Why Is Universal Health Care “Un-American”?

Last week supporters of health-care reform gathered around the country, including in Austin, TX, where 2,000 people crowded into a downtown church to hear speakers talk about different aspects of the issue. Asked to speak about the ethical dimensions of health care, I tried to go beyond short-term political strategizing and ask more basic questions. This is an edited version of what I said.

Is anyone else here having trouble with the fact that we are even having this conversation? Is anyone else having trouble believing this topic is really controversial? I have been asked to talk about the ethical dimension of health care. Here’s one way to frame such a discussion:

If an infant is born to poor parents, would we be more ethical to give medicine to that child so he or she does not die prematurely of preventable diseases, or would we be more ethical if we let the child die screaming in his or her parent’s arms so we can keep more of our money?

Or, let’s say someone who worked for Enron, and now is penniless, contracted bone cancer. I’ve been asked to discuss whether we are more ethical if we provide such people medicine that lessens their pain. Or would we be more ethical to let them scream through the night in unbearable agony so we can pay lower taxes?”

I can’t believe I am standing today in a Christian church defending the proposition that we should lessen the suffering of those who cannot afford health care in an economic system that often treats the poor as prey for the rich. I cannot believe there are Christians around this nation who are shouting that message down and waving guns in the air because they don’t want to hear it. But I learned along time ago that churches are strange places; charity is fine, but speaking of justice is heresy in many churches. The late Brazilian bishop Dom Hélder Câmara said it well: “When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a Communist.” Too often today in the United States, if you talk about helping the poor, they call you Christian, but if you actually try to do something to help the poor, they call you a socialist.

Some of the other speakers today have been asked to address what is possible in the current political climate. I have been asked to speak of our dreams. Let me ask a question. How many of you get really excited about tweaking the insurance system so we just get robbed a little less? (silence) How many of you want universal health care? (sustained applause) I realize that insurance reform is all that’s on the table right now, and it can be important to choose the lesser of evils when that alone is within our power in the moment. But we also need to remember our dream. I believe the American dream is not about material success, not about being having the strongest military. The American dream is that every person might have a right to life, liberty and the pursuit of happiness.

It’s amazing to hear Christians who talk about the right to life as though it ends at birth. They believe every egg has a right to hatch, but as soon as you’re born, it’s dog eat dog. We may disagree on when life begins, but if the right to life means anything it means that every person (anyone who has finished the gestation period) has a right to life. And if there is a right to life there must be a right to the necessities of life. Like health care.

I believe the American dream was not about property rights, but human rights. Consider the words of this national hymn:

“O beautiful for patriot’s dream that sees beyond the years. Thine alabaster cities gleam, undimmed by human tears.”

Doesn’t that sound like someone cared about the poor? There are those who consider paying taxes an affront, but listen to these words:

“O Beautiful for heroes proved in liberating strife, who more than self their country loved and mercy more than life.”

“Mercy more than life” — have you ever noticed those words before? Supporting universal health care does not make you socialist or even a liberal, it makes you a human being. And it makes you an ambassador for the American dream which, in the mind of Thomas Paine, was a dream for every human being, not just Americans. As we struggle to get health care to all people, we may have to settle for the lesser of two evils, but remember your dream — the true American dream, a human dream. Whatever we win through reform is just first step toward a day when every human being has a right to life, liberty and the pursuit of happiness.

Rev. Jim Rigby is pastor of St. Andrew’s Presbyterian Church in Austin, Texas. He can be reached at: jrigby0000@aol.com. Read other articles by Jim.

28 comments on this article so far ...

Comments RSS feed

  1. mcthorogood said on September 2nd, 2009 at 3:25pm #

    I agree with you Pastor, but how many other religious leaders agree with you? To hear a view diametrically opposed to yours, just listen to Pastor Steve Anderson of the Faithful Word Baptist Church in Tempe, AZ, a stain on the cloth.

    How many other religious leaders have woken up, and recognize the hate and injustice in this world? We call ourselves a Christian Nation? Unjust wars, torture, subversion of democratically elected governments and false flag operations, show us that nothing can be further from the truth.

    Religious leaders should set an example for their flock, turn off the T.V., start reading books beside the scriptures. Stop galvanizing public opinion by preaching about issues such as birth control and abortion which only serve to divide the people. People need knowledge to form just opinions, rather than reciting talking points from the likes of Sean Hannity and Glenn Beck.

