We are going to assume here - for the clarity of the argument - that boh sides
in the current US budgetary impasse are utterly sincere and disinterested. What
is the Healthcare disagrement really about, then. In essence, it is about who gets hurt.
The pro healthcare think the poorest 15 % should have show-a-card access to
medical services, the con argue that current proposals are irresponsible job-killers.
Indeed, the very same who might be talked about in both cases. In these terms,
we really do have an impasse, for our sincere debaters would be morally to blame to
abandon their ideals.
Can the debate be reformulated into an argument about a what. This messy situation
is probably the result of having failed a needed reformulation.
What happens if we make a distinction between health services and medical care. The
health stuff is a state responsibility, and the private sector is free to contribute. Indeed,
unions can negotiate for different treatment rather than for standards!!.
The medical stuff needs to insured, and to the extent that medical bills are a form of unfair
taxation, the government can use the tax system to stabilize low-income citizens.
That is it.
Such a split does solve some problems. Universal health care is a bottomless pit
because sooner or later, eveyone is entitled to a boob job. Medecine, on the
other hand, can be a restricted good, with some priorities: only so many bariatric
procedures a year, so many hospital beds for heart patients and so forth. Heath care
can be different in different areas: California might want to offer weight management
clinics starting at school age, another state might off nutrition counselling and school
breakfasts. One state promotes breast feeding; another feeds young mothers. According
to need, then, and the wisdom of the local political class.
Insurers and professional associations will want medical standards. That is their
respective priviledge. Health indicators can vary across the land, and you can move.
Might work.
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