Tuesday, January 6, 2009

Asking For Change: Intensive Repair

Asking For Change: an occasional series on what should change in the U.S. under a new president, why it should change, and how we all can make it happen.

Obamathon Man's relatives happen to have many contacts in the Denver metro area, and yesterday we all went to lunch with one of them. While I'm not at liberty to divulge much more about this individual as it may produce unintended consequences, he is employed by an organization involved with the health care system. I figured he might be able to help clue me in on the state of health care in the US. When I asked him about it, the first thing he told me was, "Everyone knows the system is messed up."

A quick search online reveals some scary stats about US health care. For instance, health care spending in the US is 4.3 times what the government spends on defense. Worse, the US has 46 million people without insurance. That's 13 million more than the population of Canada, which ironically is rated higher than the US in health care. As this individual explained to me, the problem is basically that there is a wide range of people who make too much to qualify for Medicaid but don't have insurance or are underinsured.

I asked him if he had any news about what Obama and his pick for Secretary of Health and Human Services, Tom Daschle, were planning to do. He assured me that he was no political insider, but said his best guess was that they would try to streamline costs in general. Obama's official website does include an outline of his health plan, the bulk of which is focused on "[making] health insurance work for people and businesses, not just insurance and drug companies"; however there are other proposals like reducing costs for foreign medicine imports. Also, WebMD has done their own write-up on Obama's health plan - it's a bit more level-headed.

I asked him about his own take on what should be done to improve health care. While he had many sophisticated and nuanced ideas that I wasn't able to fully understand, he said one thing that really resonated with me: "The structure of for-profit insurance companies is contradictory to a system which would promote general health and well being. It could even be called morally questionable." I couldn't help but agree. Theoretically, insurance companies are motivated to collect as much money from their patrons while providing the least coverage in order to maximize profit. But shouldn't the motive be to provide as much coverage as possible? Should we be willing to accept deaths for dollars?

I had been crafting a comparison which I submitted to this individual. Afterward, he said, "That's an interesting analogy", which I took to mean he approved of it officially. Suppose someone breaks into your house and steals a number of your possessions. If you are wealthy, you can hire a private detective to find the thief. But no matter who you are, you are entitled to call the police and have them investigate the case. Municipal security is a service provided by the government and funded by taxpayers, and yet all but the furthest on the Right suggest that it be privatized. Justice is one of the fundamental principles of our society, and we view it as a right, not a privilege. Likewise, we need to make health care a right, not a privilege.

The rich will always have a larger number of health care options. As in the scenario above, wealthier citizens have a larger number of security options as well, the same applies to education, and even fire prevention. This is not a bad thing, and people rarely object to this. But expanded options for wealthier individuals should not come at the expense of the basic rights of everyone. Admittedly, I lack the experience or research time to make more specific recommendations about health care - although some of the websites I've linked to are excellent resources if you would like to do research yourself. But this much I know: America needs to stop looking at health care as a commodity or a privilege, and start looking at it as a right. Only then will our first aid cease to be second rate.

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