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?"
Spring Break
