November 12, 2008

Universal Health Care


Universal health care is, in its purest form, obviously, a proposal to give everyone in the universe health care coverage.

It has recently been watered down to only apply to Americans. Why is this?

If you think we should have universal health care in this country, why do you think it should only apply to Americans? And if you say it's because Americans are the ones paying into it, do you approve of our progressive tax system that requires the wealthiest Americans to pay for much more of it, while people who pay no income tax could potentially get healthcare benefits for free.

If they can, why shouldn't wealthy Americans be forced to fund it for people outside America, too?

17 comments:

Tim said...

We already pay for other people's retirement income as well as unemployment income. Why shouldn't we pay for everyone to have healthcare as well? I don't know about the rest of you, but I LOVE watching around a third of my income fund other people's lives.

Jeff said...

The philosophy behind Universal Health Care is simply that everyone should be able to see a doctor and receive the medicine or treatment they need, regardless of their economic means. Since there is no universal governing body with the authority to finance the inherent costs or dole out the treatment, its proponents obviously lobby the political system in which they live.

This is no different than any other political issue, so I think the premise of this post is merely a semantical one.

However, if you want to debate health care policy, I'd happily argue in favor of a universal health care for the U.S.

I'll go on to advocate on behalf our progressive tax system.

First of all, the percentage of people who pay no federal income taxes has been wildly overstated. This statistic also ignores the property taxes, sales taxes, capital gains taxes, state income taxes, and any number of other local taxes. Secondly, John Rawles' "Veil of Ignorance" theory best explains the thinking behind a progressive income tax (and I'm grifting from a West Wing episode): Imagine before you're born you don't know anything about what kind of education you'll receive, where you're born, what natural abilities you've been blessed with, or who you'll be. Now design a tax system. Wouldn't you tax the people who have benefited most from the system and who can spare more of their disposable income?

Anonymous said...

What about this theory:
Imagine before you're born you don't know anything about what kind of education you'll receive, where you're born, what natural abilities you've been blessed with, or who you'll be. Now, how will you decide to spend and allocate the resources YOU are given?

Jeff said...

Anonymous,

I'd work hard, try to get an education, and spend whatever resources as best I saw fit to take care of myself and my family and improve my life. But that doesn't mean I was born with equal opportunity.

It's easy to turn a blind eye and say "Every man for himself," especially if you were born into a middle or upper class family with two parents, provided with a quality education, and had a network of people that helped support you.

But in the absence of such circumstance for everyone, government can be an instrument that helps the least well off to succeed. It's not the solution to all of life's problems, but a progressive tax policy is a modest means to recognize this inequality that greets us at birth.

Sabai said...

the semantics was more of a satirical intro, Jeff.

my intention wasn't to debate what the best health care would look like in this country, or to question whether government "can be an instrument" for good or that "lobbying the political system" isn't the quickest way to get it done.

i'm questioning the constitutional means by which we believe we have the right to use taxpayer dollars to offer it.

Jeff said...

What would be unconstitutional about a universal health care policy?

Sabai said...

10th Amendment: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

So, in order to declare that the Fed has power to fund/regulate healthcare among the states, we need to find that power delegated to them elsewhere in the Constitution.

I'm still looking.

By the way, anonymous' question is awesome.

Jeff said...

The Commerce Clause (Article 1, Section 8, Clause 3): Congress has the power to regulate commerce with foreign nations and among the states. Connected to this specific power is the general power "To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof."

Love it or hate it, we have all kinds of New-Deal style federal programs like Social Security, agricultural subsidies, minimum-wage laws, child labor laws, and Medicare that were created under this defense.

I'm not a constitutional scholar by any means, but it is easily argued that the health of the people and the commercial transactions related to medical care fall within Congressional oversight under the commerce clause. Especially when 47 million of its citizens are uninsured, driving up medical costs for everyone, when medical costs are the number 1 reason for bankruptcy in the US, and when millions of businesses are faced with skyrocketing insurance costs that our foreign competitors are not burdened with.

Sabai said...

it's not about me loving it or hating it.

I think that's actually where the problem lies. We don't question the constitutional authority of certain legislation, because we are happy with the effectual benefits of it.

it's a dangerous precedent that we have already set with every Department of _____ we've created, under the defense of "interstate commerce", which is entirely unconvincing.

Jeff said...

I agree that there should be limitations to the scope and responsibility of the federal government. And there are real dangers to expecting the federal government to have a hand in every part of our lives. I share your concern about government sticking its nose where it doesn't belong and its a slippery slope (note that on other issues we'd probably be on the opposite side of this concern).

But on the issue of national health care, I believe there's a constitutional basis and a precedent for arguing in favor a law that would establish a system.

I'll also make two other arguments unrelated to the constitutional one:

1) I think access to health care is a moral imperative, regardless of one's income.

2) I believe it's in our economic interests to establish a national health care system, as I think it would create a more competitive insurance system, lower costs for everyone, and allow American businesses to compete with countries that provide insurance to their people. A great example is the auto industry -- the cost to GM to provide health insurance to its workers is more than the cost of the steel to make the cars. Cite: http://tinyurl.com/5zrpkk

Meanwhile, Japanese automakers do not face this added cost, and can import better cars at a lower cost to American consumers.

