No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.
I have mixed feelings about this. It is a black-and-white statement that paves over nuance. Unfortunately, for any sort of reform to pass, we probably have to make those kinds of black-and-white statements. But it irks me somewhat.
Because while it is a laudable goal, the truth is that any health care system has to make tradeoffs. I can imagine any number of cases in which people will die because they couldn’t afford health care, and that’s the way it should be.
I had to make the somewhat difficult decision not to bank my son’s cord blood. It’s not something covered by insurance, and it costs–depending on the company–well north of a thousand dollars. We asked lots of people. A friend, who is a genetics researcher, had his daughter’s cord blood banked. The AMA was saying it was probably not necessary at this point, but that it was something that may provide a benefit to your child if certain breakthroughs are made.
Now, if I were rich, the decision to do this would have been easy. If I were poor, it would have also been easy. But I am in-between, and so the decision was harder. That money, wisely invested, could buy him a lifetime of bikes. There were significant opportunity costs in paying for banking.
If he dies of a disease that could have been cured with that banked blood, I will, of course, be crushed. And it will be tempting to say “if only he had access to better health care.” But as a practical matter, people die every day because of rational decisions about the cost of care. No health care system is going to pull out all the stops for every citizen.
Moreover, I suspect that we will not change the fact that the rich live longer than the poor do. It’s not just access to better health care that aids them, it is access to healthier food, better education about health, safer environments, and less dangerous working conditions. In some ways, if we are to have any vestige of a capitalist incentive, it’s difficult to say “those who can afford it should not be able to buy better health care.”
None of this changes the fact that today’s health care system is a mess, and that we should be embarrassed as Americans that we allow it to continue to be a mess. And it seems likely that “socialized medicine” in some form is a better solution. But the idea that people won’t die because there is a public option for insurance is just silly.
Health care is now and always will be “rationed.” Society should make decisions about how best to allocate its resources. I think the stronger argument is that today we spend more per citizen on health care than most industrialized nations, and get the least out of it. In a country where “productivity” is often our proudest accomplishment, our health care represents a shocking counter-example. Particularly because this so fundamentally affects the lives of so many people, efficiency means compassion.