Saturday, August 30, 2008

A NeoConservative Arguement in FAVOR of Universal, single-payer health care!

If bloggers could win Pulitzers... this post would be on the short list.

Just in case you are too far to the right to ever dip a toe in at Echidne's place, dig this. I sincerely wish I'd written it myself. I know, as from time to time I've tried various aspects of the argument out, to little avail. So I shall merely cheer-lead.

Skylanda, one of several high-quality writers holding down the fort over at Echidne of the Snakes has written a piece (one of a series) on the issue of health care that needs to be read by every literate citizen. Illiterate citizens are encouraged to plead with literate persons in their households to read it aloud to them.

Today, you’re going to hear something new and different. Today you are going to hear this bleeding heart, tree-hugging, west-coast, San Francisco-born, ivory-tower progressive make a neo-conservative argument. Free market, pay-your-own way, private enterprising, classical neo-liberalism. Hold on to your wallets, we’re going for a ride.

This argument concerns the question that underlies everyone’s hesitation with heath care, no matter what your political orientation: how are we going to pay for it. Covering every child, woman, and man in America is an expensive proposition, and paying for it is the key stumbling block between dreamy idealism and real movement forward toward universal health coverage.
A tall order, one would think. She pulls it off with the grace of Billie Jean King beating Bobby Riggs in the rematch.

Anyone who wants to answer this question - from the most laissez-faire neo-liberal to the farthest left socialist - needs to understand one thing, and one thing alone: we already are paying for it. No health care economist disputes this one common understanding: Americans pay more - per capita and as a percentage of our gross national product - for health care services than any other industrialized nation. And for that sacrifice, we cover less of our people, we live with the gripping national fear of health care insecurity, we measure out at some piss-poor rankings on standard outcomes measures like infant mortality and childhood nutrition. We pay more money for the great privilege of getting less health.

Pulling these three forces into alignment is - in this one opinion - key to founding a sustainable, affordable version of universal coverage that Americans can live with and thrive on. And here is the sinking realization that should haunt every American when it comes to health care: we already pay too much for too little. We are getting the rawest end of the deal in the developed world. We now have a choice: we can continue to bury our heads in a very expensive sort of sand and believe that a fractured system with ever-increasing premiums is working to our advantage, or we can start to wonder what would happen if we took all that cash - that enormous chunk of the GDP now wrapped up in health care - set it all into one collective system, redistributed without the skimming of profit or the redundancy of hundreds of parallel systems, and set about planning a rational health system for the next fifty years. Could we do it? It would be one of the toughest, most contentious enterprises America could take on…just a hair less tough and contentious than our current health care system, I would wager.

But, you say, would I have to pay higher taxes?

Well, that’s a good question. I submit that if you are paying insurance premiums in America today, you are subjecting yourself to one of the most ludicrously progressive tax schemes on the planet. You may consider yourself middle class (or otherwise), but the public good known as the nation’s health is resting on your shoulders - not only are you contributing directly to the private pooled premium fund, you are also paying federal taxes to support others on the Medicare-Medicaid axis and a variety of other programs. And if you are not paying health insurance premiums, it’s time to buck up and do your share - in the proportion to which you are able, so that you may draw resources that you require. There is only one way to accomplish this: taxes.

If you worry that only the wealthy, the documented, or the honest will pay their fair share? Well then heck, make it a sales tax - no one walks the American soil without buying something. If you want to ensure that every person stepping foot on American earth deserves their fair share of the health care pie because they contributed their piece, sales tax is probably the most thorough (though probably not the most equitable) way to do it.

And if we paid for single-payer health care out of an increased tax, what would that buy you to make it worth your trouble? You could do away with your health care premiums. Stop wondering if Blue Cross is going to double your deductible this year just for the heck of it, or triple your premium because you just found out that persistent nagging cough is severe asthma, or deny your coverage because you had that condition before your employer switched plans last month. You would buy portability, security, and predictability - ratcheting the stochastic impact of health care costs out of your emergency budget. And if you get what you expect out of a single-payer system, you actually have a voting say in who stays in office to guide the system - unlike your coverage today, where you only have a voice in Blue Cross’ policies if you are a major stockholder. And remember, head for head, every other developed nation in the world - by controlling the profit motive and the redundancy issue - has managed to pull off some form of access that covers more of the population for less cost than we have. We are already paying the piper; now is the time we demand that the piper hand over the goods.
An argument worthy of space on Lew Rockwell. (And I went to the extent of sending them the link.)

One thing I learned well in debate class is that if you can make an affirmative argument from several contrasting viewpoints, the odds of it being a solid premise go way, way up. That makes this a very important bit of argument indeed. One can make the same case rather easily from a Progressive Libertarian viewpoint, but for most Libertarians, the Neo-Liberal argument is close enough for government work, though I would add that without universal, transportable health care, one's freedoms and liberties are being unacceptably compromised, in terms of individual choice and freedom to choose varieties of employment and calculated, creative risks. Worse yet, it's not even arguably due to an economic compromise. We can indeed afford that degree of liberty, since we are actually paying for it. Therefore, who and what is getting in the way, and why have we not done something about such an obviously violent trespass against our most basic liberties?

Ok. Go read the whole thing at Echidnie's - so I get the traffic props. :P

Then please, drop by her blog - Loose Chicks Sink Ships - and subscribe to her feed, like I did. I think she's gonna be worth keeping an eye on.

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