Sabai said...

note to your note: you're wrong. you've just been away too long to have noticed. glad to have you back.

The moral argument was met by anon's revision of your question. If you believe it's a moral problem, is it your responsibility to step up to the challenge, or to make it illegal for others not to?

Sean said...

Good ol' universal health care for the U.S.A. What a concept. I think that it would be a great idea for everyone to have access to health care and they will be able to come to any hospital and receive care and leave without a bill or a bill that they can handle.

The reality of the situation is that there are a variety of ways ANYONE can receive health care with little to no cost already in place.

I went to a clinic with my wife at one point and the cost for evaluation was $35 and we had medication for $4. For $39 my wife was relieved of discomfort and she did not have insurance. This happened when we are both in school were below poverty level income.

Other places to go are free clinics where my sister has been before, which the cost there is $0. Often medication are given to these clinics by pharmaceutic reps to MDs and then given at no cost to the patient. How about that $0 for medical treatment? But these clinics are tax subsidized or fully funded by taxes already.

Now what happens if I get hurt and have no means of paying? Well, in Illinois I can go to the ER, and may have little or no cost for treatment. Some hospitals have charity cases.

Really the point is, health care is available for most everyone in some form, maybe not the best but it is out there. Also, there is MedicAid. Finally, if everyone is so concerned about universal health care allow the people that feel that way and 'have disposable income' to donate to places to assist with medical costs for people that do not have money to pay.

Jeff said...

Well, it's good to be back. I know I'm outnumbered here, but I'll keep taking a crack at changing some Sabai readers' minds.

I don't believe that the re-framing of the "Veil of Ignorance" to put it on individual responsibility does anything to solve the problem (or even really acknowledges the problem).

Like I said, it's extremely easy to take on the mentality of "Well, just pull yourself up by your bootstraps." This kind of Social Darwinism is a nice way of looking at the world because it removes any burden of a social contract between citizens. But it requires putting your fingers in your ears, closing your eyes, and pretending like the problems that exist for other people don't affect you in anyway.

Health care and the rising number of uninsured Americans is a prime example of a massive, societal problem that impacts everyone, whether or not you choose to acknowledge it. Sean, I understand your point that people can go to clinics or emergency rooms if they have to, or we can point to charitable foundations to fill in the holes, but that ignores that this kind of approach doesn't work well (and isn't currently working well) when you're trying to take care of 300 million people. Like I said, roughly 47 million people (or roughly 1 in 7 Americans) are uninsured and costs related to medical bills are the most common cause of bankruptcy in America.

Here's how it affects you and me: when those people get sick, they often try to avoid a doctor for lack of the money to pay for it. Often they put it off until the situation is so dire they have to go to the emergency room, which is dramatically more expensive (the old expression 'An ounce of prevention is worth a pound of cure' is appropriate). The hospital will still treat them, even knowing the person will be unlikely to pay. But the hospital still has to make payroll for its EMT's, doctors and nurses, so it finds the money elsewhere -- charging more for each procedure and allowing the insurance companies pick up the slack. The insurance companies aren't going to just take on the cost, so they turn to their customers and build in higher premiums, deductibles, and cover fewer and fewer procedures to limit their exposure. You and I end up paying more or our employers end up cutting back on coverage.

If we had a non-profit national health insurance program as an alternative, it's conceivable that millions of these people would have sought out more affordable insurance and avoided that whole cycle. Or maybe our employers would seek out a governmental insurance provider to lower their monthly premiums. This could force the highly profitable insurance companies into a more competitive environment, where they might lower costs for the rest of us or improve their coverage to keep us as customers.

So that's my economic argument.

My moral imperative argument is much shorter: everyone should be able to see a doctor without the fear of losing their life savings. Donating to charity won't fix this problem (if it did, we wouldn't be facing the scenario we are in right now).

Sabai said...

noone is arguing that the answer is "pulling yourself up by your bootstraps", or that a non-governmental answer would provide better or faster effectual results.

My argument is simply that i find no constitutional allowance for the federal government to take taxpayer money and fund a nationalized healthcare plan.

chris said...

Jeff! Sabai gained a reader for your side while you were gone :) Welcome back!

Sabai said...

i reject the notion that are only two sides to political thought, and the notion that we are on opposing sides. I know many things that I agree with both Chris and Jeff on

That being said, I am very glad when people question the thoughts posed here. It would be very boring w/out a wide variety of opinion, and we would all learn a lot slower.

so, thanks to all of you, for making us questioning why we believe what we believe.

sean said...

I like everyone else believes that it would be great if everyone had health care. The means at which this occurs is what is most bothersome. If we are to force the wealthy to continue to pay for the rest of society, what is the encouragement for people to become wealthy? If I was to make millions of dollars but then I am taxed like crazy to pay for programs that are very wasteful, that would make me rather annoyed.

The only way that this can be achieved is by the markets of the insurance companies. Although an insurance company's main objective is to make money, I am sure just like the "Chillary Factor" of the 1990s that insurance companies across the board will start to offer low cost forms of coverage with policies that cover a lot of preventative medicine and MD visits. This will happen if the president-elect goes after universal health care during his term. Would universal health care really save us money? I am surprised at the bureaucracy of MediCare and now this will add millions more government aided individuals costing billions of dollars in overhead, let along treatment costs.