It’s your health

Weigh in on health-care reform as if your life was on the line

Chuck McIntyre is a Sacramento economist and author

Never mind the 50 million Americans who have no health-care coverage. Those of us who do are also desperate for health-care reform, if only because we fear waiting hours with a serious injury or illness in the overcrowded emergency room and forking out increasingly higher deductibles and co-pays for care.

The logic of reform is simple. Health care is a mixed private and public good. I benefit from my own good health and willingly pay for it, but I also benefit from the good health of my neighbors and should willingly chip in something for that as well. Since I don’t have a vehicle to do that, government steps in and facilitates the process.

It’s not “socialized medicine,” it’s good sense. I willingly pay taxes for the Centers for Disease Control and Prevention to help keep my neighbor from infecting me with swine flu, for the National Institutes of Health to research a cure for my impending Alzheimer’s disease, for the Food and Drug Administration and the public health service to keep flesh-eating bacteria out of my chicken wings and beer, and so on. I’m even willing to pitch in for Medicare, Medicaid and a “public insurance” option that keeps workers healthier, at work and out of the ER, and, therefore, reduces the price of the goods they make and I buy.

The politics of health-care reform, however, are more complex. That’s because reform is opposed by Congress members whose political campaigns are underwritten by those who profit from the current system: health-insurance companies, drug companies and some medical practitioners. Some more ideological opponents cast the choice as either “our present ‘capitalist’ system” or “Canadian-type ‘socialized’ medicine.” The reasonable choice is neither.

A Canadian recently told me about his friend who was suspected to have a life-threatening illness. Having no “private option” would force him to wait seven months for the confirming MRI; he reasonably chose to come to the United States and pay for an immediate MRI. We need a “broader private option,” was the Canadian’s conclusion.

My response is that we need a “broader public option” for our 50 million uninsured in the United States. Obviously, some compromise system is necessary.

Still other opponents argue that President Barack Obama’s proposal doesn’t cope adequately with the ever-rising costs of health care; therefore, it’s not real reform. That’s a more complex issue. U.S. health-care costs may exceed those of other developed countries because we utilize far more advanced technology, more treatment procedures, more outlays in the last several months of life, and put as much as one-fifth of our expenditures into insurance processing and other administrative overhead expenses. Each of these problems has different moral, ethical and economic considerations; they require distinct solutions.

Health-care reform, if it happens at all, will not be “perfect,” whatever that means. But reasonable observers agree the current system isn’t sustainable. If you’re concerned, let your senator and representative know how you feel; you can bet the insurance companies are doing so.