  2. lynn said on September 2nd, 2009 at 4:28pm #

    Seems it pays to hate?
    There’s a piece at: http://www.npr.org by Randall Balmer(professor at Columbia) about how this fear mongering started- type in Randall Bamer in the search box and it’s the June 23 article.

  3. Jeff said on September 2nd, 2009 at 5:29pm #

    Bottom Line, nothing more under that line. America is a joke! Print that. What ya’ gona’ do, shoot me?!

  4. Todd Pellman said on September 2nd, 2009 at 6:55pm #

    Christ said, if you would be perfect, sell all your property and give it to the poor. He did not say, and when you’ve done that, organize an armed gang and FORCE everyone to do likewise.

    Yes, it is more ethical to give. But how ethical is it to use coercion to make everyone give, whether they want to or not? It is not only unjust, but foolish and will lead to waste, fraud and abuse.

  5. B99 said on September 2nd, 2009 at 7:08pm #

    Todd – We live in a society – a society must look after its citizens. Taxes are dues you and I must pay to live in this society. All other civilized societies do so. You’ll change your mind about societal obligations the moment your medical bills bust you down to nothing.

  6. mcthorogood said on September 2nd, 2009 at 8:19pm #


    Thanks for the NPR link that exposes the raison d’etre of the evangelical right!

    I would have never guessed.

  7. Obstreperous said on September 2nd, 2009 at 10:29pm #

    “We live in a society – a society must look after its citizens. Taxes are dues you and I must pay to live in this society.”
    Holy Cow!! What idiocy, the faith that is being placed in the hands of the parasites in Washington. I thought this was a dissident website and not a Democratic party kiss-a$$ group. The proposals are power grab attempts and NOT related to health care reform in any way. Wise up. What needs to be done is not even under consideration. Health care is a pawn that will be sacrificed at the altar of power. Guess who suffers?

  8. Mulga Mumblebrain said on September 3rd, 2009 at 1:24am #

    America is, in reality, a feudal state, where a vast mass of serfs are ruled by a hereditary parasitic elite. The serfs have been kept quiescent by massive brainwashing, partly religious indoctrination, by definition from birth, in a type of religion obviously frequently the antithesis of the Nazarene’s teachings. Moreover the serfs have also been relentlessly brainwashed in the doctrine of US ‘exceptionalism’ a species of the Judaic conceit that they are a Chosen People’ borrowed from the Old Testament.
    While the US has always been a very unequal society, for years it was able to ‘buy off’ the serfs with a rising living standard, based first on the exploitation of the US’s unparalleled natural resources of vast forests, deep agricultural soil and mighty rivers. Slavery helped, as well. Later US wealth was further enhanced by neo-imperialist pillage, particularly of Latin America. The destruction of European societies in the world wars and the continued submission of India and China exacerbated US advantage, to the extent that in 1945 the US controlled over 50% of global manufacturing output. The US ruling elites constructed an international order, with a UN emasculated by a US veto and bullied by US power, the IMF and World Bank, later joined by the WTO, all designed to force the rest of the world into submission to US economic power. And the US built a mighty military apparatus, unleashed on victims from time to time, ‘to encourage the others’.
    Alas, such empires, particularly when as brutal, cynically hypocritical and self-obsessed to the point of self-delusion and far beyond, never last long. Imperial overstretch gets ’em in the end. We are living through that process now. The US decline is complicated by the control of the country’s politics, media and business by Judaic money power, which, with its divided loyalties, forces the US to follow policies no longer in its national interest. The rise of the ancient civilizational centres of China and India means that the US must accept multi-polarity or risk 0blivion.
    In these fraught times, as the US working class sinks into the mire of debt, as US indebtedness soars, as the technological edge that the US has enjoyed disappears and as US cultural supremacy is threatened, the true nature of the ruling ethos of the US reveals itself. The US has always followed the idea that society is characterised by the ‘war of all against all’. Competition is lauded over co-operation, individualism over collectivism, every time. Not, of course, that all Americans act this way, but the ruling elites and the well brainwashed amongst the serfs certainly do so. These people are plainly more or less psychopathic in their character formation. They fear and despise other people, particularly those of other races or social classes. They lack empathy, and are indifferent to the suffering of others. They are monumentally egotistical, and find no moral qualms in lying, stealing or chreating, just so long as they are ‘winners’.
    It can hardly come as a surprise that these dead souls not only do not care that the poor and indigent suffer greatly from lack of health-care due to inadequate or totally absent insurance, but they are also liable to quickly resort to belligerence and violence if thwarted. For all intents and purposes the poor are as alien to them, and as hated by them, as were the ‘gooks’ in Vietnam and the ‘rag-heads’ in the Middle East. If the Rightwing psychopathic tendency in the US did not have the outlet of murdering foreigners, destroying and pillaging their countries and raping the biosphere to produce profit, they would turn against their neighbours. In fact I fully expect the US, as its economy implodes under the weight of debt and parasitic exploitation, to either seek a safety valve in far greater aggressions, say against Russia and China, despite the risks, or to explode in civil strife, a second Civil War, but one with racialist overtones, directed against Hispanics, Blacks and the ideological enemies of the Fox/News pathocracy.

