Needless to say, it's been a hectic four weeks.Through all of this, my wife and I (but mainly my wife) have received a crash course in premature babies, accepted leave policies and the paperwork associated with giving birth to a child in the United States. As a side benefit, quiet nights in the NICU give you time to think and by virtue of being there, we have a lot of time to ponder the health care system here.
I intend to work with this in the theoretical realm, so feel free to keep statistics comparing wait times to the United States, horror stories of health care in Europe and Canada and anecdotal evidence supplied by your neighbor to yourself for now. There's certainly a time and a place for that discussion, but this post is not designed to be that time or place. (Also, this was the premise of debate team competitions in high school, where Frankie was a member and I was not, so I fully anticipate an ass-kicking in the comments section, but that's OK. We'll still be buddies after that.)
More to the point, I got into a little Facebook back and forth with a conservative friend today, who bemoaned the wait at a local hospital and jokingly told everyone in his friend network to expect that to happen everywhere with a socialized system.
After a bit of friendly dissension, another friend jumped in, pointed out how much doctors paid for medical school and asked us to question Canadian cancer patients about their experience. That certainly rubbed me the wrong way.
I looked up numbers both supporting Canadian supremacy in the field of health care and others that showed slow response times, especially dependent on which province you were trying to receive care in. Through that process though, I still fail to see why this is a bad system in principle.
A few weeks ago, a similar situation arose (again on Facebook, as I am apparently unable to interact with other humans outside of the digital realm) where someone offhandedly commented on a friend's page that they didn't want to be paying for someone else to "not work" and receive health care.
You'd think with the economy in flux and white collar workers being laid off en masse that there'd be a little more sympathy these days.
The crux of that arguement falls short for me as well. Medical insurance is essentially a group of workers, banded together to cover the costs of that group. The understanding is that younger workers (men and women in their 20s) will get sick less, need primarily checkups and help defray the cost of older workers who are having babies and might have more serious ailments down the road.
This was illustrated by an employer of mine years ago that I was told pulled a few high risk employees into their own coverage to drop the overall price paid by the rest of the office. To oversimplify, risk assessment is done to keep the balance in an office or an overall pool that assures the insurance company that while a few people may need more care or more expensive care, the rest of the pool is pretty stable and so it's a fair bet that they will turn at least some profit.
So, while it's accepted that you will be paying your premiums to help Bob in accounting get the extra tests he needs with his high blood pressure without going bankrupt, it has somehow become unacceptable to do the same if another person doesn't work in your office or company.
Again, setting aside the numbers, what is so bad about that system? I understand that feeling of busting your hump to provide for your family and having that resource pool drained by others who won't return the favor because they refuse to work. I also understand that people who can't work or can't find work are under a tremendous amount of pressure to find health care coverage in case something happens.
My brother in law is one of those people because he was laid off. I suspect a new friend of ours at the hospital is as well because she is legally too young to work. I was once one of those people because it was too expensive to get insurance when I was working as a temp.
In what way is it better to have the uninsured cut adrift than to pool as a country and try to help some of these people? Shouldn't we expect more from ourselves than to simply play defense when it comes to our nest eggs and health care coverage for our immediate family? If we're paying indirectly for emergency care that have the costs passed along to us in the form of higher bills, shouldn't we at least pay that out in the open and be able to feel better about the whole process?
(As an aside, I wholeheartedly reject the premise that millions of Americans would quit their jobs, kick back and refuse to do a damn thing if offered free health care. It has been my experience that many of these hypothetical situations have more than a hint of racism surrounding them.)
Getting back to the original point, I was more put out by the subtext that "socialism" was the problem in the equation. I don't deny that any system is subject to red tape, abuse and shortcomings, but I rarely hear discussions about how to improve that system here in the United States.
It seems most discussions about universal health care begin and are bogged down in the early stages with disagreements of the relative virtues of things being state-run and the possibilities of governmental incompetence. (I am starting to call this the "DMV Defense.) I guess what I'm asking for is a little more intellectual room to run - to set aside the entire disagreement over the merits of socialism or the possibilities of a full government takeover and actually examine the nuts and bolts of the systems in the rest of the world, find ways to tweak those systems and see if it's a possible fit for the country.
What disappoints me is the rejection out of hand because it's "socialist" without giving any serious thought to the upside and downside of the possibilities of such a system. This bothers me more each day on the practical and theoretical sides as we edge closer to nationalized banks. If I were to walk down the street from my office tomorrow and ask people if they would prefer to be issued a magical health care card that would enable them to walk into any hospital or clinic in the nation for treatment when they didn't feel well or if they would prefer to keep the current insurance card in their wallets, I can't imagine I'd have many takers on the second offer.
We like to lean on our Chevy truck ad vision of what it means to be an American. We drive out in the middle of a thunderstorm to help mend a fence and rope missing cattle, we send blankets and prayers after a massive hurricane comes ashore in the South and we send buckets of money during concerts after 9/11. We like to see ourselves as generous people, always willing to help out as best we can when our neighbors have a problem.
For me, this begs the question - How big is your neighborhood? Does it go to the end of your street or does it extend to the borders of your zip code, city or state? At what point do you stop seeing neighbors and start seeing individuals who are other people's problems?
(Cartoon by Patrick Chappatte)
