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An Exercise in Perplexity

We have to begin somewhere.  Let us begin here: 

We spend twice as much as any other developed nation while trying to provide health care to our citizens.  At the same time, every one of those other developed nations has a longer life expectancy than we do, and a lower rate of death at birth. 

Ouch! 

Let us put the waste argument aside.  Every system has some waste and fraud.  The job is to step on it when we see it.  Hard! 

Government is what people devise to organize their affairs as they increase in size.  Even small, wandering bands develop customs and mores and rules about what must, and what must not, be done.  Large societies necessarily require large governing systems.  Even Libertarians call the police, and expect city water, and for someone else to train the doctors they think they provide for themselves.  Most Libertarians would rather not educate their own children:  they are too undisciplined. 

Our economic system is heavily weighted toward mass capitalism.  Economically, we more-or-less choose how we want to build ships, make cars, raise pigs, and provide health care.  It is part of our philosophy that private enterprise can do anything better than public servants can.  The Bush administration even thought that people should provide their own "social security"; that is to say, take their own money and invest it in the stock market.  Yes, sir!  Government will steal you blind, but AIG is on your side.  Bernie Madoff is on your other side. 

Health care is expensive.  Part of what makes it cost us twice as much as it costs anybody else is that we pay insurance companies to manage how we get health care.  They cannot provide that service for nothing!  Of course not!  They have to have agents, and computers, and bonuses!  Thinking of our best interests, they deny coverage to people who are already sick, or who have really bad problems, or who cost them too much money.  After all, the business of insurance companies is to make money for their investors and executies, not to worry too much about public health.  We  worry about health.  They worry about profit. 

Every other industrialized nation has a national health care plan, just as they have public schools, armies, police, fire, road systems, parks, social security, and building code systems.  For the public good, some things are too important to turn over to private enterprise and decision-making.  We have partial public health care systems:  Medicare, for instance.  People like it so much they want government to keep its hands off it!  Go figure!

The health care proposals proposed by the House and Senate were lame-brained.  They were--are--patches on a hopelessly expensive and mismanaged, overly-privatized mishmash. 

A real solution is a single-provider system, a public system, covering everybody.  People who want, and can afford, "Cadillac Health Care" could purchase supplements.  It is so plain!  It is so sensible!  The English, the French, the Germans, the Scandinavians, and nearly every other industrialized nation does it. 

Instead, we protect insurance companies, guaranteeing them customers, guaranteeing them protection, making their big bonuses for not covering everybody, while adding enormously to the cost of the health care some of us do get. 

Health care should not be tied to, and paid for, by employers.  It should be universal, and paid for by our own taxes. 

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