A popular sentiment regarding health care is that unlike other goods, we simply cannot tolerate differences in consumption based on income differences. Having a rich guy with a 90-inch plasma TV as compared to a poor guy suffering with a 36″ cathode-ray tube TV is not nearly as intolerable as the idea that if both a rich guy and a poor guy waltzed into an Emergency Room with a gunshot wound (OK, gurneyed in) and the rich guy was able to secure emergency surgery before the poor guy.
Health care is just different folks say. It is unethical to allow rich people to buy emergency surgeries before poor people can get them. To which I say:
The fact remains that even if we morally agreed that equal access to health care is a reasonable goal, it is not achievable. But it is not at all clear to me that there is moral unanimity here too.
I haven’t heard the argument so much for “equal” healthcare as much as I’ve heard the desire for some minimum standard. Should people be turned away from the ER for a GSW or whatever malady they present with? Society has a difficult time answering anything but “NO!” to that question. Once you’ve pushed that cost onto the hospital and thus other patients/consumers, it’s really not that far to get to ACA.
In my mind, the question is the line of demarcation between those who can afford to pay for what they want and those who are cast down among the plebeians to work within the government-sponsored system. Increasing access (i.e., demand) drives prices up, making it so fewer people get access to the “premium” healthcare. Ironically, this exacerbates the distance between rich and poor in terms of what that really means for how you live your life. Ultimately, the top 1% can’t be touched, but we can make it so those sitting at say the 75th percentile live much more like those in the 25th percentile than the 90th percentile.
I know and have known many medical doctors, some dear friends, one a dear uncle, and enough less close, but respected all. They do not distinguish between rich and poor, never have, when someone ill comes before them. The first thought is to do no harm, and the next is to decide what to do.
Yes, there may be stories counter to my experience, but I have never, ever, encountered any doctor who has not thought of his patient first, period. I do not think that is dumb luck.
Now, the other day I was talking to a friend who said he would not schedule a colonoscopy for a Wednesday at 10AM with his GI doc, because we both know he tees off at noon and might rush the examination.
But this is not about rich or poor, it is about good scheduling.
My responses to those that suggest level delivery for all users of medical services is best:
– there are 2 things more important, the vast majority of the time, than medicine: food and shelter (including clothing) – making them much better talking points than consumer electronics. By the standard argument these same people should be heavily campaigning for food and shelter “insurance” and related services doled out by a bureaucratic team, to ensure that no-one receives better food or shelter than anyone else. If they perk up and think that rationing food and shelter are great ideas, trotting out Soviet food and shelter allocations, and wartime rationing, generally will get a thoughtful response.
– in a transaction where money is not the deciding point for who gets the best/goes first – which I generally concede might be nice for argument’s sake – something else will replace money in that transaction. As it is in Canada, money is replaced by bureaucracy, influence and connections, meaning that the well connected – not necessarily the well heeled – often get preference over those without. Then the debate over whether an unaccountable bureaucrat (toss in cautionary stories about taxes, child services, et al) is necessarily better than a transparent market occurs.
These can both be delivered politely, and if you’re not going to force your co-conversationalists to change their minds immediately, you can plant the seeds.
Watch out, Todd. They might dream up a national “insurance” program for that, too. How about National Tort Insurance?
Or college road trip insurance (covers beverages, gas, and major medical, including sex and disappointment counseling — free)?
Hey Harry – you’re right, there’s always an opportunity to drag the whole damn conversation into crazy town. If that happens, I just look around for another drink.
That said, I have talked to actual humans that have advocated for coercion in something like experiential (e.g. college road trip) “insurance”, back-stopping bad decisions and prepaying for others. Nutty.
White people don’t have to worry about having health insurance.