Russell, in order for your question to be answerable you must make a distinction between health care and medical care. In all the debate about medical insurance, the sloppy interchange of these terms has clouded the debate to the point that it has become a tragic parody.
(I am going to borrow heavily from the Ivan Illich bucket here, but his discussion is most relevant, and like all of Illich’s essays you have read the definitions first.) Medical care is a part of health care, and medical insurance is only a part of medical care.
In my opinion, health care must be local. Local to the point of an individual, or even perhaps to level of an individual’s thoughts. Health care in its most basic form is taking care of your health: Getting enough sleep. Eating right. Getting enough exercise. Brushing your teeth. Etc. On the family level it is: Teaching you kids how to take care of themselves. Telling you wife that her pie Kung Fu is better than her sister’s, but I am really full. And of course giving and receiving hugs are important. On the community level health care is about having safe places to recreate, walkable communities, access to clean water, pure air, and healthy food. These circles continue to expand to the regional, national and global scale. For good or bad, the arrow of causality is (mostly) pointed from the individual out to the larger segments of society. Having a global authority telling people to brush their teeth is insanity embodied.
Medical care is different. Telling someone that should have brushed their teeth when have a broken arm is nonsense. Having trained doctors and nurses and adequate facilities is a necessity. However, it cannot replace health care at the its most basic and most inclusive form. Telling a 350 pounder that can cure her diabetes with a syringe is equally nonsensical. The causality arrow is much more balanced here.
Medical insurance is a subset of medical care. Medical insurance can never supplant either medical care nor health care. You can insure against medical costs, but you can never insure health. Perhaps our failure is semantic. We want to “ensure” our health, but all we talk about is “insuring” our medicine.
Wednesday, August 12, 2009
While the Democrat's current health reform plans may not be a good solution, still this post by Mr. Giraldi reminds us that the current system does not seem to be without its problems. Donald Goodman offers a distributist perspective on the Democrats' proposals. "Rex" posts this comment in response to Russell Arben Fox over at FPR: