First, I must say that I am sympathetic and mindful of the need to provide some level of basic service for those without medical insurance. Regardless of one's current state of employment, income or health, everyone in society is entitled to some basic level of care to keep them healthy and sane. I would even go so far as to concede that the government might be able to find an effective means of backing such a "stop gap" insurance plan, though such a program should be approached with caution. The last thing we would want is the Government to mess with what currently works in the American health care system. We just need to find ways to plug the holes.
Beyond my belief that the government might have a role to play in providing a base level of health care coverage, there is nothing in the Constitution that would say the federal government can or should play this role. As Kelly asks, "The downside is people who decry the resulting inequity as if every citizen deserves equal service regardless of their states economic condition. North Dakota has a lower average income from which to draw tax revenue compared to California so it follows that North Dakota wouldn’t be able to afford as much coverage for their citizens." Without the citizens of the more wealthy states subsidizing the citizens of poorer states through the bureaucratic nightmare of the federal government, a federal scheme is not possible. Even if this limitation could be overcome, it would not be desirable, given the proven inefficiencies of the federal bureaucracy. Better to keep any such governmental role at the State level.
Nevertheless, many on the Left look to Canada and Great Britain's socialized health care systems as some sort of panacea that Congress should adopt for the entire nation. They think it somehow "unfair" that people have different access to health care given different levels of wealth. We generally don't like the fact that the rich can afford more access than the average middle-class citizen restricted by the insurance companies or the uninsured shut out cut off from all but emergency care.
Somewhere along the way, though, our society's definition of "equality" morphed into something different that what the Founders understood. For the Framers, equality equated to what was right. Witness the words of the Declaration of Independence:
We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness.
Thomas Jefferson talks about equality being the ability of men (and women, by extension of our egalitarian ideals throughout the nineteenth century) to live their lives unoppressed by Government and free to pursue their passions and dreams as they see fit. But present-day concepts of equality has more to do with what people perceive to be fair.
We don't think it's fair that people with more money have access to elective surgeries that we might like for ourselves, but who, I ask, would they propose should define what is "fair" health coverage? If it is impossible for everyone to receive reconstructive breast surgery after a mastectomy, should no one be allowed to receive it? If Zoloft is too expensive to be given to everyone, should it simply be banned so that no one can be freed from their depression?
The things that work in America's health care system are driven by the free market. As we debate ways to bring some basic level of health care to everyone (a worthy goal for which we should work to make happen), let's not adopt the concept that equality can only mean sameness of level for everyone.
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I did a search on "welfare" this morning to look for a different post, but I ran across this one. Now that the health care reform bill has become the law of the land (a process that witnessed the messy business of American politics somehow churning out an answer - even if it is imperfect - to an extremely complex problem), it's interesting to read what this post called for and how close, in principle, it is to what Congress passed. Stop-gap measures to provide interim coverage to the unemployed and poor and the seeds to start tackling rising health care costs. The bill is not one I would have crafted, and we will be in huge trouble if the projected deficit reduction promised by the bill does not materialize, but this is an interesting (and American) attempt to preserve freedom and liberty while providing some level of medical coverage to those without. In the end, it might fail, but at least we will have tried.
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