A nation's health care system reflects its morals

There is a simple explanation why there are so few GOP health care plans and why the existing ones are dismissed out of hand. The reasoning goes like this:

Health insurance companies are criticized for refusing to insure certain people or for readily canceling insurance. But they can't be forced to take everybody until everybody has insurance. Otherwise people would wait until they are sick to buy insurance.

Not everyone will have insurance until they are required to have insurance.

You can't require everyone to have insurance until you provide subsidies for those who simply can't afford it.

If you provide subsidies then one of three things must happen: (1) the federal deficit goes up, (2) other government spending is cut, or (3) taxes go up. And the GOP hates all three of those options.

I give Newsweek credit for chutzpa for giving their cover article the title, "The Case for Killing Granny." Evan Thomas reports that the sickest -- thus costliest -- patients are in the last couple years of their lives. Most doctors go for heroic measures up to the moment of death for basic reasons. They are trained to preserve live and they get paid for each action they take. But at the end of life that isn't best for the society as a whole or the patient. About 70% of patients don't want to die in a hospital, yet about 50% do. So perhaps we shouldn't kill off Granny, but we should certainly recognize when continued efforts are pointless and allow Granny to go in peace.

The very next article in the same issue of Newsweek says that the character of a country can be determined by their health system. Author T.R. Reid explains:

Canada provides free and timely care for acute conditions. For something not urgent the wait may be long, but the wait for a rich person is the same as that for a poor. Health care doesn't go to the highest bidder, but to all. That matches the national character: egalitarian and thrifty.

East Asian nations that practice the teachings of Confucius expect doctors to treat patients for free. They make their living by selling medicine. Naturally, they overprescribe the medications they sell.

Italy makes sure you never see a doctor's bill. France requires a cash payment, even though insurance will reimburse two weeks later, just to make sure you know money is involved.

France justifies coverage for all by saying some people are beautiful or brilliant and some aren't, yet when we are sick we're all equal. Americans say we're all equal, but we're not. The Swiss stress we're all in this together and our community demands all must have equal care in spite of the stroke of destiny. Not exactly American rugged individualism. This concept is basic in so many places it is in many national constitutions and in the European Charter of Fundamental Rights.

In Britain, they admit, "We cover everybody, but we don't cover everything." Rationing? Perhaps. So is America's method of rationing based on ability to pay or be insured.

And America? Many around the world wonder why we haven't figured it out, especially because we claim to be so smart. Out of the developed countries, only in America are there medical bankruptcies, only in America is care sold to the highest bidder, only in America do people die from lack of care. What does that say about our morals?

Here's one answer to that question. I've written before (long enough ago that I don't want to search for it) about one of the prominent themes of conservatism, though not one that anyone would actually claim. The way it was worded before was something like this: prosperity is an indication of good morals. If you're poor you are morally inferior. If you couldn't afford to get out of New Orleans before Katrina, you deserved to die in the flood. Another take on it is the Prosperity Gospel: If you follow God's commandments God will bless you with riches. Of course, that gets turned inside out: If you aren't blessed with God's riches you aren't following God's commandments and therefore deserve to be poor. And the latest flavor: That you need help is proof that you don't deserve help. Heartless.

Put in context of health care: If you can afford health insurance (or pay for care out of pocket) you are worthy of the good health you can get. If you can't afford insurance you don't deserve good health. Therefore it is a waste of my money to pay for your medical expenses because you don't deserve what those treatments will do for you. Call it America's mean streak. It isn't confined to health care.

For the record: This particular definition of morals has completely missed the mark.

Another component (mentioned in previous posts) is racism: I don't want my tax dollars going to help Those People.

What kind of country do we want to be? What kind of health care will reflect those ideals?