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by Hector N. Fertig
There are two fundamental issues with regard to universal health coverage: the practical issues involving costs and quality, and the moral issues involving who should be covered. For most supporters of universal health care, the moral issues trump the practical. Further, for many opponents of universal health coverage, moral issues are historically common and powerful motivations for their support (abortion, for example).
I understand and appreciate the moral argument for universal health coverage. What I struggle with is the asymmetry associated with Congress’ addressing of this particular moral imperative. Katrina’s devastation created just such a moral imperitive; a humanitarian need that honest, hard-working people from every walk of life rallied around and addressed. Taking the President at his word, why is this moral imperative different? Why does the burden, in terms of tax rate, fall disproportionately upon those with greater income? And by disproportionately, of course, I mean exclusively (at least for now)?
On complicated issues, I often try to reduce things to the simplest analogue I can find.
Consider a small town of 20 people. Three of these people are elderly, 5 are either infirmed or children and two others who are not providing for themselves something considered critical… say, clean water. The argument is raised that having clean water is a moral imperative and the town should provide it for everyone. Everyone agrees that clean water is important for everyone, but when the town begins to discuss who should carry the water to those who cannot (or chose to not) carry the water for themselves, different arguments arise. In one camp, people feel that those who are the strongest should carry the water. In the other camp, people feel that its ok to help the elderly, infirmed and children, but if the remaining two people above want water, they can contribute to the effort. Further, the work should generally be divied up so that everyone who is able, works the same amount even if the amount each person carries differs.
The current health care bills in Congress are from the first camp. As I said, I am sympathetic to the moral argument, but I can only see it from the second camp. Everyone works, everyone drinks.
