Debating health care in 2008, day 2

Saturday, February 09, 2008 by Dave Winer.

Yesterday's piece on health care and the presidential election got a great response, and some of it from Republicans, using the slogans and logic I hoped they wouldn't.  

But that's okay, it helps me focus my rhetoric on the precise point of disagreement, and hopefully by illuminating it, I can either convince some of them to come over to my side, or help eliminate some of the confusion on both sides. Or maybe it'll just keep the argument from slopping over into all kinds of irrelevant issues. 

The basic Republican argument goes like this. Why should I pay for the health needs of people who are so irresponsible as to not have health insurance.  

If I got it wrong, please set me straight. 

Now I'd like to answer this, very carefully. 

The Democrats aren't proposing that you should pay for the uninsured. Key point. They either agree with you, or know that they're not going to get their proposal passed unless they take this into account. The Obama plan says you don't get care unless you have insurance. His proposal aims to get a lot more people insured. Clinton goes one step further, by requiring everyone to have health insurance.  

Also, you already pay for the health needs of the uninsured. Whether you or I like it, we don't look the other way when someone is in need. You may feel the system should work differently, but that's not responsive to the proposal the Democrats are making. 

The debate is how health care works for the non-indigent.  

If you have property, a car, a house, or if your kids go to private school or college, or if you want to take a vacation, or have a baby, or exercise between jobs, getting sick without insurance is a sure way to go from being middle class to being poor, quickly. This is why we have health insurance, to smoothe out the risk, to protect our family's lifestyle. It seems to me it's a good thing. It's the market solving a basic human need.  

So this is what we should be discussing, how can we get insurance for all the people who want it, or should we require it for everyone -- this is the debate of 2008. This is what the Democrats are putting on the table, and what McCain, or whoever is the Republican nominee, will have to respond to, if we're going to have the respectful debate everyone is talking about having.  

Why is this such a problem?  

A lot of people, even healthy people without pre-existing conditions, can't get health insurance. And what if you have a pre-existing condition? Do you really think it's cool for the insurance industry to refuse them coverage? Why is that a good thing? I honestly don't get it. Consider the penalty for not having insurance. (See above.) 

So far the leaders of the Republican Party have managed to keep health care off the national agenda, but this year, it's there. If you doubt me, just ask a few people you know, and don't just ask poor people or Democrats, ask Republicans. Disease isn't a party issue, and while poor people tend to have poorer health, even well-off people need health care. And most people can't afford to pay for a catastrophic illness, and enough of them can't get health insurance to make this an important national issue. If you disagree with this, please let me know why. 

PS: Phil Windley asks where it stops. Should we provide free housing for the homeless? And what about free cable TV for people without cable TV? (He provides other examples.) No, this is only about health insurance. It's not about any of the other things mentioned in Phil's post.