Social Security All Over Again?
A young person I know is surprisingly bitter at the prospect of universal health care. He says young people are going to get screwed again. He sees it as a pyramid scam because most health care costs occur in the last few years of life and he would essentially be paying for the old - but when he gets old there won't be enough young to support his health care. Social security deja vu: you pay in, but the government can't reciprocate for you. It starts out a well-meaning, pay-as-you-go system and ends up depending on what others contribute and is made worse by the fact government makes everything more inefficient.
I hadn't looked at it as unfair for the young, probably because I'm middle-aged.
I checked the index of the Compendium of the Social Doctrine of the Catholic Church and found very few references to health care. One was that all workers have the right to health care insurance, but that doesn't say that workers must buy health insurance or that non-workers have a right to it. Elsewhere it said that all people are deserving of basic health care. I think the line-drawing occurs over what is "basic" and everybody has a different definition.
For me, the crux of the problem is that line-drawing. It's not fair for a wealthy person to receive better medical care than a poor person, but we're never going to be to the point where both receive equal quality of health care without ruining the medical profession. (Why? Because equality of medical care would require compulsion via laws, which would drive up the demand for medical care while not increasing the supply, which would cause prices to skyrocket but that would be artificially held down by government fiat, which would cause doctors to simply fold up their tent and go into another profession. We see this already with skyrocketing malpractice insurance.)
So unless we want to go the way of Europe and are fine with two year waits for an MRI (not to mention killing our pharmecutical industry by stripping all R&D money) then we have to draw lines. Which is an anthemna. It seems irresistable force (human nature is marred by original sin) meets immovable object (man has an inherent dignity).
The problem with a welfare state is that it fails to recognize the truth about human nature. The problem with a capitalistic state (as typically practiced by those with that flawed human nature) is that it fails to recognize the truth about human dignity. Conundrum!
The problem with health care is that, unlike food and clothing, it can't really be supplied by private charity can it? I'm more sanguine about relying on people to help others in need of food and clothing, seeing it occur on the local level all the time with the Ohio Food bank and various Catholic Social Service agencies. But how can anyone begin to help people afford, say, medical operations? Only the government can, and even the government can't in the long run.
The welfare state ends up pitting people against each other; with capitalism it is done in such a way that both can profit ("I'll trade you this, which I have extra of, for that, which you have extra of.") and/or is done out of freedom. As we begin our inevitable slog towards universal health care, will we begin our inevitable slog towards treating as a pariah anybody who isn't as fit as we are because they will be perceived as taking money out of our pockets? The new scapegoat will be the heavy person as is already happened in Britain. But it's ironic that it may not be the heavy or the smoker that costs society money but the thin. Another scapegoat could be anybody old, if the young see them as being financially burdensome.
I wonder how much of the anger over illegal immigrants is the perception they are a drain on schools and hospitals since they use services they can't pay for. This wasn't a problem a century or more ago because schools and hospitals weren't as ridiculously expensive as they are now. (Of course, the job threat situation isn't new - immigrants have always worked for cheaper wages which has always created some resentment.)
What the welfare state seems to introduce is even more envy and resentment because you have to steal Peter to pay Paul. If health care were completely nationalized, it would be "free" and thus have to be rationed and demand goes through the roof and any time you frustrate demand you'll frustrate people. Once medical insurance came in vogue it took people a step away from self-reliance and step towards socialized medicine because consumers of medical care now feel no pain when paying for procedures they once experienced as moderately costly.
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