  9. Glenn said on September 3rd, 2009 at 3:34am #

    Thank you Rev Jim.
    I share your amazement at Christians who advocate war or murder or social inequality, or perhaps most deceived of all, the selfishness of “whats best for me”.
    Jesus (or “the Nazarene” for those who find it too difficult to use his name) had two main messages. The first of course was Gods Grace and the forgiveness of sin.
    The second was love and care for each other. It is a message of community. In all our decisions our consideration should be for what is best for my neighbour (and for we Christians that will never conflict with Gods will).
    There is much discussion on this site seeking solutions to inequality and injustice in our societies. But no amount of human endeavour is going to achieve the sought utopia. Look around and see how your fellow man behaves when motivated by his own welfare.
    At this time it is more obvious than ever. What is the source of your outrage at the actions of certain individuals in the finance industry? Why did they behave as they did? WHY DOES THAT BEHAVIOUR CONTINUE?
    You are intelligent people. You must know in your heart that no amount of social engineering will work as long as we are self-centred in motivation & action, and conflicted within by our own feelings of guilt.

  10. bozhidar balkas vancouver said on September 3rd, 2009 at 5:54am #

    Whoever said [it cld have been also jesus] that “ye shall always have poor among you”, sold us one of the most deleterious lies.
    Poverty appears made! Made by people! Such as kings and now ceos and billionaires.
    It is not possible to become that rich unless one robs people. Both the constitution and the laws are written by plutocrats so that they can stay rich and powerful in perpetuity.

    In addition, quran, bible, torah/talmud, constitutions are interpretative writs; solely or largely interpreted by clergy and the plutos.
    Healthcare, clean food and air, right to be informed, free higher education appear as our inheritance.
    it is not about giving nor receiving; it is about us getting back what belongs to us. tnx

  11. TheEvilOne said on September 3rd, 2009 at 6:05am #

    Reverend Rigby. You just don’t get it. Universal Health care is not just unAmerican but Unchristian as well.

    You think that you are a Christian but you are not a Christian. You are only a follower of Joshua (aka Jesus) of Nazareth. Joshua of Nazareth was a very wicked person who seriously pissed off the authorities and the good people of his day and as a result he was very rightly given the death penalty. Joshua of Nazareth hung out with all the wrong people. If he were around to day he would not be consorting with billionaires and senators but with niggers , ex felons and drug addicts that is if he were not already in prison on a long sentence for donating to a charity connected to Palestinian terrorism.

    But Joshua of Nazareth after being punished by the righteous of Rome was then punished by Almighty God. God transmogrified him into Jesus Christ. While Jesus of Nazareth was an evil person, a dark skinned Jew Jesus Christ is a pure blood Aryan the son of God himself, a figure of impeccable respectability who would be welcome in the Nazi Party, at dinner parties in the White house and in the drawing rooms of right-wing Latin American dictators.

    Decent Christians concern themselves with ensuring the foetuses of poor parents are born to grow up in squalor and poverty and to become criminal killers so that they can receive the death penalty after they whack the wrong victim. Decent Christians concern themselves with maintaining in society the correct privilege structure with the good things God put in the world reserved for the righteous rich such as major company CEOs and wealthy shareholders in Exon Mobil and maximizing the misery of the undeserving poor .

