In my last post I briefly discussed how our debate about healthcare has mostly been a debate peripheral to healthcare. For example, one assumes that even the loudest, sign-misspellingest teabagging blowhard would prefer to pay less for better healthcare. But unfortunately he got the idea in his head that reforming healthcare will lead straight to fascism, much the same way that pressing D4 will lead straight to a bag of Skittles. It’s much the same attitude as the one my cat has toward going to the vet—he’s really sure something terrible is going to happen. But I think it is worth considering that in the history of civilization, healthcare is still a very new problem and most of us are still unsure how to think about it.

One hundred years ago, no one would even think about paying current rates for healthcare because doctors couldn’t do all that much for us. Certainly, there were doctors and certainly, some of them made a lot of money, but not many of their treatments were very effective. You couldn’t get antibiotics before 1943 so you might die from pneumonia or some minor infection. You might have a grandparent who likes to tell you about that. For that matter, you might have a grandparent who had polio. You couldn’t get vaccinated for that until 1955. If you had a heart attack before 1960, you would have been in trouble because you wouldn’t have been able to get a coronary bypass. Through these and thousands of other incremental improvements, modern medicine can keep us alive longer despite a steep decline in physical activity and quality of food.

All these thousands of improvements are expensive. The costs in terms of education and equipment are enormous. We get a lot more, but we also pay a lot more. But now, the average person can’t possibly be expected to pay for certain kinds of medical care. We buy insurance, but the insurance company takes its 30% profit and then may or may not pay for treatment. So now that healthcare has advanced to the point where it can almost certainly extend life, we as a society have to decide whether treatment is a privilege or a right. Those who oppose healthcare for everyone like to march with their tricornes and wave their Gadsden flags. The first leaders of this country had to assert our rights in a way no other society had done. Today’s self-proclaimed patriots should remember that when Ben Franklin established the first volunteer fire department for the public’s protection, two men were always assigned to stand guard by the burning building because on the worst day of your life you don’t want to worry about being robbed as well.

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