Thursday, February 12, 2009

Health Care

For all the talk about the health care reform and the dangers of "socialized" medicine, I wonder why I haven't heard this simple question: Why is it when we dial 911 for emergency services, the fire department comes for free, the police department comes for free, but an ambulance results in a bill?

Of course, nothing is really free. Fire and police services are paid for by our tax dollars. But, really, would we want that any other way? Can we imagine a system where the fire department shows up and demands a credit card before starting to put out the fire? Our how about a police department that can't address an armed robbery in progress because they're responding to a petty vandalism call from somebody with better "police insurance?" Yet we accept as normal the idea that medical treatment, even in emergency rooms, is typically not delivered until billing information is collected. Why do we not hear more outrage at how absurd this is?

How do free market ideologues justify the notion that people suffering a medical emergency will behave as the economic rational actors required for free market principles do be effective? We recognized as a society long ago that emergency situations can not be handled by market principles. Yet for some odd reason we've "socialized" police departments and fire departments, and we've had a "socialized" military since the founding of our country, but there remains a disconnect when it comes to health care.

Here's a further absurdity. We already have universal health care...but only for people over age 65. (Is it just coincidence that seniors also make up the most reliable voting bloc?) If government-provided universal health care is so bad, why do we give it to all of the seniors in society? What makes this arrangement mind-bogglingly nutty is the effect this has on who gets care. Much is often made of how a socialized system requires the government to make choices regarding who gets rare instances involving older people not getting care in favor of a younger person. While this situation is unfortunate, why is it better to subsidize care for a person beyond working age at the expense of not allowing a working age person to receive care? Currently, young working people in America are frequently uninsured. So somebody just starting out in the work-force, possibly starting a family, might not be able to get access to necessary health care. Yet we're willing as a society to make sure this person's grandparents receive health care? This makes no sense. If we can afford health care for those who need it most and are least able to afford it, why can't we, as a society, afford to provide health care for those who are least likely to need it and most likely to repay the costs in their working life?



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