  12. Don Hawkins said on September 3rd, 2009 at 6:13am #

    Thank you Bozh

  13. Max Shields said on September 3rd, 2009 at 6:47am #


    You touch on (even if indirectly) an important point: what is the role of government, and particularly one scaled as it is in the USA? There are those among us who think a decentralized, local/regional scale is the appropriate means for governance. That democracy is achievable within a much smaller scale and most human problems can best be handled at the “grass-roots”/local level with some consideration for regional and broader solidarity/trade and the like.

    I don’t think the political system in the US is capable of dealing squarely with the problems we face. And I’m not convinced that polity is the domain that many of these problems should even fall within. Health care is an example. While single-payer is an excellent idea, it is nearly impossible to consider given the scale of the USA. The health care system, such as it is, reflects the nation. “Fixing” it is not even the answer. Replacing it is unfathomable given the multitude of interests and lack of focus on whether it is a right for all or not.

    Most of these “insolvable” problems, are really quite solvable on a smaller scale. That’s why the “best” solutions have been achieved by relatively smaller nation-states (where war and expansionism and empire maintenance are not their preoccupations).

    I do agree that regardless of size, some form of revenue is required. I have been a strong supporter of land rent (rent applied to the commons for use by one and all). This would readily pay for our needs, particularly on a human-scale basis. It would also address the inequities of class and wealth we see today.

    I don’t think smaller scoped entities are perfect. There are issues, but the issues of a large (and growing) empire state makes these problems pale in comparison. To be human is to err, and live in a state of perpetual dilemmas. But that doesn’t mean we cannot create a sustainable world that makes meaningful work something we do with a kind of joy rather than the unsustainability and anguishing focus on material gains that depletes the spirit and denudes a society of meaningful culture.

  14. Az said on September 3rd, 2009 at 9:16am #

    B99, very nicely explained. Yes, we live in a society and we should support -everyone- in our society.

    Proper medical attention is a basic human necessity, it is criminal to force a class of people to suffer because they are poor.

    All this talk about human equality and democracy, human rights, freedom and liberty, yet people are refused medical care because they can’t afford insurance?

    Why on earth, in this day and age with medical technologies advanced as they are, should -anyone- be excluded from medical attention. Why should any one person suffer, even die, as a result of not receiving medical help simply because they are poor, when taxes are spent on missiles and cluster bombs? How is this not a miscarriage of human rights?

    What is right about that? Isn’t the preservation of life more important than the preservation of capital?

  15. b99 said on September 3rd, 2009 at 12:05pm #

    Obno – Yes, taxes are dues that one pays to live in a society. No taxes – no effing water treatment plant, no taxes – no sewage treatment plant. If you don’t believe in taxes then go find your own potable water and your own way to dispose of it cleanly. And build your own stoplights, and make sure you save enough money for old age because we ain’t sharing social security with those who don’t believe in paying taxes for it.

    Obviously no contributor to this site believes in the current health ‘plan’ nor any currently offered up by mainstream parties. This is for all intents and purposes a pro-universal-health care site. So tell us your plan Obno to provide for public health if not thru taxes? Magic? Barter?

  16. Obstreperous said on September 3rd, 2009 at 7:13pm #

    Max; Local administrationseems attractive except for the mobility of society. People and businesses (i.e., jobs) have demonstrated that they will migrate to the best local deal within reason, which can lead to an overwhelming of the system. So a more national approach does seem inevitable. In all cases it comes down to what needs to be included in universal care. The only approach that makes economic sense is a very basic care universally. Beyond that, the expensive stuff (MRIs, cardiovascular surgery, etc.), cannot be borne by a society with any significant proportion of elderly. So either mandate ‘so-called’ equity by degrading care for most people or provide basic care for the poor and live with some inequity. I think that the latter may not be intellectually satisfying, but it is realistic and achievable. Utopian thinking gets one nowhere.

    B99, Taxes. There should be no income taxes, only consumption taxes. If you are rich and consume more, then you pay more…no loopholes.

  17. Max Shields said on September 3rd, 2009 at 8:20pm #

    Obstreperous ,

    What I’m suggesting is NOT utopian “thinking”. There is a premise – there always needs to be a premise in these matters – otherwise we’re just blowing smoke up our arses – don’t you think?

