The Health Care Debate

OK, so I'm not going to post my third essay just yet. After listening to most of President Obama's speech last night and listening to various pundits and radio show callers today I feel like there is actually a little bit of air left in the discussion and that there are a few points about the health insurance/ health care debate that are worth addressing.
1. One of the most common complaints about any attempt to create a public option or a national single payer system is that "the government can't run anything efficiently and all the money would be wasted in bureaucracy." Even if we ignore the fact that the government spends one-sixth what the private insurance companies do on overhead in the government health programs that do exist, there is a very basic economic problem with this argument. Economies of scale and a natural monopoly mean that if the government chooses to cover an additional 50 million people or the whole population then the health care providers would be required to pay whatever the government demanded. There would be an instant reduction in the cost of health care in this country. Additionally, since the government wouldn't need to advertise to attract customers there would be no money diverted from the plan into the pockets of TV stations. Finally, because of the way insurance works, the larger the group covered the lower the costs to individuals because any risks are spread out over larger groups.
2. "All we need is more competition to drive down prices." Ah the naivete of free market true believers. The problem is that in this case, the free market is driving up prices for consumers. The free market in health care and the profit motive which is claimed to cure any problem mean that not all of the money going into insurance or health care is going to provide care or pay those people who provide care. A big chunk of money is going to the share holders. If and when what little competition exists (i.e. I don't get to choose my insurance company, it's negotiated through my union and employer) manages to drive down the costs of providing insurance or health care those savings are passed on to shareholders in the form of dividends not consumers.
3. Health care is a for profit business. We've decided that health care and health insurance instead of being for the good of the consumer is for the good of the share holders. We've decided that government ownership of this or other necessities is bad. Instead of people getting electricity, water, phone service and health care from one big company run by the government not for profit, but with the goal of providing free or inexpensive service to everyone, we end up with local monopolies charging whatever they want (and people want to deregulate them even further.) When you grant a private company a monopoly they have no more reason to to be efficient than a government monopoly would and they have the motive to keep prices high to pay shareholder dividends.
4. The 40-50 million unemployed are only part of the problem. A bigger problem for schools, small businesses and many individuals is the cost of keeping people insured. A cheaper national insurance plan would save individuals and companies billions of dollars allowing them to hire more workers, invest in new technology and in general stimulate the economy. Schools spend more each year on teachers than they ever have while employing fewer teachers per student and paying salaries that don't keep up with inflation because the size of increases in health care costs exceed the increases in revenue that even the lucky districts get.

It's been interesting to me over the course of this public debate to hear the same arguments against Obama's plan that were used against Clinton and LBJ and Kennedy and FDR and Teddy Roosevelt when they all tried to fix the health care system in this country. Eventually, I hope, people will come to realize that their best interest lies not with the corporations but with their neighbors, coworkers and friends. I know a lot of the rhetoric around this issue has been intended to frighten and misslead, but at some point doesn't common sense and long term self interest have to kick in?