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George Pyle: Spencer Cox and Mitt Romney say the quiet parts about health care and families out loud

A Better Way

Spencer Cox said the quiet part out loud.

Well, technically, it was the spokesbeings for the governor’s office, the Utah Department of Health and TestUtah, that collectively let the cat out of the bag. But it’s the same thing.

Asked why the TestUtah program of rolling out COVID-19 tests for all comers didn’t stop to bill anyone’s private insurance, or their Medicare or Medicaid accounts, the answer was simple and honest. Perhaps more honest than was intended.

Health insurance gets in the way of health care. If your first priority is a healthy population, a healthy family or a healthy individual, you don’t make either the patient or the provider slog through a system of codes, forms, rejections, appeals, co-pays, deductibles and limits.

Those are what health insurance is, things that aren’t health care at all. At best they are cost containment or cost sharing, structured to benefit the insurer, not the patient and not the provider. And not our society as a whole.

I’ve never been comfortable with the expression that health care is a human right. You know, like free speech or due process of law. Health care is a public good, like public schools and fire departments and libraries. So good are those things that, in any semi-civilized society, they are by default available to all, regardless of ability to pay.

Stopping to check a patient’s health insurance information makes as much sense as the 911 dispatcher asking the number of your homeowner’s insurance policy before she rolls the fire engine. That’s why any nation we would regard as First World doesn’t do it.

I’ve heard a couple of news broadcasts where a BBC reporter in London is interviewing an American doctor or health care wonk, and trying to explain to a Brit how the U.S. health care system works — or even make the argument that it works — is always a confusing event.

TestUtah was, and is, funded out of the boodles of cash the state has, and will, receive from the federal government as part of the assorted waves of coronavirus relief. It has had its share of problems and there’s still no evidence that it was necessary to create it in a state that has a humming health care establishment.

But the public funding angle is what you do when health is more important than money. When you are dealing with a highly communicable disease, the fact that testing one person is a benefit to the whole society is obvious. But that’s true of all health care.

It’s why people who have crunched the numbers conclude that Medicare for All would actually be cheaper — billions of dollars cheaper — in total national health care costs than the existing system.

Mitt Romney said the quiet part out loud.

The U.S. senator from Utah has honestly explained that the purpose of his proposed Family Security Act, which would send monthly per-child payments to most American families, is to encourage people to have families, by making it easier to support those families.

Other Republicans, including our other senator, Mike Lee, are opposed, arguing that it would discourage parents from working. A strange attitude for people who are supposedly pro-life and pro-family, as it asserts that it is more important for Mom to flip burgers on the late shift than help her children with their homework.

Opposition to both publicly-funded health care and publicly-funded child support rises largely from what has always been in the way of First World status for the United States. It’s the deep-seeded fear that some of the benefits will go to Black and Hispanic people, a fear so strong that a lot of white folks are willing to live in sickness and poverty themselves rather than give a hand to the undeserving poor.

Romney began life as a high-rolling businessman but, if you count running for and being governor of Massachusetts, running for the U.S. Senate (twice), being a senator, running for president (twice) and running the 2002 Winter Olympics in Utah, he’s got about as much public sector experience as anyone.

He merges the two worlds by understanding, and promoting, the idea that if you want something, you have to pay for it. Bain Capital Romney may be comfortable with the standard American conservative idea that rich people are fools if they behave in socially responsible ways without being rewarded. But Sen. Romney doesn’t argue that poor people should be expected to engage in socially productive behaviors without compensation.

Personally, I think it’s downright creepy that the government would encourage an increase in the birthrate. Our economy will do just fine without it, if we stop being afraid of all the immigrants who are clamoring to come here and work their tails off.

But however many children we do have, we all benefit when those families have financial and emotional support. And Mitt Romney says we all should pay for it.

(Francisco Kjolseth | The Salt Lake Tribune) George Pyle.

George Pyle, opinion editor of The Salt Lake Tribune, is six months away from Medicare. The rest of y’all are on your own.

gpyle@sltrib.com

Twitter, @debatestate


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