Health Care Debate part 1

I’ve been meaning to write comparing British and US health care for a while, but it’s not a very easy topic to get around. However it is the main subject in the news these days so it’s about time I weigh in.

The most emotive piece I’ve heard on the radio this week was from one of many ‘town hall’ meetings (I forget which). A sobbing woman says, “The president is trying to make us like Russia. I don’t want America to be Socialist!”

Of course, being me, this leaves me thinking, “but why?”. The speaker obviously thinks ‘Socialist’ is a ‘bad word’ – I don’t. (I’ll leave aside the debate over whether Russia is really socialist any more). Since the quote doesn’t give any more reasoning, I’m left to wonder what this woman is actually opposed to – she clearly feels strongly about it.

Unfortunately, to me, the opposite of socialism seems to be selfishness. Selfishness in health care seems to lead to a situation where you are fine while you remain healthy but if you are unlucky enough to get sick you’d better hope you can afford it. A lot of illness isn’t selfish, by the way – the flu is happy to spread fairly to all people, given the chance.

In practice paying for US health care is somewhere along the selfish/social scale. As companies or organisations buy group insurance plans, they form small pockets of socialness. The only reason insurance works is because it spreads the cost across a group of people, with the assumption that not everyone will suffer illness. So people who pay insurance premiums and are healthy, are necessarily subsidising the health care of people in the same group who are less healthy. That sounds like socialism to me.

Of course, the American argument is that people have freedom of choice about what insurance they buy, or don’t buy1, and that the current debate is about the government taking away that freedom. I need to think more about that, so maybe more later.

1 I live in Massachusetts, and it is mandatory for people here to have some kind of health insurance.

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