    So, here’s the premise: this is a nation which is built on CHEAP fossil fuel which provides (now pay attention to this) high mobility and low accessibility. Remember all this is based on CHEAP fossil fuel. All civilizations exist through leveraging energy forms – ours is fossil (coal, natural gas, and oil). Rome had wood and some coal. Oil is like VITAL. Food, electricity, buildings, heat/airconditioning, water access…essentially all of our necessities, as we enjoy them, are provided at the pleasure of CHEAP oil. Now, you say, but we didn’t always have oil…right? Correct, oil came on the scene around the mid-19th C. But at that time there were only about 1.6 billion human souls on the planet. After that, and largely due to it (the leveraged use of cheap oil) the population exploded to almost 7 billion (in just over 1 Century whereas the 1.6 took tens of thousands of years; medical technology is all CHEAP fossil based…)!!!

    Ok? Now, in the case of the US (unlike Europe, for instance, where cities are dense and where most people live) we created a world built like no other – utterly dependent on CHEAP oil and it provided the mobility you mentioned to zigzag all over the earth on tarmac roads…willynilly. And suburban sprawl became the NEW AMERICAN DREAM. This is a life and a life style which cannot exist, as it does without….you got it…CHEAP OIL.

    Let’s assume, as I must, that you got the picture…so far. (You can disagree…anyone can disagree…doesn’t take too much thought to disagree…shit GW Bush disagreed all the time with reality…and he got away with it for 8 years, and Obama is locked and loaded for the same.

    Ok, let’s play a game. Let’s assume the CHEAP oil is no longer CHEAP. Let’s assume, just for kicks…the world’s reserves start to dry up. Let’s assume that there is evidence all over the place that, as it happened here in the US (once the world’s largest exporter of OIL) that it will happen in all the other places…and has begun.

    What then, Obstreperous? The utopia isn’t a utopia. You can choose fascism…or you can work toward healthy alternative. I choose the latter.

  18. Obstreperous said on September 3rd, 2009 at 8:42pm #

    I wasn’t accusing you of any type of impractical thinking, just saying that holding out for a theoretical ideal (utopia) can lead one to pass up real opportunities (imperfect compromise).
    Okay, so regearing the line of thought, I guess I’m missing how we go from cheap oil not being cheap in the future to universal health care administered at the local scale…maybe not your point, but as I said…I’m confused. If we start making different world economic assumptions compared to where we stand today, then the methods for providing universal care become even muddier. Expensive energy (be it oil or whatever) will suppress economic activity and provide governments with even less resources than we have now. The type of universal care that could then be considered would be even more rudimentary then we can consider today. It would also defund innovation and medical progress, so we’d progress into a medical ‘dark ages.’ Yes, there’d be health care, but it would not keep pace with the ever growing need and new threats (emerging infectious diseases). Even keeping the economic status quo, health care is facing some very dark times just as both America and Europe have high proportions of elderly population. An article in the most recent Economist shows that Africa and Asia have a demographic advantage at the moment as represented by higher percentages of younger people. No one is addressing this degradation of health care provision…they are just discussing how to add more to the rolls. The latter is laudable; however, the system will collapse without attention to the health of the health care system and infrastructure itself.

    BTW, I don’t get the choose fascism part…I think the governmnet should work for us and not us for the government. That means smaller and less powerful government…the antithesis of fascism which seeks only control of its population.

  19. Max Shields said on September 3rd, 2009 at 9:13pm #


    Appreciate your raising questions (some just say, it’s all about Zionism and turnover and go back to sleep).

    Ok, so how does one get “universal health care” at the “local level” and how does that figure with cheap oil?

    First, like Santa Claus doesn’t and won’t exist, USA Universal (meaning everyone gets health care, no exceptions and fully covered) isn’t going to exist. Now, when I say USA, I’m not talking about a future configuration or reconstitution of what we know as the United States of America; I’m talking about what we’ve known and see in front of us. That USA is not going to implement an authentic universal health care. So, let’s stop pretending.

    The depletion of cheap oil creates massive contraction in nations dependent on cheap oil. That contraction will be at every level, socially, culturally, population, and governance. It will happen..but as it happens it can spin off to a fascistic state – perhaps relatively short-lived – or we can avoid a stretch of ultra-fascism (we see it now).

    Nature will take its course. Oil has created, at least in the human collective mind, a sense that it is above nature, or can control it. Oil has allowed for this temporary delusion or insanity. Our life times have only known this delusion and so many of us keep thinking that “god” intended for this to be as it is. But that’s insanity…understandable…but insane just the same.

