Monday, January 16, 2012

Politics: Healthcare

Given what the Republican candidates have been saying about “Obamacare”, I figure now is as good a time to vent some ideas regarding how Americans, as a society, view health care and how the costs should be paid.

On one hand – we’ll call it the right hand – you have the conservative/libertarian notion that paying for health care is an “individual responsibility”. This is the “private sector” system where people with health issues (be they diseases or injuries) pay the provider (doctor, nurse, hospital, clinic, or whatever) for whatever they need to make them healthy, or at least keep them going.

On the other hand – which we’ll call the left – you have the liberal/socialist notion that health care is a right, and everyone (via taxation) pays into a national system that provides everyone with the health care services that they require.

Those are the extremes, of course. What we have now is somewhere in between, as purchasing insurance is something of a compromise between the right hand and the left hand. We’re not completely averse to a “socialized” medical system. After all, a health insurance company can only charge a “reasonable” premium if there are plenty of healthy people on the rolls paying premiums without getting many medical services. They need to have lots of people who are paying more than they cost in health expenses to cover those who are paying less than they cost, especially if they want to make a profit. That’s why insurance companies lobbied for that clause in “Obamacare” that requires everyone to buy some kind of health insurance.

But I want to consider another way of looking at healthcare. Just for a moment, let’s look at health care the way we look at police protection and fire protection.

If you look at them from the “right hand” perspective, then police protection is a service that has a cost, as is fire protection. If you call 911 to get a response to a burglary or a fire, the dispatcher will ask you how you plan to pay for the police car or fire truck that will be sent to your home. In the extreme-right scenario, they won’t come at all unless you assure them that you can and will pay them.

From the “left hand” perspective, the police department and fire department are government services, and the salaries of the officers and the costs of their equipment are paid for by everyone’s taxes. Surprisingly, that sounds an awful lot like what us capitalists already expect.

If you look at health care the same way, then doctors are government employees with salaries (good ones, I should think, given the many years of education they need), and the machines, hospitals, medicines, and so forth are government expenses paid for by taxes. Sounds terrible!

Except for the fact that no one has to pay insurance premiums or copays or doctor bills.

“But health care under a single-payer system will be inferior and rationed!”

I guess that depends on whether we’re all willing to pay enough into the system to still have top-level health care.

I expect to get lots of feedback on why both scenarios suck, but I bet that most of it will be conservative/libertarian “why socialized medicine sucks” posts. It will be interesting to see if they have objections that I haven’t considered.

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