You use the term "common funds" inappropriately imo. An insurance company's funds aren't "common funds" owned by society or even by the policy holders. They're the insurance company's funds.
True, but I think they are effectively the same. The company's funds available for paying medical bills come from premiums paid by policy holders. The amount of those premiums goes up or down based on how much the company has to pay out. So the net result is exactly the same as if the company was paying with the common funds of the policy holders. The pot of company money used to pay bills is the pot contributed collectively by the policy holders. Works pretty much the same as any collective. Just has an insurance company as the middle-man.
If health "insurance" operated in a true insurance paradigm like car insurance, then I would agree with you. For those of us who have individual health care policies, I do agree with you. But for almost everyone the paradigm is not one of insurance but one of the collective. Most of us get our health insurance though our employers where all parties are covered equally. That is no different from Medicare where all parties are covered equally. Or Canadian medicare where all parties are covered equally. The monies used are common monies doled out by some authority according to some schedule. The differences among them are details, not principle.
You're implicitly accepting a defacto socialist outlook imo.
I don't think it's socialist to recognize reality. There is private property and then there are resources of value that are not owned. Air, for example. Fortunately with air there is plenty of it, at least for now. We can breathe it in at will without anyone having to ration it because it is not scarce. Some water is not owned; some water is. There have been feuds and lawsuits and wars over water because it's a scarce resource in high demand, at least some of it is. Society sets up various authorities to ration it when necessary. I suppose you can call that socialist if you want to but, unless there is another alternative, which there doesn't seem to be, I don't see how you can deplore it. If something is inevitable, it may be unfortunate but it can't be wrong. "Wrong" requires a better alternative.
Health care isn't a "scarce resource" ... Not free though.
Exactly. Health care isn't scarce. Money to pay for it is. Which means it gets rationed. It's either rationed based on the individual's ability to pay or it's rationed by the holder of the collective pot of money available to pay on behalf of the members of the collective.
An insurance policy almost certainly isn't written to accept "anything" its almost certainly written to cover normal, effective and reasonable treatments. There may be disagreements about what is normal, effective and reasonable but thats something that can be worked out either via negotiation, arbitration, or litigation.
The process of getting that "worked out" is what we're going through now. Some folks consider the input of bioethicists and economists factors in the determination of how best to ration the funds. Do you think that there would be no economists and bioethicists called to testify during arbitration or litigation? There would be just as they are being called into this national dialog that's going on. Some may discount that input but the input is still there.
Everything that's covered by a policy is covered. Its shouldn't be an issue for "society" ie government to decide.
If tax money is supporting one's Medicare policy, then who decides what is covered if not government on behalf of society--the recipients and the tax payers? For employee plans, the employer plays a similar role. It's the employer's money so the employer makes the decisions but the employer will keep in mind the expectations and demands of its societal microcosm, its employees. If enough employees complain about something not being covered, then the policy will most likely be modified to cover it. The bottom line is that whoever holds the pot of money juggles the various interests and determines how to ration the pot.
Health care isn't commonly owned property like a city park.
I am no expert on property law but a city park isn't "owned" in the same sense that the cash in your wallet is "owned." That is mostly a term of convenience. Private property and public property are different concepts. Public property like parks are a subset of "the commons."
From Wiki: "Public property is property which is jointly owned by a whole community of individuals or by a non-communistic, dictatorial, or totalitarian government, as opposed to private property, which is owned exclusively by an individual or individuals jointly that do not constitute the whole community.
In the modern representative democracy, "public property" is synonymous to state property, which is said to be owned by the people as a commons."
Anything with a shared pot falls under the general paradigm of "the commons" in terms of how it works, thus how we need to think about it. That includes tax monies supporting Medicare and group health insurance. There is no private property in the commons. The rules of private property don't apply. Rationing is an inevitable part of the paradigm of "the commons." |
