The Great Health Care Debate

I recently participated in an ad-hoc discussion about the "health care overhaul" thingy that was recently passed by Congress and signed into law by President Obama. I put some thought into it, and I figured it would be with sharing to an audience beyond my friend's other Facebook friends. The following is a summary of what I think...

First, some background on my own political philosophy. It's changed over the years. A LOT. As an illustration, I have voted in 3 of the 4 Presidential elections I've been legally able to do so in. The one I didn't was because of .. time concerns? Laziness? Something like that. And each of those 4 elections, I voted for (or would have voted for) candidates from 4 different political parties.

In 1996, I was in college, and all about "independent" stuff, and I gravitated toward the various third parties out there. I was drawn by the Greens, but was more impressed with the rhetoric of the Natural Law Party, who put emphasis on implementing government solutions that have been proven effective (they also had a Transcendental Meditation under-platform, but I ignored that whole thing).

By 2000, I had become a big Rush fan (the band, not Limbaugh), and by extension, a moderate admirer of Ayn Rand (e.g., "2112"). I was all about free society, free economy, all that stuff. I was also in excellent physical, emotional, and mental health, with an very well paying job. I was well off, and I wanted more of the same. So I voted Libertarian.

The early 2000's were a shitstorm for me personally. I won't go into it, but suffice it to say that I emerged from the crisis with a new found spirituality, focused on Evangelical Christianity. I was interested in all matter of Evangelical stuff, including the national Evangelical media (e.g., Focus on the Family). I was looking for a candidate who shared my orthodox Biblical worldview, and I found a willing partner in George W. Bush. (In retrospect, I see how I fell for the Bush campaign's strategy of leveraging people of faith, without necessarily exploring the totality of the Bush's policies as they related to Biblical principles and values.)

2008 was another shitstorm year for me, from which I'm still recovering. My life was a stereotypical country song--I lost my wife, my job, even my dog (though I was fortunate to retain possession of my motor vehicle). My parents were willing to take me in, so I moved back to Lake Mills to be with them. In the meantime, I was questioning a lot of my values, both spiritually and politically. I found myself undergoing sometimes daily shifts to the left. I was becoming less and less convinced of the truth of Evangelical doctrine, and of conservative politics. I went into the election season election with an open mind, and found myself utterly unimpressed with anything McCain said or advocated, and very impressed with most of what Obama said and advocated. I think the deciding moment came during the "forum" style debate when John McCain took a question from a young African-American man, and told him some background about the financial crisis, naming companies like Lehman Brothers, Fannie Mae, and Freddie Mac, and telling him, "of course, you've probably never heard of them before." It so embodied the gulf between older white men in power, and the increasingly complex face of America's younger generations. I voted for Obama.

Okay, so that was longer than I intended. Sorry about that. Anyway, on to 2010, when this "historical" health care has been debated, and now passed. I've developed some pretty strong opinions, and they go a little like this:

My (current) general philosophy is that of community responsibility, which comes in part from life experience, and stuff I've gleaned from various academic sources over the years. I strongly believe in individual freedom, both socially and economically. But I also believe that "freedom isn't free," and that society should make sure that its disadvantaged are taken care of. Individual freedom precludes equal outcome, but does include an attempt at equal opportunity. Ideally, I believe any random human being born in this country should have a chance to make the best life for himself or herself. Hard work should be rewarded, but circumstances beyond a person's control should not hinder him or her from becoming the person he or she is.

In practical day-to-day society, we rely on public institutions for this kind of thing. For most of us, that means the government. There are other resources available to some, such as family, friends, church, and other organizations, but government is what is available to all of us. As a leftover from my libertarian, I generally support a free economy and a free society. Where I differ is when it comes how one's actions affects others in society. I'm not allowed to do whatever I want to do, because doing so can harm myself or others. Economically, I'm not allowed to enter into certain financial contracts (such as involuntary servitude), because doing so can harm myself or others.

In my Economics 101 class in college, I remember a principle that we learned about taxes. Part (or most, or all) of the point of taxes is to provide financial disincentive toward economic activity detrimental to society as a whole--a disincentive that otherwise wouldn't exist within a free market. One example given was public transportation. It's a fact that everybody wants to drive their own car. But if every worker and an urban locale commuted in their own car, the city is negatively impacted by pollution and traffic density. An individual car driver has no incentive not to drive to work. So the local government can (and usually does) subsidize a public transportation system. For every 20 people that take the bus, that's 20 cars off the road, 20 less cars to pollute and create gridlock.

I've seen this principle used elsewhere in public policy, such as public roads, police force, military, and education. These are all things that our society benefits from, but that we would otherwise probably not support as much individually. We benefit from our educational systems, because then kids can learn how to become productive members of society. (Unfortunately, the inverse has also been proven to be true.)

So what about health care? What is it? I happen to view it similarly to education. It's something that everybody needs in order to maintain a certain livable standard. If I'm sick, I can't be productive. Sometimes I can't get better on my own, so I need some help. Where am I going to get that help? That's where I believe government should be stepping in. I think we would get a similar public benefit from public health as we currently get from public education. People would get a chance to get up on their feet and have a shot at being a productive member of society. People who would otherwise not be able to.

I support some kind of public health care system, similar to our public education system. Public schools aren't the greatest, but if you can afford better, you're free to get private schooling. Public health should be the same way. Provide some minimal level of coverage available to all. Preventative care (e.g., regular screenings & physicals) for all, and specialists for those with special health needs. If an individual can't (or doesn't want to) wait for the public doctor to see someone, then they should be free to shell out the $$$ to see a private doctor.

So how about the health care overhaul just passed? I think it's a step in the right direction. It's got some good stuff, and some not-so-good stuff. Obviously, I would have wanted some kind of public option to be in there. But I'm glad that there's at least something in there to help impoverished folks to get insurance. I don't agree with the "mandate" requiring citizens to get insurance--that goes against the individual freedom I value. I've also heard that there isn't much in the bill to get health care costs under control. Beyond that, I'm not familiar enough with the bill to comment much on it. From what I understand, I'm not going to be affected that much by it (if at all). So while I ultimately reserve judgment, I've gleaned enough from news sources (mostly NPR, Google News, and admittedly a smattering of liberal talk show commentary) to generally agree with the spirit of the current health care legislation, to move toward health care being more accessible to the general public.