You realize, don't you, how un-helpful that is to someone who doesn't get it and who expects rationales?
And previously….
What exactly it about health care that makes it different from every other key service or commodity?
Let’s start with first principles.
…We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.
Police, fire response, mandatory public education, all these things, for example, are key services or commodities which could be provided by the private sector. They ARE typically provided by the Government because they promote the general welfare. Time and experience has shown they are most efficiently provided by the Government (if the government is run efficiently, i.e., not corrupt). Putting aside the efficiency argument we could go to a pure laissez-faire economic model where only those who could afford to pay would receive these services, but then the general welfare wouldn’t be promoted – only the welfare of those who could afford to pay. That gets you the French or Russian Revolution.
So essentially we have a public policy argument. My public policy argument – my rationale – is the same as that for fire or other public goods. The general welfare is enhanced when citizens are not at risk for catastrophes or force majeure occurrences. (acts of god).
I don’t fear terrorists. I don’t fear “islamofacists.” I fear the loss of my employment which would immediately put me in the position of choosing - without income – between paying the mortgage, and buying food, or writing an annual $16,000 check for health insurance to care for a family of five – assuming for the sake of argument the “private” insurance market will even cover me and my family. So if my daughter, who has only had a drivers license for a year gets into a horrific accident, maybe the system will care for her, maybe not. Assuming they do, I still face the situation where here I am, a middle aged, relatively successful middle class parent, hopefully deemed by my peers as a good citizen, who has probably paid more in taxes than 90% of the population, and my entire life’s work could be wiped out by circumstances beyond my control (loss of job, loss of income) and no affordable private market mechanisms exist to cover that risk environment.
Why?
Profit.
Run the math. On a personal level, 6 months worth of unemployment can easily wipe out 3 years of sacrifice and saving. That’s the Country we’ve become, prostrated on the altar of free market capitalism. And it’s always the individual citizen’s “fault.” (But in every - REPEAT - every single business contract - you'll find force majeure clauses. Businesses cover themselves - but citizens have to "suck it up".)
But that’s on a personal level. Think of it on a macroeconomic basis. Lets say – oh – 3% of the population is hit with events and choices such as this annually. That means that in 10 years time, you’ve wiped out the savings and wealth of 34% of the US households. (Simply – 1.03^10 or 1 plus 3% raised to the power of 10.)
You have created the perfect conditions for permanent poverty of the lower class and destruction over time of the middle class. If we want to be South America, all we need to do is stay on this same road. We’re already half way there.
The “terrorists” killed 3,000 people. (… and I was there). How many of our fellow citizen’s economic lives are destroyed annually by lack of affordable health care. Even if its only 1% that is 3,000,000 people. We have an orders of magnitude problem. While I’d probably agree that wellness care and/or discretionary care are different, catastrophic care is a must.
Again, what does “promote the general welfare” mean?
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