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Archive for November, 2009

Is Healthcare Like a Highway?

November 6, 2009

highwayA day or two ago, I found myself launching into a discussion of healthcare reform via the comment capabilities of Facebook. Taking the Facebook approach is, to be charitable, a fool’s errand. Healthcare reform is complex, and opinions on all sides are passionately held. Yet I think I learned something by trying to take the discussion to the land where BFFs LOL.

The difficulty lies in the divergence of our fundamental beliefs about healthcare; and it has proved insurmountable, in Congress as much as on Facebook.  The current debate should tell everyone that it’s finally time for us to decide where healthcare belongs in our view of the world. We’ve long since made such decisions about many other things. The military, for example, protects everyone at taxpayer expense, including people who don’t pay any taxes. In the same way, public highways, libraries and schools are available to everyone, whether they contribute a lot or a little in taxes.

Highway usage is admittedly constrained by tolls and vehicle registration and use fees, but pedestrians and bicyclists generally use public ways for free. People paying to register their cars usually don’t fret about paying taxes to provide roads for cyclists. Taxpayers don’t ask public libraries to limit patrons’ use of their materials and facilities to a “fair” share. Public schools don’t tell families with lots of kids that they can’t all come to school. This is because over the course of our history, we’ve decided that the nation as a whole benefits from establishing and maintaining roads, libraries and schools as public institutions. Availability is based upon universal need rather than the ability to pay.

So, does healthcare belong on the same list as highways, libraries, schools and the military? People who think the way I do say yes. From that premise, of course, it is impossible to imagine healthcare reform without the so-called “public option.” The nation as a whole will benefit from a healthier citizenry. Government therefore must be involved. How else are we going to to take care of everyone’s health needs?

On the other side of the debate are people who believe that doctors and hospitals provide a personal service, like accountants, mechanics, maids and dog-walkers. From this premise, it follows that healthcare should be available based on the ability to pay rather than actual need. But everyone needs healthcare. Against this backdrop, therefore private insurers currently earn billions of dollars, through ever-increasing premiums, by making healthcare available to people who otherwise couldn’t afford it.

Given that government is already in the business of providing and paying for healthcare, through Medicare, the Veterans Administration, the military and the health plans members of Congress currently enjoy, I maintain that it isn’t much of a leap to take healthcare public. The military wants its people as healthy as possible, because healthy people do their best work. The military therefore provides healthcare for service people and their families. That seems to me like a direct, simple and smart approach as well as a worthy goal for society as a whole.

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