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Medicine for the Masses by J. F. Kelly, Jr. 1/3/08

Some conservatives opposed to government-provided, single payer healthcare are fond of saying, “If you think health care is expensive now, just wait until it’s free!”  They allude, of course, to the high taxes needed to pay for government-provided medical care for all. Most conservatives have, in the past, preferred something like the status quo or, if reform is needed, a more entrepreneurial approach without government assuming all or most of the risk and expense.

Conservatives and libertarians fear the nanny state’s ever-expanding intrusion into our lives in the process of providing cradle-to-grave benefits and security. Liberals respond that health care ought to be an entitlement and that wealth should not determine the quality of anyone’s treatment or, to put it starkly, who will receive life-extending care and who will be allowed to die. Conservatives are apt to counter with the claim that no one in this nation is denied emergency medical treatment because of inability to pay, to which liberals are likely to respond that one shouldn’t have to be destitute in order to get it and that too many people fall through the cracks under our current systems. “Life comes with risks,” reply the conservatives.

Critics of proposed universal health care schemes point out that we have the best health care in the world. They fear that with government-mandated health care we will lower its quality, cause it to be rationed and bankrupt the nation in the process. They point to the allegedly inferior quality of Canadian health care and to the high tax rates of the European social democracies that provide free health care.

Let’s all take a breath and examine some issues, priorities and trends. What services should a government provide its people, assuming limited resources and endless demands on them?  Most would agree that those services which people cannot, primarily through their own efforts, provide should head the list. Security from foreign and domestic violence comes quickly to mind. Safe and reliable food stocks and water supplies are high on the list. Freedom from persecution and discrimination and all the freedoms guaranteed by the Bill of Rights must be enforced. Somewhere, of course, a line must be drawn. Government cannot provide everything we want and ours emphasizes individual responsibility and risk-taking.

Individuals must labor and sometimes struggle to feed, cloth and shelter themselves and with the proper effort, all but a tiny percentage can manage somehow and help care for those who can’t. By and large the quality of their effort and abilities determine the quality of their lives in our democracy. But should wealth determine the quality of life-extending health care? An increasing number of conservatives, myself included, are saying no. A recent poll by the Public Policy Institute of California, for example, found that over half of California’s Republicans would support a plan requiring all Californians to have health insurance with employers either providing it or paying a tax to the state in lieu of providing it. This bodes well for Gov. Arnold Schwarzenegger’s plan to overhaul California’s health care system and provide greater access to health care insurance.

Hard work and effort, plus skill and talent can achieve many things in life, but not necessarily good health or protection against debilitating injury or illness which can financially devastate a family of modest or even moderate means. Healthy lifestyles may greatly influence health but the luck of the gene pool may be the greatest influence of all. Government cannot protect us from all accidents and illness but a nation as rich as the United States can and should provide some protection from the financial ruin that too often accompanies them for those whose employers do not provide health insurance and who cannot afford to purchase it themselves or are unable even to obtain it at all because of prior medical conditions.  .

It remains to be determined how best to fund expanded access to health care insurance. Some scheme for sharing the expense between government, employer and individuals must be developed and agreed to. Any plan must include incentives to contain costs and prevent abuses. All this is, admittedly, easier said than done, given the astronomical increases in the cost of medical treatment. But the first step is for a majority of Americans to agree that it is the right thing to do. That appears to be happening. CRO

copyright 2008 J. F. Kelly, Jr.

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