Goal 2:Universal health care support for every member of societyObstaclesIn addition to all the issues raised for support of the nonworking mentioned in goal 1, there are some additional ones for health care. Nonworking support can be handled by distributing funds, and except for the incompetent, it can be expected that most people will be able to decide how to live within the provided budget. The incompetent simply require a proxy.For health care, matters of appropriate care become difficult to resolve. It is not sufficient to pay for care, who is to decide what, if any, treatment is to be provided? Another objection, the personal responsibility one, arises when poor lifestyle choices cause health problems. Do we treat smokers for lung cancer? If not, do we rescue mountain climbers who fall? Are people mean spirited or just worried about costs? Once again we assume that everyone agrees that each individual should have the best quality of physical well being that they are capable of. It is only issues about how to allocate scare resources that cause disagreement. Once again this is an implementation issue. Some have objected that with "free" health care people will abuse the system. The analogy was to free food. Everyone would order the fillet mignon. We have examples of societies which provide "free" health care and overuse (or strain on capacity) has not proven to be a major problem. During the days of the Soviet Union health care was a government program. It was one of the better parts of the system (although some would think that is not saying much!). Many European countries and Canada have universal health care systems. While they all could be improved they do not suffer from frivolous consumption. In many cases the per capita cost is half of that in the US and the general level of health, as measured by longevity, maternal care and other such factors, is better than the US. Non-essential services can be handled as a fee-based system as is done now. ImplementationSupport for the old, young and infirm has long been a measure of a society's maturity. With wealthy countries implementation is not a question of availability of resources, but one of allocation. If we assume that a mature economy is not going to change much in size we must fund such programs by taking funds from elsewhere. The opposition to giving up wealth for this purpose has already been discussed. To achieve this goal requires adopting an economic model so those required to sacrifice feel that they are being compensated in some other way. The implied value of social stability must be made explicit. The costs associated with health support will then be seen to be appropriate. Remember many social costs already exist they are just hidden. Paying for preventive care to reduce the need for emergency care later actually saves money. Having a healthier workforce reduces employer costs. These types of benefits just need to be brought out more clearly via education and public discussions. |