The Common Good

Crux of the Health-Care Debate: The Role of Government

I'm not sure I completely understand the health-care debate. But I'm going to take a shot and put down my thoughts and would love additional education, feedback, and thoughts as well.

Let's start with the numbers. I keep hearing in the news that there is something like 40 million Americans without health insurance. (I heard former Republican Sen. Bill Frist say that of the 40 million uninsured, only 20 million are the "hard-core" uninsured. But I don't know what the difference is between the hard-core uninsured and the other 20 million. If you know, please tell me.) From what I gather, these people don't have health care for three main reasons:

1. It's too expensive and they can't afford it.

2. They are unemployed and do not have access to employer-sponsored plans.

3. They are denied coverage due to expensive preexisting conditions.

What the debate is NOT about. From what I can tell, we've somehow reached a point in our country's history where most people are now saying that it is not right for a country of our wealth to have so many people uninsured. Therefore, some change is necessary.

What the debate IS about. So if we all agree that we need some sort of reform, then what the debate seems to get stuck on is whether the private market can move toward insuring all of us, or if we need the government to step in and provide some sort of tax/market incentive to help them, or a public-run option to compete with the private market. Secondly, it seems like the debate moves out of simply being about health care and moves toward a debate on what is the role of the federal government in the first place. The biggest fear I hear is that by even simply entertaining a public option for health insurance, we are essentially moving away from being a democracy and are somehow moving closer to becoming a socialist state.

And this second debate is where I begin to really struggle. For those people who argue that a public plan is tantamount to socialism, I am left to wonder about all the other areas of America in which our government is already heavily involved, either currently or in our recent past.

Here are some examples where the federal government has been a significant player (and these are just health-care related examples; there are more if you were to study federal housing policy in the 20th century):

1. Medicare: A federally funded health-care option for the elderly.

2. Medicaid: A joint state- and federally-funded health-care option for the poor.

3. The Department of Veterans Affairs: Provides health care for our veterans.

It seems to me, and please correct me where I am wrong, that within these examples the federal government has stepped in to provide benefits for those groups of individuals otherwise not adequately receiving assistance from the private market. And all of this seems fine to me. If the private market is somehow leaving out significant portions of our population, such as the elderly, the poor, and our veterans, then it makes sense for our government to step in and bridge the gap.

So, to the current debate, if there are some 40 million uninsured in our country that the private market is not able or willing to provide benefits to, then for the government to step in and provide support seems like the correct role for the government to play.

Am I totally wrong here? Help me out

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