Now I'm a libertarian at heart, and I believe that the government should only stick its hands into things that are completely necessary. However, like I explained in a previous article, there are some things where I believe the government should handle things. In that article I talked about farm subsidies. In this one I'll talk about healthcare.
When the founding fathers put together this country, "healthcare" as we think of it today didn't even exist. What healthcare there was was comprised of heroin, mercury, and leeches. (A bit of an overstatement but not far off the mark.) Nobody understood the behemoth costs associated with the modern healthcare establishment. And as such they didn't plan for it within the constitution.
There are two things I believe put healthcare squarely in the same category as roads and libraries: healthcare is usually unexpected and unrefusable. You cannot plan ahead for cancer. It strikes out of nowhere. You cannot refuse treatment for cancer. If you do, you die.
Now what about insurance? Surely that should solve the problem! But here's the rub: insurers are not in the game to benefit you. They're there's solely to make a buck off of you. This is okay when you're choosing between kettle chips and crinkled chips at the store--when you buy from a normal company, you have choice. But when you need lifesaving surgery now, the insurance company doesn't have your best interests at heart. If you think of the healthcare system as a whole, insurance is a vampire that sucks away resources from the most vulnerable when they need support the most. In a world without insurance there are less people who are asking to get paid.
The main argument that I hear when people disagree with nationalized healthcare is that it is of inferior quality. When the government pays for everything there is no incentive to improve, no incentive to do things better. This may be the case, yes. But Americans are paying out the wazoo for this "privilege." The question one must ask is this: do we support a system that systematically destroys the lives of those who use it through massive quantities of medical debt; or do we support a system where a number of people who qualify for life-saving surgery won't get it in time because of medical mismanagement and overload? I don't know the numbers here but if anecdotes from people living in the UK and Canada are anything to judge by, then this really isn't much of a problem at all.
Near-mandatory insurance for an American who wants to not die from an unexpected cancer diagnosis is something I do not think benefits the person or society. Insurance is scummy. Everyone knows the cliché of the slimy insurance salesman. Why do people believe that medical insurance is any more moral?
The government, at least in Western nations, wants to help you. Like, they want you to be alive and like them so that you vote for them. While this paradigm is reversed almost everywhere else, when it comes to healthcare, the government really does have your best interest at heart. (Not because they're paragons, but because they want you to be alive and voting for them.) And the government is used to footing huge bills with little chance of return on investment. I'd rather pay the government what I would pay in insurance through taxes than pay a scummy insurance company who only wants to use me as a long-term investment. When designing economic and societal systems, one must not use a blanket idea on every individual point of that system. Because healthcare is sudden, unexpected, and impossible to say no to, it falls further into the category of public infrastructure than private enterprise.
Now, the production and research of medical equipment, technology, and medicines? That I believe should be privatized. Because a hospital can choose which MRI machine it buys. The government is footing the bill, but the military industrial complex really shows what can be achieved when the government works hand in hand with private contractors.
Sure, there is a ton of pork, but the average citizen gets all the benefit without any of the "cost." (Cost in this question is more of a situational effect. Taxes, no matter how draconian, are fair and predictable and never actually leave individuals destitute. In the Western world at least.) In the same way that your average citizen can no longer afford to pay for their own national defense (Can you buy a Bradly IFV?), the average citizen now has a hard time paying for medical care because, frankly, it's become so intensive and dependent on extremely sophisticated technology. When hospitals are run under a national healthcare system, the priority becomes saving you. In an American hospital today, the priority is making a buck off of you. I'm happy to have a car company making a buck off me--they earned it and I can make a choice at my leisure. But when I'm at the mercy of the doctors, I want not only them but their entire system to have my best interests in mind.
So how do we go about doing such a thing?
Obamacare is stupid for one reason and one reason only: they're trying to emulate the insurance industry when they're the bad guys and their model sucks ass. It would be easier to just bill the government for everything. Minimal copays. The same way the government pays for a road or a tank. Straight out of their pocket without any of this insurance bullshit. Lawmakers need to understand that the government sucks at emulating or competing with the free market. When you can buy traditional insurance, and the only alternative is regular insurance but government, of course the damn system would fall apart. Stop trying to run the government like a business. Treat it like the gigantic bureaucratic nightmare that it is and just stop trying to compete with the free market. Kick the free market back an integral and be the only interface between the regular citizen and their involuntary healthcare.
What do I mean when I say "back an integral?"
Well, in math, an integral is a function derived from the area under a curve--or to put it in terms local to this argument, "one step removed, yet still dependent." The military is back an integral from the free market. The government foots the bill, and hires the personnel, but the free market actually does the hard work of building tanks and stuff. There is still a free market here. Companies are still motivated to do the best they can in the most efficient (or job-creating) way. I propose that healthcare also needs to be moved back an integral and an individual who has involuntary medical needs does not need to ruin their financial future with no recourse except "you should have picked better insurance." And what if he had a preexisting condition anyways? And was denied the best insurance? A government doesn't care. Its pockets are deep.
How will a government pay for this? The American government is no budget king, but how will we find the extra money to pay for all this medical care?
Let me introduce you to "Medical Security." It's like social security, but for medical care! You pay a certain amount out of your paycheck and it goes to a fund just like social security. What makes this different from regular insurance? The government! They don't care about making a profit! All they care about is keeping you alive and happy so that you'll vote for them! See, the government is a tool. It has things that it does well, and it has things that it does terribly. The government sucks at a) making boots and b) designing new footwear. It can't innovate with any regularity. It's bulky, ponderous, and obese. But it has bankroll for days and an interest in the happiness of its citizens. And, crucially to this argument, it doesn't give a damn about profit.
I do not believe the current president, Biden, has any balls at all, let alone the balls to push this kind of groundbreaking legislation through. A president will have to be seriously beefed to actually manage to shift the entire American healthcare industry. There's a lot of vested interest everywhere in this behemoth of a rotten cow. The insurance companies won't like being shut down, so they'll lobby. Any red state conservative who a) blanket hates the government and b) has never had a life-shattering medical emergency with the debt that incurs will knee-jerk vote against this legislation. So the president who pushes this through will have to be strong and clear-headed. And there are a million ways to screw this up. A million and one, probably. Like Obamacare. That was a fiasco that was caused by Obama being too tame, trying to surgically insert universal healthcare into an already-dead corpse and hope that revives it. What we need is a defibrillator. A pig's heart that has been genetically engineered to work in humans. We need drastic change.
And, crucially, we need this change without the liberal baggage that comes with ideas like it. I do not believe in universal healthcare because I want people to feel good. I place the independence and self-reliance of the individual above all else. But what happens when you can't rely on yourself? When your own self is damaged by nature or accident and you can't bootstrap your way out of it? What happens when your family is left straddled with life-changing amounts of debt even after you caused them immense pain by dying anyways?
This is what the government is for. Government and free enterprise should work together (back an integral) to satisfy the real needs of the people. Spread the shock. Healthcare is not a right; it is infrastructure. Just like electricity and bridges are not a right; they're infrastructure. They serve the same purpose. Improve the lives of those using it without trying to gouge them for money. Let the government foot the bill and pay the private companies in your place. The government is a tool, a dangerous one, but when used correctly it can build great things.
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