By most estimates, at least 47 million Americans are without health-care coverage. Millions more are at risk of losing their coverage because, quite simply, they can barely afford it and losing it is better than losing their home. Thousands more will be severely financially impacted by a serious illness because their premiums and
co-pays amount to more than they can pay or insurance companies issue a
post hoc denial of benefits.
An important question in the debate is whether this is the best we or any society can do. Obviously the answer is "no." But another question strikes even deeper and at the heart of American politics, if not identity. It is: Are the best interests of a business always coincident with the best interests of an individual? The answer to that question seems almost obviously "no" in some cases, therefore "no" in the general case.
Health care and social assistance is a $1.6 trillion industry. That number is staggering.
It accounts for a significant portion of the services that compose 55% of our economy. According to the
2000 World Health Organization report of health care around the world, our expenditure is #1 in the word, we are ranked #37 overall (right behind Costa Rica), and #72 for the level of health we achieve (right ahead of Bhutan and right behind Argentina). So, while the industry has been recording record profits and unprecedented wealth, we have been achieving the dizzying heights of wellness of countries like Bhutan.
Health care has been left in the hands of the free market for at least the last 35 years, since the Nixon administration, and in that time we have seen an escalation in the price of nearly every medical/wellness/social service or product while the health care/services industry has ballooned to almost unfathomable prosperity. All the while the numbers of people left without care they can afford or without care at all continue to swell. Don't forget, all those who were lucky enough to receive care/service have joined the ranks of the Bhutanese.
So, what are the arguments against universal health care (lest we forget that all best health care systems are government run and do more with less money)?
Position #1: Government sponsored health care is tantamount to socialism.
Response #1: OK, is government run firefighting tantamount to socialism? What about the Postal Service? If they are, is that a reason to privatize all fire departments? There are services that citizens need that most agree should not be withheld if they can't afford it, like fire fighting. The previous is a good working criteria for what services should be public. Hell, I'll pay for my postage if that means that people can see a doctor.
Position #2: A free market solution will save us money and give us the best care.
Response #2: The free market solution has not served us well to this point, why again should I place my faith in it? The best business model is to collect as much money while providing the least amount of care. That is what we have now. We are charged significantly for care we don't receive. Granted, world renowned experts practice in the US. Unfortunately, most of us can't afford them. Remember, US free market solution has given us Bhutanese level of health, now those are results.
Position #3: The government would be bankrupted.
Response #3: See Response #2 on how well the free market is doing. Admittedly, much would have to be done by way of tort reform to limit damages against the government. But with people given wellness and sickness care from cradle to grave, overall medical expenditures would come down as health improves (much the same way numbers of fires go down when we improved fire prevention and response infrastructure: detectors, sprinklers, etc.) There is plenty of fat to be cut out of our current federal budget. After all, how many Osprey's does the USN/USMC really need? Or, do we really need a federal department to tell old ladies to take their shoes off at the airport?
Position #4: People could afford health care if they just spent wisely.
Response #4: That is true but it is not true for all or even the majority of people without access to care. American economics is complicated but there is an alarmingly and increasingly applicable catch-22 that many don't want to admit. Our economy is as robust as it is because people spend beyond their means and many businesses need that to be true. Put differently, if Americans spent and saved wisely by living within their means, our economy would collapse. Put yet another way, the American economy presupposes consumers will be saddled with debt for goods that consumers will have to spend a lifetime working off. And let's face it, health care can't be repossessed so why should it be funded with a loan. (Note: the politics/economies of debt is worthy of further of discussion that will occur in a future post)
We can do better as a country. We are willing to sink trillions of dollars into wars every 15 years but we can't seem to come up with the money or will to take care of our
infirmed? If war metaphors are the only way to motivate action, then where is the war on preventable illness, or infant mortality? So, instead of falling prey to the rampant demagoguery out there, give me the argument for why all of my countrymen should not have health care. I am happy to oblige with a response.