Guaranteed Healthcare

I'm just back from vacation - a bike tour in France - where I happened to learn about one more of the ways a single payer system works better.

One of the arguments we get from the Right on healthcare is that we don't need single payer or better insurance, we just need for people to behave in healthier ways so they won't get sick.  Of course the hard reality is that the very fragmentation of our system is one of the reasons we don't do a better job of investing in interventions to promote better health.  If you are an insurance company with a subscriber who is obese, or diabetic, or has hypertension you have no incentive to invest in preventive care because you know that by the time that person develops complications of their condition it's highly likely they'll be insured by someone else.  But in a single payer system, where one is covered by the same agency across the lifespan, that agency has the incentive to invest in prevention.

I'm a cardiac rehab nurse and I see it all the time: come into our hospital in the midst of a heart attack and you'll get good treatment even without insurance.  But try to find treatment for your high blood pressure or diabetes so you can prevent that heart attack and no luck for too many - it's not an emergency.

So I was channel flipping in a hotel room one evening in France, and came across a good example:

A documentary film on a superb program the French national healthcare system offers for obese teens: A residential program, with education, group therapy, shopping, restaurant trips and lots of exercise.  All covered under the the system.  It follows a group of obese teens as they lose weight, gain fitness and self-esteem and bond as a group.  Excellent film, excellent program.  And I'm sure the children of the wealthy have programs just as good in the US.  But in France it's there for everyone.  Why can't we do as well?