I got into yet another debate recently about universal healthcare and think I handled myself alright, although I would be interested to know how others would have responded to the following, particularly with regards to the claim that sick (infected) people spread disease to healthy people, so it’s better to help everyone.
A system of healthcare exactly like what you described existed in the developed world from antiquity up until 1930 or so. There was no insurance, no regulation, no licensure, no anything; healthcare was exactly like any other trade, and those who would provide healthcare competed solely on the basis of price and advertising. The result was nothing short of miserable. Those who could afford it had the best medical and surgical treatment they could buy, although that generally wasn’t much (no training requirements, remember?) Those who couldn’t relied on folk remedies (what we now call “alternative medicine”) and their own physiological reserves, and if they became seriously ill or injured, too bad. Oh, and the average lifespan was about 35 years give or take, and the sick were left to rot on the public streets - or, if they were very, very lucky, they were taken in by charitable groups and largely treated with benign neglect. I sincerely hope that you can figure out why we abandoned that model of healthcare.
In public health, it has been proven hundreds of times that when you have large numbers of sick people in circulation, the general health of the population tends to decline, and the diseases they suffer tend to increase in severity. In short, sick people make the people around them sick as well. If nothing is done about the sick (i.e. they’re left to die), the population’s health rapidly becomes so severely compromised that any suitable crisis - a plague, a famine, a drought, whatever - can kill off the entire population in one shot. Luckily, though, the reverse is also true: when a population is maintained at a certain level of health, the illnesses suffered by each individual tend to be less severe than they would be otherwise, and the lifespan, working capacity and general health of that population tends to increase. Thus, from a pure cost-benefit standpoint, you’d actually be smarter to provide a certain, basic level of healthcare to each individual out of the common treasury, since it costs far, far less to treat the minor illnesses than the severe illnesses, and it also results in massive net gains in productivity when everyone is healthy enough to work. Everything else, of course, the individual can pay for, but providing basic care - an annual physical, immunizations, emergency care when necessary, etc - ought to be a no-brainer.
Our current system is far from perfect - anyone will tell you that. However, throwing it out the window for some mythical “free-market” solution is just as foolish and ultimately even more harmful than single-payer care could hope to be. It is true that people in good health, who can be expected not to incur any particularly egregious health expenditures in their lifetimes, would pay less for their care at first. However, people in poor health, who not only cost more to care for but generally aren’t physically capable of working hard enough or long enough to earn the required amount of money to pay for their healthcare and all their other expenses, will be in even worse straits. Meanwhile, thanks to the masses of sick people in circulation, now all of a sudden the healthy people are getting sick more often and more severely, which throws your putative cost savings right out the window. You’re right back to the Middle Ages - either the sick would be rotting on the streets, or you’d be asking physicians, nurses and allied health providers to shoulder those patients’ costs through charity care. How is that fair to me and my colleagues, for us to subsidize a tax break for you? Are we not entitled to the fruits of our labors?
I find it amusing how you and your ilk tout the wonders of the free market, without ever realizing that what you propose is neither free nor market-driven. You’re just demanding that someone else pay the bill for you, whether through taxes or charity. Funny how that’s so often true - the people who yell the loudest about free markets are also the ones who demand the biggest handouts, breaks and subsidies from said markets.
I’ll thank you to take your trolling elsewhere, and good day to you, sir.
(Full disclosure: The author is a healthcare professional.)
