23
Aug
Health Insurance Renamed
I find the ongoing healthcare debate shocking for a reason that rarely even surfaces. It is an issue of paradigm, and the debate proves Thomas Kuhn’s concept so right. As a society we have locked ourselves into the paradigm of regarding health as something we insure, and all discussion is constrained by that concept; we all pay our premiums, or seek an employer or state to share them with us, so that when something happens to us there is a policy ready to pay. For my part this is a sensible approach to cars and houses, but in a civilized society it seems a fundamentally wrong-minded approach to healthcare. We regard education as a right, and I have heard no one argue for “education insurance”: pay your premiums so that if you have children their education will be covered. Nor have I heard any serious argument that the provision of basic utilities - electricity, water, gas, even telephone and television - should be under an insurance policy. How can we, purporting to be a civilized society, not regard emergency care, basic vaccination programs, and basic quality-of-life treatment as an obligation of our society? As a civilized society we pay taxes for services befitting the society we choose to live in; surely the provision of basic healthcare to everyone is one of the attributes of a civilized sociiety?
I recognize the controversy of this only in the fear of the affluent being asked to “subsidize” the health of the less well-off, and in the fear of the politician finding the huge sums of money spent on this social need unavailable for local issues such as bridges, roads, and military bases that are the grease of re-election. However the self-delusion that fails to embrace education in this same wise is amazing to me.
An unnoticed effect is the perpetuation of the corporation that this enables, and I wonder if there is more to this than meets the eye. I left my corporate employment over two years ago, intending to ride out COBRA and then buy my own insurance (a misnomer, since all I really wanted to do was pay for access to the system, and have my catastrophic incidents covered). However I found that because my wife suffers from fibromyalgia, we are uninsurable. I had no interest in returning to the corporate world, but rather wanted to pursue an individual business services practice finanSight. However, I couldn’t, as a civilized man, fail to provide catastrophic health care services for my family and worried that I was trapped. Fortunately I stumbled on COBRA continuation, a Georgia state requirement enforced by the Insurance Commissioner, but had I not worked for a company with more than 50 employees I wouold have been condemned to return to the corporate world. And for my children, with the world open before them, is it right to let the possibility of congenital “defects” allow one to become immediately self employed, while the other is forced to choose between emigration and working for “The Man?”
What will it take to change the terms of the debate? Will it require some catastrophe for us to recognize how uncivilized the most advanced and powerful nation ever created by man is to its citizens? Will a real crisis (not a politicized “debate”) require us to revisit this issue at its most fundamental level and flip the debate to a new paradigm.
