Wednesday, September 09, 2009

Healthcare: Public Option, the Only Relevant Option

A government is only as good as it treats its citizens. By that standard, America sadly doesn't rank as high as most industrialized western nations. We lack one of the most important services to our citizens and that is universal affordable healthcare. In this post, I will focus on two key arguments for why it is an imperative for the United States of America to mandate a single payer system through the government. The three areas I will discuss are:
1) Nature of government
2) Morality

1) The nature of government and its role in society has changed throughout human history, as it must. All things in nature evolve and so should the government. For most of human history, healthcare was not something that was under the purview of the government and remained a privilege of educated and wealthy. The reason for that is quite simple, most of the population of the world was limited to small villages, towns or cities. If there was a doctor in any of these small communities, it was a local individual who had many a very minimal understanding of the human body. These doctors, well more often than not they were local people using shamanistic "healing", herbalism, homeopathy and other such "alternative" medicines. This method of medical care changed in the Western world around the time of the bubonic plague in which the accepted authority and "truths" of the previous systems was challenged and questioned.

The major breakthrough happened in the 1880's with the discovery of bacteria. Even in that time period, it was not the duty of the government to care for the physical health of its citizens. The accepted notion at that time was that medicine could not make huge changes in the probability of combating diseases, sicknesses and injuries. As bio-medical field grew, in no small part to inevitable acceptance of Darwin's discovery of natural selection, evolution and a common ancestry of all creatures, so did the the ability of the medicine to adequately deal with sickness in an efficient and strong probabilistic manner, it soon became an enormous industry growing day by day. Now, the advances of medicine have the ability to make it more probable that a person will live past 70 as opposed to 30.

These advances in medicine paralleled the necessary growth of the role of government. Originally government was a method to regulate human to human interaction. For purposes of this post, I am not dealing with the role of religion in government as religion's role in government makes the government become more of a "universal" entity with the ability to regulate all aspects of human life. The Enlightment Period of Europe also was the impetus for the eventual disassociation of religion and government, which this country was founded on. Until the late 19th century and early 20th century, government did not have deal with healthcare or the medical field as both were still minuscule industries, if at all. This is in the same vein as social security, anti-trust regulation and so on. Social Security came into existence when the nature of the work force changed, when the world become industrialized the focus became on efficiency and production.

When that focus changed, people were seen as gears or clogs in the economic vehicle, gears and clogs that could be replaced and should be replaced when and if they became too expensive, too inefficient and not able to perform properly. With that change and also the gains in the medical field, which suddenly changed the lifespan of humans from about 40-50 years to 50+ years, the imperative came to provide a way for the workers and citizens to survive in times of need and age. The impetus for this came with the Great Depression, when we discovered that without proper ways to survive, which the private industry would not/could not give as it was focused more on profit and institutional survival, it became a necessity for the government to do so because it became readily apparent that in order for the people to survive and work properly and with hope is to give them some sort of protection and eventual goal upon being too old to work, hence the birth of social security.

In that same rationale, the role of the government must now encompass health care because now the medical and healthcare fields are massive and affects every single human being in this country and planet. Much like equal protection is regulated by the government so that all people have equal opportunity despite their age, race, economic status, religion and so on, so should healthcare not be denied for the same reasons and particularly because of economic status. Now that is my very very brief argument and history of the role of the government and how it must now encompass healthcare.

2) Moral Reasons: Healthcare is now a moral necessity which fundamental is attached to the right to life, property and pursuit of happiness. Life cannot be fully lived and enjoyed without the ability to combat diseases and sicknesses. Any human being who cannot have adequate access to doctors, patient care and medicine cannot live any sort of life in full. Lack of affordable access to healthcare can destroy lives and families both in the immediate sense (the death of people) and in the long term (bills, expenses, bankruptcy). The immediate impact negates the right to life and the long term negates the right to property because people are asked to pay inhumane amounts of money to insurance companies to make sure that they have a right to life, a life worth living.

In America, it is not the extreme poor or wealthy that cannot afford medical insurance but it is the working middle class, who can barely make their day to day expenses let alone any medical dilemma or emergency. Approximately 50 million Americans cannot afford it, that is approximately 15% of the population and that number grows by 12,000 a day, which can equal about an additional 4.38 million people a year. The New England Medical Journal published that in 1999, the administrative costs of healthcare insurance companies across the country was approximately 300 billion dollars, about $1000 per person compared to $300 dollars a person in the public health system of Canada. Remember this is just administrative costs, not actual care.

Furthermore, the goal of private health insurance isn't to actually provide care but to make a profit, the companies are beholden to their shareholders. They do not have any oversight and can charge whatever they wish. The public option is focused on helping people not profit. Healthcare like public utilities cannot be private as it is necessary for people to have in this day and age so that they can survive and be contributing members of society, it cannot be profit driven, it must be service driven. Profit in the health care industry creates a clear conflict of interest and this also goes for the pharmaceutical industry, but that is another post for another day.