George Pyle: All health is public health

(Francisco Kjolseth | The Salt Lake Tribune) Crews set up three tents for drive through testing for COVID-19 outside University of Utah's new Sugar House clinic on Saturday, March 14, 2020. The in-car testing facility will be open to the public Monday but requires a call to be screened ahead of time for those exhibiting symptoms.

Opposition to universal health care in the United States, whether its Medicare for All or some other scheme, flows from the belief that public funds should not be used for a private benefit. (Unless the person receiving the benefit is already rich. Or a senator from North Carolina.)

That has always been flawed thinking, as events of the last several weeks should have made blindingly clear.

Health care is not a private benefit. It is a public benefit, and it is both logical and just to pay for it with public funds.

As the COVID-19 virus oozes across the world — suggesting that Mother Nature perhaps wants her planet back, or at least to get our attention — it becomes more obvious than ever that human health is a public concern. That not just public sanitation and epidemic control, but also doctors and nurses and hospitals and labs, are a public good for which all should share the burden and the benefit.

We have long known that some functions of our health were a job for the public sphere, beyond the reach of the individual to control or cure. Piping in clean water and piping out the dirty. Making sure that food and medicines weren’t contaminated. Making highways and cars safer. Promoting and providing vaccinations. Regulating the practice of medicine. Limiting what people and corporations can dump in the water or into the air. Picking up stray and dead animals. Maybe even, dare we hope, limiting access to weapons of war.

All of those are tasks we assign to the public sector to guard the health of each person.

Of course, even if the government is good about doing all that stuff, your good health is not assured. You still have your part to do. Your diet. Your exercise. Keeping up with vaccinations and visits to your doctor and avoiding unhealthy behavior.

Both the public and the private needs must be seen to. If one is neglected, the other becomes much less effective, if not altogether pointless.

Absent major epidemics or other big threats to public health, though, most health issues have become individualized. We commoditize and and monetize health care to the point that it is just another commercial transaction, or series of commercial transactions, strictly between a patient and a provider, or bunch of providers.

But as we have invented and concocted all manner of life-saving and life-prolonging stuff, which get really expensive, we move away from the kind of free market experience we have at the grocery store or the car dealer and collectivize the cost. We invented health insurance plans that, in theory, spread the cost over many people, on the not unreasonable theory that not all of us will be sick at the same time.

But the capacity of these plans to really keep us all well, to keep up with the rising cost of everything, and to make obscene profits for a few managers is withering fast. Because the goal of the insurance companies is to make money and keep itself afloat, not protect the general public or even its own members, risk pools are shrinking, out-of-pocket costs are growing and even people with insurance face large, if not bankrupting, costs.

If this were only bad for scattered individuals, people who weren’t lucky or smart enough to pick a better insurance plan, or have it picked for them by their employer or union, it might just be one of those things. But health care isn’t, never was, and never will be an individual matter.

The Age of COVID-19 is an extreme example of how every one of us is affected by the health of people we don’t know. But the whole system is like that. It is, always has been and always will be, in your own enlightened self-interest that everyone in your community have access to health care. Real health care, not just vaccinations or mending a broken wrist. But routine care, screenings, dealing with chronic conditions, chemotherapy, the works.

If we join the First World and create a system that provides health care for all, that is to the benefit of every single one of us. Whether we are rich or poor, healthy or sickly. Even if we aren’t dealing with a highly contagious disease, we still benefit from living around people who are not suffering, not forced to skip work or school, not falling into bankruptcy and dragging down the economy.

And we all benefit from a robust health care system, with the well-equipped and fully staffed hospitals that even rural areas and inner cities will have because we paid them forward.

George Pyle

George Pyle, editorial page editor of The Salt Lake Tribune, thinks his health insurance should pay for a recuperative trip to Ireland when all this is over.


Twitter, @debatestate