Health care as a public good

Guest post by Greg Prince

Interesting stuff from Sully:

I guess some readers are a little shocked by this statement:

I see no problem with the wealthy having access to better care than the less wealthy.

It seems to me that this is equivalent to saying: I see no problem with living in a free society. Even if Michael Moore achieved his dream of corralling us all into a British-style healthcare system, private medicine would still endure in America. In fact, you'd have to make it illegal to prevent the wealthy having access to better care, newer drugs, faster service, better doctors. I know some leftists would gladly prevent the successful from getting better healthcare, but it won't happen in a free country.

At a fundamental level he's correct. Health care isn't a right, it's a collection of goods and services for which eventually a bill comes due.

But that's not the whole story.

The right wing is working itself into a frothy lather in anticipation of Sicko, the new Michael Moore movie. Yes, yes, Moore is an asshole propagandist and presents an attractive target to his critics, but it will be unfortunate if they focus on Moore and not on the issue of health care in America.

Because health care, though not a "right" in meaningful terms, is absolutely a public good. And, as it's a public good, we can't afford to continue down the road we're on.

Let's be blunt and honest about things here. When it comes to the health care dollar, the United States spends more and gets less for it than anywhere else in the developed world. A shocking number of people lack easy accessibility to even basic medical and preventative services. Costs are skyrocketing and it's coming home to roost, affecting not just patients and hospitals but even our competitiveness in the business world as the marketplace goes global.

Lots of things are public goods -- roads, the airwaves, telecommunication networks, etc. We know from practical experience that doesn't mean the private sector can't be part of the solution. But it does mean there needs to be an appropriate investment in government oversight and regulation to make sure the public interest is being met. It does mean we can do better in spreading the cost of care out so nobody has to worry about financial ruin from an unforeseen emergency. And in some cases it might even mean the government is in competition with the private sector -- if the really believe competition is good for all, they should say, "Bring it on!"

It means we accept the premise that "being human" implies a certain level of shared responsibility within our society such that people are cared for and we are honest and up front about what it takes to do that. I grow tired of critics who use personal anecdotes like "My dad suffered from XXXX and spent however long in the hospital and was taken care of even though he is poor and nobody that wants treatment in America goes without..." when we all know damn well that the cost of his dad's treatment was made up through accounting tricks and overcharges to other patients. And whatever "dad" says, we all know people who have suffered because of inadequate care.

There is no free ride, let's be honest, but let's create an infrastructure that's above board and prevents people from falling through the cracks. Sully's right, the rich by definition will find a way to do what needs to be done, but this isn't an issue because of a fraction of a percent of the population. It's the rest of us -- and our nation's economy -- who are driving the discussion.

We get the usual whining about "socialized medicine," but there are myriad systems out there, and there isn't a single meaningful definition. Having lived in Europe, I know full well there's no pot of gold at the end of the health care rainbow. But at some point quantifiable results have to enter into the picture, and, whatever system they have adopted, a common feature is they spend less per capita and get more in terms of lower infant mortality rates, lower rates of lifestyle diseases, longer life span, etc.

We don't have to endorse every single policy in every single country to recognize they're doing some things right, and we'd be foolish to not learn from them where appropriate.

Of course, the Darwinian capitalists, the insurance companies, the pharmaceutical companies, and many others have a vested interest in keeping things the way they are. But the principle of a safety net is ingrained well in the civic consciousness. People "get" it. They understand why it's appropriate and even necessary to have the kind of society we want to live in. What we haven't done well is figure out how health care ties into that.

Recognizing the nature of the discussion is that of health care as a public good is an essential first step. But just as important, we have to do a better job holding our elected representatives’ feet to the fire. What are their plans? How do they propose to move forward?

A lingering lesson of the Hillarycare debacle is that it isn't safe for candidates to address health care head on. That needs to change. We should demand better.