Monday, March 05, 2007

Yes, Even More On Health Care ... But This Is A War Well Worth Fighting

“In the individual market, the federal protections provide precious little help to people seeking coverage,” said Karen L. Pollitz, a research professor at the Georgetown University Health Policy Institute.

This from today's New York Times story on the growing numbers of middle class Americans without health insurance, part of what I believe is a growing movement in the mainstream media to make the case for government mandated universal health care.

My biggest problem here is the vocabulary. The story focuses on Vicki H. Readling, a 50 year-old real estate agent who, after losing her prior health insurance, was not able to obtain new coverage following a diagnosis of breast cancer. According to the Times, this is a typical story for people with serious illnesses. Now, I don't want to overlook the personal tragedy here, the sort of tragedy that's all too well known to many Americans, but merely feeling bad doesn't do anything for the people stuck in these positions. Misidentifying the problem doesn't help anyone either.

First, the problem of covering the health costs of the uninsured is not an insurance problem, in so far as it is a problem in the immediate present. People with serious medical problems can't get health insurance because in all likelihood their immediate medical costs far exceed the costs of medical insurance. The whole concept of insurance is based on insuring coverage for possible future events, not providing discount costs for current expenses. When you have cancer, you need medical treatment, you don't need medical insurance. Insurance coverage mandates or price ceilings would help people like Ms. Readling, but they would also drive up the costs of health insurance for everyone else, and could potentially bankrupt some companies. It makes no sense to mandate that a private company take on a customer that would lose them money.

Of course, the real point of the story is the growing number of middle class Americans who don't have health insurance in the first place. This- in part- is where I most fear the propaganda machine. The troubles of the poor may not be enough to rally support for universal health care, but as Eminem put it back in 2000 in the song "The Way I Am", "Middle America, now it's a tragedy, now it's so sad to see ..."

Of course, the interesting question not raised by the article is the question of what it means for the middle class to forgo health insurance in the first place. At some point you're talking about sacrificing health coverage in order to maintain a certain standard of living. For every individual who forgoes health insurance because of the costs, there may be a similarly situated individual who sacrifices some measure of their standard of living in order to have complete health coverage. The concept of universal health care avoids dealing with the question of whether or not that individual who choose a higher standard of living over health insurance should have their health costs paid by taxpayer dollars. In fact, I think it is one of the reasons that the concept of a compulsory universal system has become more popular.

I'll be honest- I fear the worst. Institution of a mandatory, universal health care system would justify government intrusion into our private lives and our bodies, all in the name of costs to public health.


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