Life, liberty and the pursuit of health care for all

Can universal health care conform to American values?

doctor 248.88 (photo credit: Ariel Jerozolimksi [file])
doctor 248.88
(photo credit: Ariel Jerozolimksi [file])
America, the land of opportunity, was settled by individuals seeking a new beginning. Hard work, determination and individualism were at the core of American values. Alexis de Tocqueville during the early 1800s described the American nation as hard-working individuals enjoying unprecedented dignity in comparison to the deeply embedded aristocratic class system of Europe. Government was created to be small and efficient. But over the course of time, views on the role - and size - of government in America have been transformed. With universal health care once again in the foreground of the public debate, the American people must ask themselves some serious questions about the values upon which America was built: whether universal health care can conform to those values or, conversely, whether American values can conform to universal health care. AS AN American citizen living in Israel, I admittedly do not have to face the consequences of health care reform. Nonetheless I feel entitled to express my opinions on the subject because the principles involved have universal applications. When you simplify the health care debate down to its most elementary level, it seems to be centered on an argument as old as government itself: What is the role of government? The Obama administration has stepped up government intervention during the current economic crisis, thereby increasing the national debt to monstrous proportions. We have seen the government bail out everyone from insurance companies to auto manufacturers and make similar offers to broadband carriers. In defense of the government's actions, if we have learned anything from this economic crisis, it's that a free market lacking in government regulation results in irresponsible speculation, as was the case in the banking and real-estate sectors. It is too soon to tell if President Barack Obama's mixed economy will lead to sustained economic growth and a healthy economy. Government, when utilized effectively, can be a force for good. But government is not the most logical health care provider. In 1966 the American government spent 1 percent of government funding on Medicaid and Medicare. By fiscal year 2008, that figure rose to 20%. What with US GDP totaling some $14 trillion, an additional $1 trillion-$2 trillion spent on health care over the next 10 years is a significant bite out of the national wealth. The US already spends approximately 15% of its GDP on health care. Compare that to the approximately 8% of GDP that Israel spends on socialized health care and you realize what a startling amount that is. And yet, as many of the critics of the current health care system point out, there are roughly 45 million Americans without health insurance. Alternatives to Obama's health care plan have been suggested. One of those that I agree with - and that I believe better suits the values and needs of the American people - was suggested by David Goldhill, in his article "How American health care killed my father." in The Atlantic. Goldhill suggests reducing, rather than expanding the role of insurance companies and having the government focus on services that only it can provide; protecting the poor, covering against unforeseen medical emergencies, enforcing safety standards through regulation and ensuring provider competition, thereby relying on the consumers as the ultimate guarantors of good service and reasonable prices. So what went wrong? Basically American government was relatively small and efficient until the Great Depression, but poverty and unemployment on a first-time mass scale forced it to take serious action in order to quickly alleviate the suffering of American citizens. These quick fixes led to the formation of Social Security, unemployment insurance and, in 1965, to Medicaid and Medicare. One of the greatest critics of Medicaid, Ronald Reagan, went as far as saying, "One of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free." In contrast to the social democracies of Europe, the US has proven exceptionally successful in creating a seemingly paradoxical society where an entire nation reaps the benefits of individualism, yet slowly but surely, individualism as a virtue in the US is on the decline. Who is to say that the American people are not responsible enough to determine their own health care needs? Through creating a system where health care is viewed as a product and the American public as the consumer, this system will better conform to the values of American society, instead of American society conforming to universal health care. The American health care system is already disproportionately expensive and its costs will continue to rise with the universal health care proposal. More importantly universal health care does not conform to the American ideal. Somewhere along the way the assertion of Thomas Paine that "the best government is that which governs least" was lost in past and present governments' rush to solve the ills of American society. After serving in the IDF's Nahal Reconnaissance Battalion, the writer graduated with a BA in government from the Interdisciplinary Center, Herzliya. He lives and works in Kibbutz Sasa.