Why can’t we fix this problem? Why can’t a nation that won the Space Race, won World War II, dominated the Cold War, and produced the doctors who pioneered a large percentage of the world’s most important surgical and medical interventions of the last century, figure out its own health care issues? Pundits and politicians have ranted about the economics and legalities for decades now, but regular Americans don’t seem (for lack of a more elegant term) to get it. A conversation I had with a relative recently has served to clarify the issue in my mind.
The reason we Americans are so responsive to single-issue campaigns (think the Reagan assassination attempt and handguns, spotted owls, gay marriage, and abortion), is that we don’t do well when confronted with systemic problems. For all of the regular news we get on housing starts, stock markets, the traded value of currencies, and various unemployment rates, macroeconomics is a foreign (and terrifying) language to most. Our nation’s health care system is immense; like most budget issues, regular folks who are busy with family and work, faith and friends, can’t grasp how truly big the numbers are. Our nation’s health care system is also filled with regular folks like us; people who worked through their schooling and training, people who have jobs to do, people that we trust.
Most Americans are ready to “reform” systems and organizations like the law or government, we readily recognize “crooks and liars” in both. But our family doctors? The nurse who held our hand when we got our shots? The facilitator who answered all of our questions, handed us tissue, and was there for us when our loved one was dying of cancer? Slimy lawyers and thin-lipped politicians (my Father-In-Law’s tone-perfect Midwestern description) need reform, not those good people at the top of this paragraph.
My relative doesn’t like “socialized medicine”. She is alive today because of the Social Security and Medicaid systems, but in her mind, those two sentiments are perfectly compatible. Her brother has lived in Germany for most of his adult life, and struggled mightily with many debilitating problems. Were he to have had the same problems in America, it is unlikely he would be alive today. But my relative was ardently complaining about the German system of socialized medicine. She was upset that “they” wouldn’t approve of a certain treatment. She thought (and thinks) it wrong that the poor of the world should be denied health care. But she doesn’t like “socialized medicine”.
My relative is a caring, intelligent, and motivated individual. She would give her own life to save a friend or family member, and would probably consider doing the same for a stranger. She is one of the reasons that I dislike it when treasured liberal friends use the phrase “right-wing nut job”. She is one of a majority with little understanding of how a market really works, and how badly constructed our American health care market really is. For us as a country to move past these issues, we need people like my relative to gain some level of basic understanding of the marketplace, and economics, and the realities of medical delivery.
Until she understands, we will never have the critical democratic mass necessary to support real fixes. Without a real fix to our medical marketplace (regardless of the president or party who champions it), we will never control long term deficits, and we will never ensure long term retirement benefits. What is certain is that the free market can never provide a comprehensive solution set, because the profit motive is not compatible for quality, universal medical outcomes. The Rational Middle will feature many more columns on this topic in the run-ups to both the June announcement on the Supreme Court case, and the general election in November. Until then, in the comment section and on the Facebook page…
The Rational Middle is listening…