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Steven Hill: Obama can learn from ‘Old Europe’
01:00 AM EST on Friday, January 16, 2009
WASHINGTON
THE INAUGURATION of the 44th president next Tuesday is starting to look like the most dramatic debut since the Beatles arrived in America for the first time, in 1964. But soon it will be time for Team Obama to produce results. For three of the president-elect’s top priorities — energy and climate change, health care and jumpstarting the economy — President Obama would do well to look toward “Old Europe” for guidance.
Europe recently displayed its global leadership by enacting its 20-20-20 Plan: agreeing to cut human-produced carbon emissions that contribute to global warming by at least 20 percent by 2020. It will do this by ramping up renewable-energy technologies to 20 percent of its energy use, and by enacting the world’s most ambitious carbon- trading program. And the richest European nations have agreed to do more toward combating climate change than the poorer nations, an important principle for any global climate agreement.
In a friendly challenge to the president-elect, European Union Commission President Jose Manuel Barroso said, “Our message to our global partners is: Yes, you can . . . especially to our American partners.”
The Obama administration also should learn from how Europe has enacted universal health coverage and quality care at an affordable price. European nations are rated by the World Health Organization as having the best health-care systems in the world, spending on average far less than the United States for better results. France has the top-rated health-care system, while the U.S. is ranked 37th — just ahead of Cuba and Slovenia.
Yet contrary to stereotype, France, Germany and most other European countries do not use government-run, “socialized medicine.” They have figured out a third way — a hybrid with private insurance companies, short waiting lists for treatment and individual choice of doctors.
This third-way hybrid is based on the principle of “shared responsibility” among workers, employers and the government, all contributing their fair share to guarantee universal coverage. Participation for individuals is mandatory, not optional, just as you must have a driver’s license to drive.
These health-care plans are similar to what Massachusetts recently enacted, but with two significant differences. In France and Germany, the private insurance companies are nonprofits. Doctors and nurses are paid well, but you don’t have corporate health-care CEOs making hundreds of millions of dollars. The profit motive mostly has been wrung out of the system.
The second key difference is in cost controls. In France and Germany, fees for services are negotiated among the health-care professionals, the government, patient-consumer representatives and the private nonprofit insurance companies. As in our Medicare system, together they establish a national agreement for treatment procedures, fee structures and rate ceilings that prevent costs from spiraling out of control. This is good for European businesses, too, because it doesn’t expose them to the soaring health-care costs that have plagued American businesses.
The Obama administration also could take notes from how the Europeans are jumpstarting their economies. Europe sometimes is criticized for its lack of unity, but at times that multi-headed hydra lets each nation act as a laboratory for the others, learning from each other’s successes and shortcomings.
For example, during the recent financial meltdown, as markets reeled and the U.S. announced a $700 billion bailout plan, each European country initially tried its own bailout formula. Within two weeks the British strategy under Prime Minister Gordon Brown emerged as the most effective. The rest of Europe quickly adopted it, as did the U.S. eventually, since the American plan had been so ineffective.
The European plan also includes stricter controls over the bailout money, and equity in the banks, reductions in dividends and concessions from the bankers, all of which were lacking from the U.S. bailout. And Europe already has enacted a fiscal stimulus worth hundreds of billions of dollars at the continental and national levels, while Americans still await Obama’s plan.
With half a billion people, Europe is the world’s largest, wealthiest trading bloc, producing nearly a third of the global economy — as large as the U.S. and China combined. While its critics have derided Europe as a land of “creeping socialism,” Europe has more Fortune 500 companies than the U.S., China or Japan.
Like the U.S., Europe is fighting against the rising economic floodwaters. But something about Europe and its “social capitalism” seems particularly well-suited to this make-or-break century challenged by a worldwide economic slump, global warming and new geopolitical tensions. Team Obama would do well to take notes.
Steven Hill is director of the Political Reform Program at the New America Foundation. His book Europe Rising will be published by the University of California Press this year.
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