The current health care debate appears stuck between two irreconcilable positions – government-provided single-payer health care for all versus private health care chosen voluntarily from a competitive environment of health insurance companies.
Neither of these approaches emphasizes what is decisive for an efficient and affordable reorganization of the health care system in the U.S. and everywhere else – the factor that every citizen, without exemption, must be obliged to be health insured. How the individual provides health insurance is of secondary importance; the primary concern is that every individual must be health insured. It should not depend on the private and personal initiative of whether one is insured or not. To put this obligation in legislative terms is as far as government guidance should go; to support those who cannot afford health insurance is as far as government intervention must go.
People must understand that sickness and injury do not depend on a healthy lifestyle and youth alone. The transcendent aspect of human life, this particular dimension of life upon which we have no bearing, applies to everyone, is self-evident beyond all differences in faith and existential designs. We all know of friends, relatives, or acquaintances who suddenly got struck by cancer, got injured in a car accident, or came down with some unexpected illness that nobody could have possibly foreseen.
In principle, the crux of health care is easy to comprehend. Everybody who works and has income must pay into some health insurance system covering him (plus all his dependents like spouse and children). Everybody who has no work or is otherwise unemployed and unable to care for himself has got to be insured by way of social support. A specific part of unemployment or retirement or disability benefits has got to go straight into health insurance coverage in the latter case.
The major flaw in the health reform model promoted by the Democrats is demanding government-provided, single health care coverage for everybody instead of affording it only to those who cannot pay coverage for themselves. The major flaw in the health reform models promoted by Republicans is rejecting government intervention as endangerment of civil liberty or considering it even to be unconstitutional. They neglect that single-care coverage through government support for unemployed and no-income people is essential for social stability and overall societal well-being, as is the legal obligation for everybody else to provide for their health care coverage.
The government could provide all of this without changing the current state of affairs of competing insurance companies by subsidizing private insurance companies for those who cannot buy their health insurance. This arrangement would provide social stability as far as the most pressing social issue of nationwide healthcare for every citizen is concerned without implementing a new system of entirely restructured nationalized health care and without colossal budgetary expenditures.
When it comes to health care, there is no reason to violate the perennial principle of good governance – as much government as necessary, as little government as possible!
