Saturday, April 3, 2010

On Healthcare Pt. 1: Economic, Ethical and Political Decisions

Health-care reform has been a BigDeal(tm) lately, and I wanted to express some thoughts about it, the way it works and my general gripes about what is decidedly not real progress in my mind. In this series I will explore the benefits and failures of the current path of health-care reform in the United States. I will talk about insurance companies and risk pools; the difference between moral, political and economic decisions; and (in)efficiencies of scale in different levels of the industry.
I'd like to begin this series by explaining that I am decidedly not a fan of large government. I also do not think that health-care is a right. I think that as a wealthy nation, it behooves us to share this cost to improve the life of the collective and improve our collective experience at a small cost to the privilege. If it all works well, we will collectively be more efficient, create more value and ultimately all be better off. To me, denying health-coverage to someone because of a socio-economic disadvantage that they may not be at fault for is tantamount to denying a child a polio vaccine until they can pay for it out of their wages. An investment in health-care is an investment in our labor force and our future, and I like to think it will have a positive return. That being said, that is an economic decision, not an ethical or political one.

My personal ethical inclination toward universal health-care lies in the fact that  we all get sick. Children in Nigeria, children in the United States, children in Sweden and children in China all get sick. The Queen of England gets sick, the Pope gets sick, Socrates got sick, the Dalai Lama got sick and even the seemingly invincible Dr Gregory House gets sick. Getting sick is as much a part of being a human as is being born, getting hungry and dying. Denying someone the right to live because of something they can't control seems a little backwards. We've spent so many thousands of years innovating, working towards advancement and creating this thing we call society. Fighting this just seems like spitting in the face of thousands of years of human ingenuity and progress over, as Frances McDormand once said, "just a little bit of money," which as I will explain later in the series, may not be as much as you think.

Finally, it is important to plainly state that this system implies a redistribution of wealth, which is a political decision I happen to favor, but many are opposed to *ahem*libertarians*ahem*. It is important to understand that the reasons people support, or oppose, universal health-care are varied in many different dimensions. Calling someone names over their ultimate answer is, in my opinion, unwarranted and a sign of ignorance since, ultimately, these decisions are all deeply personal. Right, wrong and truth are all subjective in this context and calling names because someone refuses to accept our truth as their own is not only intolerant, but ultimately totalitarian. This democracy thing we have going, after all, rests in the idea that we all get to have a say so we can influence, not dictate, what happens. 

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