US Health Care

I could go on at length about what the health care “debate” says about US politics and culture, but I’ll restrict myself to five points:

  1. The health-care bill is publicly available. The language is fairly accessible. It’s long, but given the double-spacing and 50-character line lengths it’s the kind of thing you could easily read in a day. Claims about the bill are easy to check. Most of the claims being made by opponents of the bill are flat-out lies.

  2. The bill leaves the basic US health-care infrastructure entirely in place. It does two things: it sets up an insurance plan provided by the government comparable to, and competitive with, the low-end plans from private insurers, and it says that everybody needs to sign up to some kind of insurance (by punishing those who don’t with a tax penalty). A debate over the merits of a single-payer system, or salary- versus procedure-based pay for doctors, or socialism in general, has no relevance to the proposed bill.

  3. The only real facts that can be debated are the economic consequences of a new competitor in the insurance market: if the government plan covers a lot and is heavily subsidized then private insurers may have trouble competing; if it covers little and receives little subsidy then nobody would choose it over private insurance. Debate on this topic has been completely incoherent: if you’re worried about the new plan hurting private insurers, then the fact that it might not cover certain treatments is surely a good thing.

  4. If you quit your job to start a one-man business (e.g. software developer; web designer; artist; consultant), you could cut most of your costs to almost nothing: move somewhere with cheap rent, switch to a small used car, etc. The cost that will break you in the year(s) before you’ve built back up to a basic salary is health insurance. The US system is a huge discouragement to entrepreneurship, innovation, and the kind of “flexible employment” that the world so desperately needs.

  5. My view is that basic health care is a right in the same sense that basic childhood education is a right. Putting your kids through school isn’t dependent upon the education plan offered by your employer; it’s an unexpected consequence of antiquated tax policy that health care is.