The reason why we can’t have a health care system that covers everyone, some members of both political parties tell us, is that some of us already have pretty good insurance coverage. (At least, we think we do, until we file a claim.)
And that if anyone else is to have sort of what you have, you’d have to have less of it. And that would be bad.
So, in order for me and my family to stay healthy, and not go into bankruptcy in the process, you and your family have to be at risk, sick, broke or dead. And that would be OK.
It’s early yet. But I’d rank that as the most morally reprehensible argument of the 21st century.
Yet it is the idea that the entire debate seems to be turning on.
An early version of Barack Obama’s health care reform package included a public option, a way to buy your health insurance from the federal government if you thought that was a better deal. Sort of Medicare for All Who Want It.
Calling it an “option" suggested that it would be, well, optional. And Obama stressed that by saying, often, “If you like your health care plan, you can keep it.”
Which became the PolitiFact Lie of the Year. Because the Affordable Care Act that eventually rolled out — without a public option, because insurance companies wouldn’t tolerate the competition — did set standards that some old policies did not meet. If you had one of those policies, it got cancelled.
Maybe you were a fool to like the health care plan you had because it was a piece of junk that would leave you holding the bag for thousands of dollars in costs you couldn’t pay.
Still, it was the coverage you had. And the idea of the mean ol’ government taking it away really stings, even if it was demonstrably for your own good.
Now, as a score of Democrats try to score their party’s nomination for president, the question is whether to save Obamacare, add the public option that Obama wanted all along, or move on to the kind of not-optional public option favored by Bernie Sanders, Elizabeth Warren and, sort of, Kamala Harris.
None of which will be an option unless they beat the incumbent and his repeal-and-don’t-replace Republican Party. So some Democrats, and some of the journalists who make a living badgering them, worry that any plan that smacks of taking anything away from him that’s got in order to give to him that don’t is a political loser that will be denigrated as “socialism” by guys like Utah’s Rep. Chris Stewart.
By socialism, of course, they mean anything that isn’t dog-in-the-manger selfishness based on the idea that being decent human beings is just more than we can handle.
When reformers point to Canada and European Union nations as good examples of how to do health care — nations that irrefutably provide more access and better outcomes for a fraction of the cost — those standing athwart progress raise the bogymen of an influx of previously uncovered patients that will make it harder for you to get an appointment.
Which means that if it is necessary for this guy I don’t know to die, or that lady I will never meet to spend all her retirement savings, in order for me to see a specialist in three weeks instead of eight, well, they should have thought of that before they decided to be poor.
It’s not exactly like the T-shirt philosophy, “Equal rights for others doesn’t mean less rights for you. It’s not pie.” Because health care, sort of, is pie. But, with a system that is created to serve patients, and not a system that is designed to take your money, we’d have a lot more money to bake a lot more pie.
Yes, First World health care systems are run by human beings, so there are things wrong with them. Rural areas and poor neighborhoods can get shortchanged. Even in the best of systems, demand can outstrip supply.
But nobody with universal health care wants to give it up. The baldfaced lie that leaving the EU would make Britain’s beloved National Health Service financially stronger was a big reason why Brexit passed. The rise of anti-immigration populism throughout Europe is anchored on the fear that a flood of poor brown folks will over-tax those nations’ prized health care systems.
Which it might.
But when they defend their health care systems, they are defending systems that serve everyone, as they define the word, from interlopers. When we defend our health care system, we are defending a system that serves a shrinking share of our citizens from a growing portion of our citizens.
George Pyle, editorial page editor of The Salt Lake Tribune, will be eligible for Medicare for Himself in two years and two months. Good luck to everyone else.