Thursday, September 24, 2009

Health Care Utilities

From a letter to Andrew Sullivan:

I'm an American who has also decided to leave the US. However, it's not because of HIV status. It's because of my concerns over healthcare. You see, my European wife has a chronic disease that worsened soon after we moved to the US two years ago. I have insurance, but with a sick wife and two children, our bills are quite high. Worse, should I ever change jobs, or get fired, I have no doubt our insurer would drop us, or at least dramatically increase our premiums.

I'm a senior exec in a software company. I've always wanted to run my own company, and I have an idea that I think will work.
But we'll move back to Europe before I take that risk. In the US, I just cannot be without healthcare for any length of time. I wonder how many other potential entrepreneurs are discouraged from striking out on their own for this very reason?

I'm constantly hearing from libertarian types who wax poetic about the importance of choice in health care, as though there is some big difference between the insurance options we have (or, sillier still, as though we are actually informed enough to differentiate between them.)

But they never seem concerned about how people are tied to their jobs, unable to leave to do something more productive because they will lose their health coverage. It's important to note that they are not reducing the cost of their care by staying; they are only reducing the cost of their care to them.

Progressives have compared universal health care to public water systems, sewers, fire departments and police. And the comparison is apt. What do all of these things have in common? We all need them. Every single one of us.

Health care is a basic need. Everyone should have access. Can you imagine what the country would be like today if corporations controlled the public water supply?

We would have hundreds of different companies, all using complex and sophisticated billing processes, designed to confuse the drinker. We would have wasteful marketing campaigns, all designed to convince you that one company's water was better than the next's, but you would have no way of testing this. We would have water company executives making enormous profits from water sales, which they would justify by saying that water is too important to leave to the government. We would have a legion of water lobbyists in Washington, fighting every attempt by the people to turn water into a public utility by saying that liberals just wanted to kill people from thirst. We would have the world's most expensive tap water, and we would have corporations that threatened to turn that water off if people couldn't pay. Instead of a simple system which just delivers water to people, we would have a complex system where people worried about how to keep the water flowing.

We must start recognizing health care a universal necessity, instead of some optional luxury. Those in the profession probably can't stand to hear it, but health care is generally a rather mundane business. Of course, there are exciting new things being discovered at the margins, and we should find ways to continue to promote this research. But for the overwhelming majority of Americans, health care is little more than a public utility. And 45,000 people a year die because they don't have access to this utility. Let's free them from that worry. .

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