Things That Are True About American Health Care

I've been sitting on partial posts on the subject of health care for some time. Whether because the debate has reached a head [AP] or because I'm too tired, at this late hour, to polish any more but too wired to sleep, I have decided to lay some ideas on you.

Here's my first principle:

1. As long as I pay my own way, it's not your business. But if I ask you to pay, it becomes your business.

This angle lays bare a critical difference between health care and free speech and the problem with the rhetoric of "rights." Sorry, fellow Barack Obama voters: health care is not a right; it's a privilege. What does it mean for me to have a right to something that costs money I don't have? If I have a right to food, and I don't have any, but you do, do I have a right to enter your home and take some of yours? But back to health care specifically:

If I can pay for the care I get, it's not your business, and it's not the government's business, what kind of care that is or how much it costs. Health care is like any other good or service in the marketplace: the buyer and seller agree on a price. I might be a dupe, and I might strike a horrible bargain for myself. That's my problem; it's not your problem.

But the very moment I ask for one thin dime from someone else, I lose any entitlement to my "don't ration my health care" soap box. If I'm bleeding out in front of you, but I'm flat broke, I'll bend my rule just a little bit and declare that it's reasonable for me to expect you to pay to bandage me up. But the cost of those bandages is very much your business.

But let's take things a bit further. If I eat nothing but doughnuts, breakfast lunch and dinner, I'm a lot less sure that you owe me the cost of my diabetes medication. If I'm 104 years old, and I have a heart condition in addition to my lung cancer, and I'd like that experimental cancer drug that might or might not add 6 months to my life, but I can't pay for it, I'm not sure you owe me that drug either. You definitely don't owe me that MRI I asked for because my kid came down with a case of the sniffles. I drive a 12-year-old Chrysler, and sure, I'd really like that new Toyota with the traction control and six airbags -- it would be a heck of a lot safer; it might even save my life one day. But you don't owe me that either.

Of course, you are paying my way. You're paying for my emergency room visits [Washington Post]. You're paying for my Medicare [Entrepreneur.com] coverage. And of course, you're paying your own way too, whether you get health insurance from your employer or not, because sooner or later, all of those costs trickle down to you and me, buddy. And those costs are probably too high.

2. As a country, we don't get enough health for our health care dollars.

Personally, I don't find it particularly interesting that the United States spends more per capita on health care than any other country. Smart people with different goals can disagree about what dollar amount, what percentage of one's personal income, or what percentage of a country's GDP constitutes a reasonable investment in good health. But what I think everyone should agree on is that, whatever we spend, we ought to get a good value. In the United States, that's not currently the case, as least not overall. Whether in terms of life expectancy [UC], preventable deaths [CBS], or any number of other factors [Economist], we lag behind many countries that pay a good deal less for health care than we do.

3. Improved health can spur economic growth.

If you're healthier, you'll miss work less. Our company will do better, and we'll both be more likely to get a raise next year.

If you're healthier, you won't get me -- or my kid -- sick, either of which will make me have to miss work myself.

If you're healthier, you'll have more money to spend on the widgets I've been trying to sell you.

If I don't have to worry about losing my access to health care, I can leave my dead-end job and develop that great idea I have.

As an employer, if I can share the costs of my workers' health care, like my competitors in other countries can do, I can offer my goods more cheaply.

4. There's a lot of political momentum behind health care reform right now. Let's take advantage of it.

If you'd like to see more people able to afford their own health care, then you agree that there's a problem to be solved. If you think you're paying too much for other people's health care, then you agree that there's a problem to be solved. If you believe you're paying too much for your own health care, without getting any healthier, then you agree that there's a problem to be solved. If you think that American competitiveness is at stake, then you agree that there's a problem to be solved.

A lot of people with the ability to reform our health care system are putting a lot of skin in the game to see that reform happens -- not just in government, but in the businesses too [LA Times], large and small [Nancy Pelosi]. Now would be a good time to work with them [AP] to solve these problems.

The liberal guy leading the charge [Barack Obama] has taken the most liberal proposals off the table [SinglePayerAction.org], annoying a lot of people in his own party. Now would be a good time to compromise.