The Case For Universal Care

TW: This piece makes a case for universal care. I do not necessarily agree with this piece entirely, but I strongly favor universal care. Will do a little fisking.

From Avia Orenstein in the Bloomington Herald:
"I attended the Sept. 2 town hall forum on health care, and I was distressed to hear a young woman ask: “Why should hard-working people like me be required to pay for someone else’s health care?”...as Rep. Baron Hill replied, we do in fact already pay for others’ health care.......her question seemed fueled by misinformation and mean-spiritedness as well. As was readily apparent from the moving stories offered at the town meeting, “hard-working” people are not being served by the current system. Although some people at the forum yelled out “get a job,” certainly they, too, must recognize that the working poor (those who serve us at chain stores or restaurants, for instance) are trapped in an untenable system in which health insurance is simply not affordable.

Joining the working poor are people who work for small business, people who have lost their jobs in this tough economy and people with pre-existing conditions. Was the questioner really willing to accuse someone with a congenital condition of being lazy? I can only hope she was merely misinformed."

[TW: Here in rests a challenge with the current debate. The original question implies several things but one is that universal care is at least partially if not primarily about care for unemployeds and the poor. It is not. Poor folks have Medicaid, those over 65 yrs old Medicare both of which involve others partially or wholly paying for their care. If folks do not like re-distribution, then attack Medicaid and Medicare . This current debate is about creating a structure by which health care is available for the working poor, the lower-middle class and those who end up launched from private insurance due to recission or pre-existing conditions. Universal care is about making the American workforce more mobile where portable health care benefits are real, where folks can move jobs without fear of losing legacy health care benefits despite pre-existing conditions.]

"...I assume that the questioner would not be heartless enough to have us turn away a critically ill individual at the emergency room; under our current system, this approach for treating preventable illnesses and conditions ends up costing everyone significantly more than the preventive care available under universal health insurance.

No bubble is vast enough to insulate ourselves from the effects of others’ lack of health care. Our economy and our well being depend upon a healthy work force. We need our baristas to have paid sick days, or, when forced to work, they’ll sneeze the foam from our frothy drinks.

If our kids’ teachers aren’t compensated with good health coverage, our children’s education will suffer hand-in-hand with every teacher who is ill. Facing an H1N1 outbreak, we don’t want fellow citizens to choose between paying rent and getting medical treatment. In short, we are simply too interconnected not to ensure the cost of others’ health care...."

[TW: This is the argument that universal care will push folks away from more expensive forms of acute care and also introduce less expensive preventative care. This is true if not compelling to most as the cost is somewhat clear and the benefit far more nebulous. The argument that unhealthy folks create negative externalities is also relevant if also not particularly compelling for the same reason. Providing universal care will cost money to claim otherwise is wrong, perhaps not as much as some claim but it will cost something.]

"There is a greater issue here that transcends economics and enlightened self-interest. Health care, like food, shelter, education, free speech and the ability to marry, is a basic human right.
Since the beginning of human existence, we have relied on one another for companionship and help. No person is an island, and no person deserves to be cast away on one, especially someone who is sick and in need of care.

A key expression of our humanity is that we care about those outside our own narrowly drawn circle of friends and family. We don’t owe each other luxurious vacations, and I accept that some hard-working people in our capitalistic society will earn much less than their more financially successful fellow citizens.

But there are certain basic decencies that our humanity demands. Caring for the weak and sick among us is one of them; it’s nothing less than a moral
imperative..."

[TW: Health care as a right? Enumerating new rights gets many folks up in arms for good reason. I do not see such an enumeration as a necessity for universal care. It is the "right" thing to do without being a "right".

Americans are when push comes to shove and given our considerable wealth not willing to let folks suffer and perish without systematically strong health care (I think...).

Americans sense health care is different than other products and services and should be available to all at some level. Right now we have a system with a donut hole of sorts. The wealthy, the poor, the elderly and most in the middle get care but there is a significant and growing group of folks in the middle who do not. Those within this donut hole may get acute care and some charitable care but they do not get systematic care at levels equivalent to those outside the donut hole. Do we have challenges paying for universal care? Absolutely, but they are by no means insurmountable. Our health care costs challenges exist with or without universal care, closing the donut hole is a step in addressing those challenges systematically.

Finally, to me those who oppose universal care for those in the donut hole should if they are intellectually consistent oppose care for the poor and elderly as well.]