US Health Care Reform: Another Historic Moment in the Administration of Poverty

With the legislation on healthcare reform coming to a head, President Obama has left no doubt about what is at stake. He has enjoined his colleagues in the House and the Senate to “seize the moment,” reminding them that “this is the moment of our legislative lifetimes. This is why people run for public office, to be here at the creation of something really big.”

Indeed, for all the rancor of the debate in Congress and the media, there is overwhelming agreement on the need to overhaul America’s healthcare system. And the ruling elites – from President Obama and politicians on both sides of the aisle to a slew of Nobel Prize winning economists – have been kind enough to tell us why they regard healthcare reform to be so urgent. Without far-reaching change, two things that are much more important than the health of individual citizens will face impending doom: the nation’s economy and the solidity of the national budget. On that basis, the population’s poor bill of health raises some urgent questions for the ruling class: Is the health of the nation’s competitiveness in danger? Does the illness of broad swathes of the population represent a disadvantage in international competition that America can no longer afford? That requires a solution, and controversy abounds. How to extend basic care to a greater portion of the population without imposing unbearable costs on “the economy”, i.e., the profits of employers, while making sure that America’s premier growth industry can emerge stronger than ever.

And average citizens haven’t been left out of this crucial debate either. On the contrary, they get to follow the ups and downs of the negotiations in Congress, listen to the pleas and arguments of big and small business, weigh the options and come to a conclusion about which is worse: their current inability to pay for the most basic care or their inability to pay for compulsory insurance, the risk of financial ruin posed by a serious illness or by unbearable healthcare costs on the companies that employ them?

This gives us no reason for joy or even “cautious optimism,” but raises some unwelcome questions of a more fundamental kind:

* Why, right in the middle of the free market economy, is healthcare such a thoroughly governmental affair?

* What does the state take care of when it takes care of the “health of the nation” and why?

* Why is healthcare always considered too expensive and in constant need of reform?

The answers to these questions illustrate why the hopes for a “historic moment” in the history of American healthcare are not only woefully modest, but hopelessly wrongheaded. We invite you to come and find out why.