The Underground Man

Is health care a right or a privilege?

I normally give some thought (and time) to the more lengthy posts I make in this weblog but today I'm just writing "off the cuff".

I listened to a fairly long show this am on my local NPR affiliate about health care and the Democratic candidates positions vis a vis a national health coverage plan.

I just got absolutely incensed. I don't know where I fall in the political spectrum of this country (my political compass values are -4.75, and -1.85 which puts me right next to Gandhi and Nelson Mandela, hah!). I feel like I have strong libertarian leanings and am quite fiscally conservative.

Be that as it may three of the four pundits on the morning show were discussing health care plans of the Democratic candidates (none of the top five advocates a single payer plan such as used in modern democracies in Europe) and the fourth was defending the insurance industry's rapacious practices.

One pundit, a US congressman, asked the most salient question in the first five minutes of the show: "Is universal health care a right or a privilege in our society?"

This is a question that we must answer as a society before deciding on further health policy issues such as how we cover the average American (what plan we implement).

Apparently, the US taxpayer/government combination spends an average of $4900 per person to extend what coverage there is in the nation today (with some 40 million uncovered, Lord knows how many "under-covered"). The average European democracy--whose health care systems rival or surpass our own--spend only $2600 per person (Switzerland is the most expensive as one might imagine).

Keep in mind that while I might agree that, funds being unlimited, one could get better care here in the US than just about anywhere else this is not the case for 95+% of our citizenry.

There is a metric from a social democracy class I took in college: if you were unable to choose your position in society, what sort of society would you create to live in? That is, in a society where you cannot be guaranteed a position one that is roughly equal for all participants is the best-case one for the individual.

Applied to health care this explains why fifteen of the other top sixteen industrialized nations have superior health care systems to the United States. The "average" citizen (and indeed, visitor) to their countries can be assured of a higher level of care than one gets here in the 'States. The French think little of going in to the doctor if they are feeling somewhat poorly because they know they are covered. So preventative medicine can be praticed there. Many ailments are detected earlier and are thus treated successfully (I have purely anecdotal evidence of this as I haven't looked it up).

These countries treat health care as a right for every citizen and having made that decision do their best to ensure that every citizen gets a decent level of health care. Yes, for the wealthy, they might still turn to the US for extraordinary services but the average citizen benefits from much better outcomes that s/he would get in the United States.

Here, I have to think twice before visiting the doctor. My coverage is $240 per month (a huge sum while I look for work). I'm nearly in perfect health (mild hypertension), nearly at an optimal weight, and I work out regularly. Never had serious health problems. And I pay a FORTUNE in insurance for a policy that has a $1000 deductible and a lifetime cap of $1 million.

I haven't personally answered for myself whether universal health care is a right or a privilege (in part because of my libertarian leanings) but given the cost to society of a lack of coverage (or an under-coverage), I think the answer has to be it is a "right".

Posted by artandscience at January 26, 2004 01:53 PM