It occurs to me that many of the debates currently waging in the US media about healthcare fail to distinguish between three questions:
1) What is the principle upon which we wish healthcare to be based?
2) What are our desired goals for healthcare?
3) How do we best administer a healthcare system?
I have some ideas about my own personal answers to the first two questions. I have less of a concrete idea about my answer to the third question - basically because I'm not expert either in US healthcare administration or in US governemental administration.
Here are my thoughts:
1) Our current system is based on the principle of 'patients are a source of profts for healthcare providers and healthcare insurance companies'. I want our healthcare system to be based on the principle that 'healthcare is a human right.'
I wonder if anyone would actually like to argue the principle that healthcare is not a human right? I wonder if anyone would like to argue the principle that 'those who cannot pay for healthcare deserve to become ill and die'? Possibly a few odd eggs, but I'm going to assume that, actually, most people agree with this idea.
2) Based on this principle, some of my desired outcomes would be goals like providing effective, preventative healthcare to everyone in society as well as providing effective specific care for specific illnesses and injuries. Such healthcare should be accessible, efficient and timely.
Broadly speaking, would anyone want to disagree with any of these things? I suspect not, although if we were going to start compliling a list of specific outcomes, there would probably be some disagreement. But let's say, broadly, we want everyone to have good, effective healthcare.
3) Now the big question. Given that we want healthcare to be a human right and we want everyone to have good, effective healthcare, who is going to pay for this? And how will this healthcare system be administered?
This actually seems to be the area where people with the least knowledge and experience have the strongest opinions.
I won't claim to have a definitive answer to this. What does seem clear to me, however, is that there are many ways to administer such a system and it's not simply a question of 'Nationalized, socialized healthcare based on the values of healthcare as a human right versus entirely privitized healthcare based on the value that patients are profit centers.'
But I think we DO need to be clear about the value that healthcare is human right and we have to fight for this principle to be articulated and to be the foundation of healthcare insurance going forward.
Given that our current system is based on the principle of 'patients are a source of profits', I wonder why people aren't afraid of insurance companies pulling the plug on granny? Or maybe more precisely insurance companies pulling the plug on mom and dad or sister and brother? If you have a long-term health condition that looks like being expensive and something that the insurance company is going to have to pay for over the course of decades, you'd better worry about having your insurance plug pulled or your access to treatment restricted. Either that, or hope your spouse has fantastic group insurance and that s/he isn't at risk of being laid off any time soon.