Heal Thyself?
When it comes to our health-care crisis, some argue for market-based solutions, saying that
by Elizabeth Edwards
Last March, after I gave a speech in downtown Cleveland, a woman, pressed and dignified in a business suit, leaned over and whispered in my ear. “My name is Sheila, and I am afraid,” she said, her face softening. “I am afraid for myself and for my children. I have a lump in my breast, but I cannot get it checked because I have no insurance.”
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In the landscape of the health-care debate, two very different paths lie in front of us. Which one we choose will speak volumes about who we are as a nation and what values we hold dear. Our choice will determine what we say to women like Sheila—whether we say, “We are with you. Your challenge is our challenge too, and we will help you face it,” or simply shrug and say, “Sorry, you’re on your own.” That’s the moral choice we face today and which path we walk down is up to us.
This decision tends to get obscured by the feel-good language that certain politicians use when they talk about health care. Too often, the fuzzy language of compassion and inclusiveness masks harsh policies that would make our current health-care crisis worse. In this political season, it’s critical that we understand what politicians are really saying about health care, so that we can make an informed choice.
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LET’S START BY examining what proponents of market-based solutions mean when they talk about giving families and individuals more freedom to choose the plan that’s right for them.
They call it “consumer-directed care,” the goal of which, as a scholar at the Heritage Foundation recently put it, is to “expand personal ownership and control of health insurance and transfer the control of health-care dollars to individuals and families.” That might sound good, but what they’re really saying is, “You’re on your own.”
What they don’t tell you is that in order to get the control and freedom they promise, you have to give up your employer-sponsored care and enter the individual market. Once you do that, you are literally on your own to deal directly with the big insurance companies and drug companies. In addition to having to navigate a whole new forest of corporate bureaucracy, the kicker is that in those negotiations, you and your family would have far less leverage than larger entities with more buying power, such as businesses or the government, have today.
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Personally, I think the notion that people splurge on health care fails the laugh test. I don’t know about you, but I’ve never heard anyone say, “Sorry I was late for dinner, Elizabeth. I got the urge to swing by the doctor to have X-rays, a CT scan, and unnecessary blood work done because I was bored.”
NOW THAT WE understand what is really meant by “individual markets” and “consumer-directed care,” we can ask the larger question before us: Do we, as a nation, believe in insurance or not? The principle behind insurance is risk-sharing—the idea that healthy people with lower risks and lower cost should subsidize care for sick people with higher risks and higher costs.
We do this in part because the reality of life is that while you may be in the healthy category today, you could land in the sick category tomorrow—and because of factors out of your control. You could get hit by a bus or have something else happen that requires urgent care. God forbid that should occur, but if it does, you’ll be really glad others are pitching in to subsidize your costs.
We do this for practical reasons, but we also do it because it’s the right thing to do. Our society is based on the idea that we’re all in this together. If you’re born healthy and disease-free, great. But others are not so lucky, and part of your responsibility as a member of this society is to help them out.
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http://www.sojo.net/index.cfm?action=magazine.article&issue=soj0808&article=heal-thyself