Universal Health Care as a Moral Question

As the debate over universal health care heats up, the question of the day revolves around this - how will we provide coverage to the uninsured people of America? I'd like to suggest that is only a portion of the real question we face.

In Robert Samuelson's excellent book, The Good Life and Its Discontents: The American Dream in the Age of Entitlement, he has a chapter on how the US transformed from a nation that balanced its budget to one that accepted endless deficits. He talks about the corrosive effect this had on society as it gave an example, the largest example possible, of the benefits of living beyond your means. You could have it all, have it forever and never have to save for it or pay for it. We're now about 40 years down that path and we're dealing with the question of how to provide universal health care when the real question is should we provide universal health care.

Morality is simple when there is only one dimension to the problem. That is, if you run over a duckling on an otherwise carless road while driving slow enough to get out of the way, people can ask you with indignity, "Why did you do that?" That's where we are right now. Since we've decoupled having from earning, everything that the underclass needs can be demanded from society at large as there is no other consideration besides need.

However, if you pose the question this way: "Shall we give health care to the poor and further burden our children with debt or shall we try to relieve our children of the debt we have laid upon them and allow the poor to suffer?" the issue becomes much murkier.

Robert Samuelson himself blasts the President's health care plan, but misses his own point.

The one certain consequence of expanding insurance coverage is that it would raise spending. When people have insurance, they use more health services. That's one reason Obama's campaign proposal was estimated to cost $1.2 trillion over a decade (the other reason is that the federal government would pick up some costs now paid by others). Indeed, the higher demand for health care might raise costs across the board, increasing both government spending and private premiums.

If you change the mindset and approach the problem from an earning point of view, the above excerpt looks something like this.

The one certain consequence of expanding insurance coverage is that it would force our children to work harder and earn more. When people have insurance, they use more health services. That's one reason Obama's campaign proposal was estimated to force our children to earn an additional $1.2 trillion over a decade. Indeed, the higher demand for health care might raise costs across the board, increasing the demand on our children to work longer hours and earn more money to pay for it.

The health care debate is being framed around the wrong choice of words. It's all about costs and how it will raise or lower them as if costs had no connection to anything else in the world. With an existing budget deficit, all of the additional costs will force our children to work harder, longer hours and earn more money so they can pay for what we're trying to buy.

Sitting around discussing this premium or that and how this or that procedure would be covered is a tangent to the real discussion that needs to take place.

How much overtime will the children in our kindergartens and preschools today have to work in order to pay for this? Further: If they will have to pay for our health care, who will pay for theirs?

Singing: Working hard is good for you, it's the thing you've got to do! Work harder and harder every day, because our bills you've got to pay!