care about the 20% who don´t. To use a public transport analysis what is going on here is that as 20% more passengers board the train some people may have to ride standing up. But the passengers in the train don´t want more passengers. They don´t care if the others have to walk. So then, aware of this Obama paints the plan in a too optimistic fashion, by telling the 80% who are insured that everything will be the same for them. And the vested interests in the status quo nail him because that´s just no the case.

In democracies it is very hard to pass measures that improve things for minorities because democracies are the rule of the majority and if the majority is better off, they just don´t care enough about the minority.

Follow Martin Varsavsky on Twitter: twitter.com/martinvars

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Alejandro on September 2, 2009  · 

Actually, people don’t have to get worse medical care to get everyone insured. That’s what is happening with the current system, because insured people are actually carrying the burden of emergency care for uninsured people, and that’s expensive.

Right now, everyone is getting slightly worse medical care, because everyone is not insured. And everyone is getting much worse, and more expensive medical care, because the health insurance and pharmaceutical industries are not kept in check. So a properly designed health care reform should give americans a more universal, cheaper, and possibly better health care.

It looks like a free lunch, but it really isn’t. There’s definitely someone who is set to loose here. Look at who’s furiously lobbying against reform.

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eye catcher on September 2, 2009  · 

ah, yeah! very good catch words 2 stay in mainstream @ technorati… go on with this!

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Diego A on September 2, 2009  · 

I don’t believe only minorities lack health coverage. That 20% is populated by a variety of folks, low-income, not-yet-seniors and middle class families. Not to mention people with medical conditions that by no private plan can get any type of coverage…I think it’s too hypocrite for the current system to ask patients to wait until they’re 65 to be covered. People in their late 50s can’t get health insurance because of any pre-existing condition. This shouldn’t happen here, anywhere.

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Martin Varsavsky on September 2, 2009  · 

They are a minority simply because the uninsured are not the majority of the public. I did not mean a minority in the sense of a certain kind of ethnic minority.

Dani on September 3, 2009  · 

As in so many other things, Americans against health reform don’t bother looking at what happens in other countries. All European countries have a public health system AND a private option that many people take. The private option costs way less than in the US and yet the quality of the care is comparable to the best you can get in the US.

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Enri on September 5, 2009  · 

While you may have a point, but the current dilemma is not about Health care, it’s about insurance and corporate America.

Check this out, you will probably find it very interesting

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RamonD on September 10, 2009  · 

We also need to analyze the current USA health care system from the American mindset and culture. American people believe that if they can afford it they have the right to obtain the best service available. This means right to elect any Hospital and Doctor at any time and with no delays. This is not possible in a universal health care system such as the one in Spain because it will economically unviable. Americans believe that their country provides enough opportunities to everyone willing to work and to progress so if someone elects to be uninsured it’s due to their own election. Keep in mind that the current system provides health care coverage in the event you are disable and so on.

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cova on September 10, 2009  · 

We should not only compare us reality with spanish social health system, there are many options.For example in Belgium you have private hospitals, private doctors, etc.Gouvernement covers always a certain amount.You choose in between paying the difference if you want to go to a very expensive doctor, paying a bit more or just going to a normal doctor in which case it all willl be reimbursed.

This means no colapse in public hospitals, you always have people who want topay a bit more, everyone goes to their chosen doctor cabinet, so no waiting etc and the system rules.You might want to pay a bit more for a certain ilness you might want tto pay a regular doctor for something silly.

Same applies to hospital.Free unless you want single room or services a bit like a hotel.You can also choose if you want to pay for a doctor or nurse and physician or widwife to follow your pregancy or giving birth but always with the hospital structure back up in case of problem.

This is not only good in terms of health system, money and self decision what leads into a less medicalised interventions.i.e I gave birth twice with just midwifes not because I could not afford it but it just felt better and less cost for myself and the community!

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