The Case For the Public Option

Question: How should we talk about universal healthcare?

Richard Gelles: I think we need to decide what are rights and what are privileges. I'm not in favor of big government handout redistribution of wealth. I think it's not going to work in our society. It's not going to get votes. But there are certain things that we might want to have a discussion about, such as, is health care a universal right? Is a quality education a universal right? Is having decent housing a universal right? And how do you fairly -- in a market economy -- achieve that cost-effectively? And I think we can do that, but I think there are other areas -- I think safety and wellbeing are universal rights, but other things probably not. I mean, we're not going to go to a socialistic society where each -- you know, going back to Marx -- each according to his or her needs. It's not going to happen. So this right and universality discussion has to be done in a society that is a market-driven society, where we don't want to reward certain behaviors because we think they're counterproductive to the kind of economic system we have.

Question: Should healthcare reform have a public option?

Richard Gelles: Oh, I think the public option is essential. Everyone is entitled to health care. Everyone isn't entitled to every test under the sun. When you dig down and look at Medicare, it's pretty obvious the biggest funding, the biggest cost of Medicare -- which, by the way, is an efficient program; let's say right now the administrative costs of Medicare are two percent. You find me a program that runs on a two percent overhead rate, and I'll say that's an effective program. But the money spent on health care is all back-ended; the majority of the money is spent in the last two years of life. And are we making that investment in quality of life, in extending life, or is it defensive medicine to make sure we don't get sued? And you know, I'm not talking about death panels, but I'm talking about evidence-based medicine. And also for the first two years of life, in Medicaid, evidence-based medicine. There's not a lot of point in investing millions of dollars to create a low-quality life. So the front end of life and the back end of life, yes, health care is an entitlement. But every possible form of health care isn't an entitlement.

Question: Has the welfare reform bill worked?

Richard Gelles: The welfare system -- and I worked, when I one year worked in Washington, on the welfare reform bill -- the welfare reform bill worked because it has a time limit, because it says welfare is a temporary right, not a permanent right. So even in this economic recession with unemployment going up, the welfare rolls are lower than they were in 1996. I think that's about as much reform as you're going to get. Where you need the reform, I think, is to -- people have to have a stake in society, and they get that by having home ownership. I'm -- I look back to the 1950s, and I think the American economy did the best when people were able to buy homes, and the consumer society thrived not by buying an extra plasma TV, but by buying all the utilities and appliances that go with home ownership. One of the great disasters of 2008-2009 is the decrease in home ownership as a result of the financial problems, the financial scandals, with the subprime mortgages.

Recorded on: October 29, 2009

The Dean of UPenn’s School of Social Policy argues that universal healthcare is basic human entitlement.

Photo: Luisa Conlon , Lacy Roberts and Hanna Miller / Global Oneness Project
Sponsored by Charles Koch Foundation
  • Stories are at the heart of learning, writes Cleary Vaughan-Lee, Executive Director for the Global Oneness Project. They have always challenged us to think beyond ourselves, expanding our experience and revealing deep truths.
  • Vaughan-Lee explains 6 ways that storytelling can foster empathy and deliver powerful learning experiences.
  • Global Oneness Project is a free library of stories—containing short documentaries, photo essays, and essays—that each contain a companion lesson plan and learning activities for students so they can expand their experience of the world.
Keep reading Show less

Why we must teach students to solve big problems

The future of education and work will rely on teaching students deeper problem-solving skills.

Future of Learning
  • Asking kids 'What do you want to be when you grow up?' is a question that used to make sense, says Jaime Casap. But it not longer does; the nature of automation and artificial intelligence means future jobs are likely to shift and reform many times over.
  • Instead, educators should foster a culture of problem solving. Ask children: What problem do you want to solve? And what talents or passions do you have that can be the avenues by which you solve it?
  • "[T]he future of education starts on Monday and then Tuesday and then Wednesday and it's constant and consistent and it's always growing, always improving, and if we create that culture I think that would bring us a long way," Casap says.
Keep reading Show less

Allosaurus dabbled in cannibalism according to new fossil evidence

These Jurassic predators resorted to cannibalism when hit with hard times, according to a deliciously rare discovery.

Stephanie K. Drumheller et.al
Surprising Science
  • Rare fossil evidence of dinosaur cannibalism among the Allosaurus has been discovered.
  • Scientists analyzed dinosaur bones found in the Mygatt-Moore Quarry in western Colorado, paying special attention to bite marks that were present on 2,368 of the bones.
  • It's likely that the predatory carnivore only ate their already-dead peers during times when resources were scarce.
Keep reading Show less

What the world will look like in the year 250,002,018

This is what the world will look like, 250 million years from now

On Pangaea Proxima, Lagos will be north of New York, and Cape Town close to Mexico City
Surprising Science

To us humans, the shape and location of oceans and continents seems fixed. But that's only because our lives are so short.

Keep reading Show less

Sooner or later we all face death. Will a sense of meaning help us?

As a doctor, I am reminded every day of the fragility of the human body, how closely mortality lurks just around the corner.

Photo by Alex Boyd on Unsplash
Personal Growth

'Despite all our medical advances,' my friend Jason used to quip, 'the mortality rate has remained constant – one per person.'

Keep reading Show less