What Do We Owe Each Other?
Americans have a lot of trouble directly addressing what we owe one another with respect to health care. Do we owe each other free access to any health care services in any setting at any time, as a fundamental human right — as several previous posts seem to suggest? Do we owe each other nothing, instead treating health care as a private consumer responsibility that competes for a share of household budgets with groceries, car payments, and cell phone bills?
A couple of years ago, the Center for Healthcare Decisions — under its “Just Coverage” project — asked Californians whether health coverage should be like:
• the fire department (everyone receives the same level of protection, regardless of income);
• education (a basic level is guaranteed for everyone, but those who can pay more may do so); or
• housing (everyone has the responsibility to meet his or her own needs).
The majority of responders found education the best analogy; they believed that Americans owe each other a “basic” level of protection, but are open to individuals paying for more services on their own. The ongoing challenge we all share is reaching a shared definition of “basic,” to help decide just what constitutes that fundamental, shared obligation.
I recently spoke on health reform to a group of high school government students, as part of a presentation on interest group politics. One student, who seemed to be a libertarian outlier in this Bay Area group , asked what was wrong with having everyone just pay their own way for health care, regardless of their health status or financial situation. I answered, basically, that that wasn’t the kind of world I wanted to live in. As the health reform debate unfolds, the question before us is: what kind of a world do we want to live in – and what are we willing to give up in order to get there?
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3 Responses to “What Do We Owe Each Other?”
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So, you don’t want to live in a world where people actually have to pay for the health care they receive. That leaves the question, “who will pay?” Of course, the answer is taxpayers. Who will decide what is covered and what is not? Government bureaucrats. Socialized medicine doesn’t work well in ANY country that it is tried. Why do you think it would work here?
So we should detroy our healthcare system because you want to live in a world where government forces citizens to pay for others healthcare, where the government will decide what care you can get, and where the health care system will eventually bankrupt the country. Oh, and I’m sure because you have an MHP and MPP after your name, you’re smarter than everyone else and can solve all those problems. Hog wash. It’s because of people like you that we have the problems today. Half of our healthcare system today is paid for by government, which is the root cause of most of the problems with our system. Where is your evidence that socialism works? Why aren’t you proposing we socialize food distribution? Surely that is more important than health care. You die without food. Yet there is not a single government office or offial that oversees food distribution in the country. There is no garantee that there will be any food in grocery stores tomorrow. Grocery stores turn over their inventory within 24-48 hours. Yet you can go to any city day and night and find an abundance of cheap food. It is no coincidance that healthcare of which government pays 50% of, and education which government pays 90% of, are the two areas in the economy where costs rise faster than overall inflation rate. Perhaps government IS the problem. That high schol kid seems to understand more about economics than you do.
1. If we want to talk about big government and subsidies, food is the perfect place to start. How many billions do we pay to the agricultural industry to keep our markets flooded with cheap corn based products?
2.The real problem here is not the government, but insurance and drug companies that are pulling in huge profits at the expense of people’s health.
3. United States’ ranks 46th in life expectancy and 42nd in infant mortality among 192 nations. Guess who is in front of us? Japan, Norway, Sweden, Canada, and the UK…just a couple nations that have chosen to prioritize the health of all over the profits of a few.
I respect the opinions of the student I mentioned, Micsca, and RL. Two thoughts in response. To Micsca: many medical needs, unlike caloric intake or housing requirements, have an element of randomness. Different people need different levels of care, at different points in their lives. To me, that argues for pooling risk and sharing costs in a way that is not solely attached to employment. To RL: I’d be happy to see a serious debate about the role of profits and administrative overhead in health care, and have little doubt it would uncover ways ito constructively reduce costs. But that alone won’t make health spending trends sustainable for either the public or private sector (nor will it bring the quality of US care up to the level that most of us aspire to.) My own view — which, according to that “Just Coverage” project I mentioned, is shared by many but by no means all people — is that we do share responsibility for financing some, but by no means all, health care services.