Thursday, November 10, 2005

Is single-payer national health insurance economically reasonable?

That is the question Kevin Drum briefly addresses.

The answer is "it depends." On what? Simple. What are your goals?

If your primary goal is economic efficiency, regardless of the damage to social networks then the comment Kevin Drum is responding to is correct. But that is a very inhumane view of society.

People don't live in the economy, they live in a society of which the economy makes up only a part. The economy is a much larger part of urban life than it is of rural life, but the economy ignores much of what is important in real life. Families are reduced to consumption units and providers of labor in the economy, and all aspects of society that interfere with the most efficient economic methods are expected to give way to the economic needs instantly. This is why so many Americans live so far from the rest of their family, for example.

Kevin's commenter assumes that the most important aspect of life is the highest income. That is the basic economic goal. Frankly, I find family and education are more important than economic efficiency. If the economy does not permit me the enjoyment of those things, then I will oppose economic change designed for greater output. The price of the greater output is too high.

The purpose of health care is to permit me and everyone else better health with which to enjoy the life. I consider that a right every human being (and many pets) should have, and that is worth taxing everyone to provide 100% coverage to every human. Besides, a standardized program of providing health care to all people in an administratively standardized manner could cut the total cost of health care to everyone by at least a quarter and possibly by half.

Goods and services are provided to meet economic demand. Economic demand is a combination of the need or desire for goods and services combined with the money necessary to purchase those goods and services. The need for health care services is normally quite obvious and is predictable by study of groups of people. The only question is whether the individuals who need the care can also pay for it.

Taxing the mass of working society to insure that those who need the medical goods and services is nothing more than a form of insurance to cover everyone. It is a need of society that is not met by the economy unless there is a government intervention. It is precisely equivalent to taxing everyone to provide defense and criminal law for all of society.

The question to consider is does society exist to support the economy, or does the economy exist to support society. As you consider that question, look at your children. They are not economically productive, and for almost all short-term economic operations, they are nothing but a market to be used to gain money from their parents. Otherwise they are not economically productive nor are they profitable. With the investment of a great deal of work and money, after 18 to 27 or more years, they may enter the economy as providers of goods or services that permit them to also become consumers.

It is in anticipation of this level of engagement in the economy that government should and in many ways does subsidize the education and health of children. Single-payer national health insurance is one form of such totally appropriate subsidy for children and their families.


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