human behavior

Republicare? I’ll take Obamacare, thank you.

Posted in American Culture & Politics, Health & Medicine by humanb on March 6, 2010

I’m a passionate proponent of any health care reform that would (1) insure all Americans regardless of pre-existing conditions, employment status or income; (2) reduce costs to the patient; (3) reduce waste in the system by all involved – including overuse of specialist services by patients; (4) promote preventive medicine and public health; and (5) provide greater transparency to consumers about the true cost of their health care.

Despite being emotionally invested in the healthcare debate in the US and having family practically invested in the result, I don’t pretend to know the nitty-gritty policy detail of the Democratic and Republican proposals of the last year, or the final House and Senate bills that passed. I’m no policy wonk. For details on the President’s proposal, go here.

But Jonathan Chait’s short piece in The New Republic, Sink or Swim, is in my decidedly liberal view, an insightful and fair description of the fundamental philosophical underpinnings behind Democratic and Republican positions on healthcare.

The modern Republican domestic agenda is, above all, an attack on redistribution, a crusade to free society’s winners from shouldering the burdens of its losers….

“Pay their own way”–that gets to the heart of the party’s new vision of health as a consequence of personal morality. “I think a national health care act substitutes for a lack of personal responsibility,” complained Republican Representative Steve King last August. Newt Gingrich gloats that Americans have moved “away from the idea of government-run health care and toward more personal responsibility.

Everyday Republicans often make the comparison of car insurance. If you need a car, you buy one, and you accept personal and legal responsibility to purchase auto insurance. This is a flawed comparison. Buying a car is a choice. Having a body is not. Bodies breakdown and not solely because of what we choose to do to them. We don’t choose the bodies (genetics) we inherit. We don’t choose the environments in which we are born and raised and which interact with our genes to predispose us to disease. There is no way to accurately tease out the exclusive role of personal decisions on our health in most cases. We didn’t choose our sex. Breasts need mammograms. Prostates need to be examined in old age. Women need to be delivered of babies.  Childhood leukemias need to be chemotherapeutically eradicated. Almost none of us could afford the true cost of our own healthcare over a lifetime. Only a minority of us could afford to purchase our own health insurance in this economy. That’s why we’ve foisted the responsibility on to the shoulders of employers for the past 50 years, giving them a justification to keep our wages low.

Republicans spend far too much time obsessing over personal responsibility, and far too little considering their civic responsibilities. They persistently fail to recognize that a society with the rule of “every man for himself” will produce the opposite society to the one they romanticize as existing in the real American heartland: a healthy, clean, safe, prosperous community where you care about your neighbor, and where your community is just that: a community.

I doubt many Republicans would enjoy living in a society rampant with disease, ballooning with bankrupt families, devolving from appalling disease-induced poverty and its resultant crime, economically crippled by a shrinking work force of healthy productive citizens, and saturated with a self-serving culture of “Every man for himself!”

You can see this happening already in American cities and towns across the country. The Republican “heartland” is shrinking, and they would hasten its death.

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