Health Care Simpliciter

At the risk of over-simplifying a very important discussion involving a cornucopia of public and private interests, I would like to ask why there is opposition to universal public health care. And at the risk of limiting the discussion to what some might consider inappropriate borders, I would like to exclude (for the moment) any consideration as to whether such health care has achieved any success in other nations or venues. In short, on what grounds--aside from an unabashed and abject form of bigotry--could anyone believe that the completely random circumstances of one's birth ought to predetermine one's ability to be healthy?

The debate is usually (when not reduced to the garrulous, tired idiocy concerning socialism) couched in terms of the costs to the public, both monetary and as to quality of care. These are, of course, legitimate concerns for any social or political venture. Nevertheless, the order of such concerns is often forgotten. E.g., most do not ask about the staggering costs of defense, as defense is considered of such paramount import as to outstrip nearly all doubts as to its worth. Why, then, is the health care "debate" not demanding of similar august status?

Today's Post (see link) has an article about the Mayo Clinic's (et al) rejection of the current health care plan being touted by Obama and Congressional Democrats. Their complaints are numerous, and they address several very legitimate issues as to the implementation of any effective health care plan. For example, they complain that the plan under consideration does not sufficiently account for discrepencies in health care cost/recompense in different parts of the country, and the cost to providers should such a plan be implemented. While some of these concerns are absolutely worth inclusion in the present debate, others at best belie the baffling status of the debate itself. That is, the signatories of the complaint state that the proposed system would result in burdening already stretched provider facilities without due recompense. Fair enough: increase the relevant compensation in the bill, and adjust it as needs and studies determine appropriate. But why on earth would anyone cite this as a justification for maintaining a private health care system which, with the force of a fait accompli, that those born poor should remain disfigured, diseased, or in any other infinite manner of situations disadvantaged solely on the basis of their random birth.

Allow me an alternative scenario: why must I be subjected to inescapable and crushing poverty if I happen upon some misfortune? Why can't I just die? Recently a family member fell off her bike on a twig which punctured her spleen or some such. If they had not operated on her she would have died. However, she did not have any form of health insurance. Thus, the amount she owed approached $60k. Like many folks without health insurance, she is literally (according to the United States government) in poverty.

I'll pretend for the sake of argument that this scenario happened to me, in order that I can be more specific regarding the realities and necessities. I am also impoverished, and have been for a number of years. This amount constitutes more than my combined annual income for the last three years. Thus, I cannot possibly imagine how long this amount would remain outstanding via even the most generous "payment plan." In other words, without some sort of stunning reversal of fortune a la winning the lottery, I would be paying for this chance occurrence for much of the rest of my life. However, I am not given an option. Taken to a hospital unconscious, it is my understanding that they would graciously and benevolently repair me so that I can be committed to their debt for the foreseeable future. Imagine an alternative scenario: imagine that each individual carried an income card which described their economic standing and possibilities, and imagine further that a hospital would accept or reject emergency patients on their ability to pay. Imagine that the hospital refuses me care on this basis, and I die. I don't believe I would find many who would support such a "health care plan," although I don't see much of a difference between this and our current system. Indeed, to quote Thoreau, given the options of parting with my money or my life, why should I be so quick to give up my money? Why would I volunteer my financial future possibilities over my life?

Yes, insane, I know. But let's switch to the wealthy person. The only problem is that there is no longer anything to consider. The story is over as soon as it begins: the wealthy person falls, she gets patched up, she goes back to riding their bike. The end.

This is truncated to the point of being ridiculous. There are all sorts of other permutations. For example, I have narcolepsy. This is a genetic disease with no cure which requires daily medication. Neurologists are incredibly expensive. If I had money, this would not be a problem. Indeed, it would not even merit discussion. However, given that I do not, it is a constant source of difficulty for me. A close friend has diabetes (the "you're born with it" type, not the behavioral variety). We recently discussed her situation, and I was completely embarrassed to have ever thought of my congenital handicap as a problem. Her healthcare costs per month exceed her rent. (And for potential nay-sayers, her living conditions are quire modest.) I need my medication to keep a job or drive. She needs hers daily to survive.

Yes, yes, one could go on with sob stories. That is not the point of any of this. One does not need to bleed from the heart to consider a very simple question: if it is callous to say a poor person who falls prey to an accident should die, why is it so common to say the same person should be forced into life-long financial ruin? Or, why can't I simply ask that they just let me die?

-W.