    We know what oil is, what it does, and have a good sense that its running out, and the US empire is running on it, and with it so goes the empire. Alternatives to cheap oil are totally inadequate in providing what fossil has provided for the last hundred and fifty years or so. Remember what we’ve collectively built with our high-tech, our industrialization, our machinery, our skyscrapers, our food system, or transportation, medical technologies…all and much much more depends on cheap fossil…but I’m repeating myself.

    We have to re-adjust our world view to reflect reality. Look at the nation-states that have such universal health care. They are a tiny fraction of what the USA is in land mass and population. Additionally we have a culture of denial when it comes to having our cake and eating it.

    Only an utter collapse will provide correction to this meandering empire. Just think about the millions of lives this USA kills in meaningless endless wars – insanity without question, war criminality, absolutely.

    So, you want to have Universal Health Care? As your President gives the orders to escalate two war fronts…for no fucking reason except he “can”, you want Universal Health Coverage.

    Americans have the health care they deserve. The warmachine that kills babies has given you the health care you deserve, I’m afraid.

    Only the natural collapse and working to create an utterly new and different landscape in this stolen piece of once gorgeous earth, while be preserve some, we have done much to destroy the planet’s fragile life force, as we scrape the earth to extract energy of one sort of another.

    Universal health care will come when the USA that you and I have known is no more. Smaller, perhaps, regional localities will emerge and provide, in a much more contracted form, a world significantly different than the one you woke up to this morning…

  20. Todd said on September 4th, 2009 at 4:52am #

    b99, I agree fully that we have societal obligations. The state is not society. Every time the state takes control of something, it takes it *away* from control by society. The state is not society. It is the enemy of civil society.

  21. b99 said on September 4th, 2009 at 6:40am #

    Todd – We are in a state system for now and likely for a long time. So right now we can either have taxes collected to build and maintain water/sewage treatment plants or we can have a private corporation – call it Watermart – do it. And it WILL be for profit, just as happened in Bolivia (since ousted by the Bolivian people).

    So right now your societal options are the state, which is at the very least nominally answerable to public pressure, or we can have our society entirely in the hands of the profit makers – the Walmarts and Boeings and Microsofts of America, which are answerable only to shareholders.

    Those are our options. If you’ve got a third way, show it to me quck, because the water treatment plants malfunction if not attended.

  22. b99 said on September 4th, 2009 at 6:45am #

    obstrep – How much more do you think that Gates consumes than the rest of us? His consumption rate is not nearly as impressive as his income rate. If you base it on consumption, revenue drops precipitously and is ESPECIALLY regressive if consumption is taxed at the same rate for all. Food and clothing and rent make up a far larger proportion of poor people’s income than do that of the wealthy. Taxing the poor and middleclass on consumption is a recipe for accelerated pauperization of America.

  23. Obstreperous said on September 4th, 2009 at 6:56am #

    Wow. I’d be a little more hopeful than that. Disintegration of the USA would simply lead to a filling of the void with Chinese and Russian power/influence structures and certainly not lead to a situation where satisfactory universal health care could be achieved. Perhaps, I’m more of an incrementalist than a revolutionary…or somewhere in between…big increments, small revolutions. We can transform to a good, but modest, universal care system that will ideally also allow for options of level of coverage. Failure in the past has come from trying to give unlimited care to everyone, which is not economically realistic. Again, I’d like to get somewhere realistic that can be achieved in my lifetime, rather than holding out for a system that requires and unheaval that would be worse than any benefit would justify. Thanks for the discussion…off to work now.

  24. Max Shields said on September 4th, 2009 at 8:08am #


    “Incrementalist” is like “I’m a middle of the roader” as an all purpose solution to all problems.

    Some problems are best resolved gradually, incrementally, but even than with no little controversy. But there are definitely problems which demand holistic solutions, incrementalism actually exaserbates the problem.

    It is fair to say, after some significant analysis of the current USA health care system, that it is not just about coverage. The system is broken in terms of the very care provided, and in terms of total cost of such below comparative outcomes. This is not an incremental problem, Obstreperous.

    I would suggest that looking at any system, one applies a holistic systemic view. “Correcting” one part of the system generally worsens the overall problem. So, making sure more people are filling the inadequate system with “better coverage” just makes matters worse.

    The political domain in the USA is incapable of solving the entire problem so that it in fact has the greatest positive outcome. Gradual, or incremental change is simply not the remedy.

    “Failure in the past has come from trying to give unlimited care to everyone, which is not economically realistic.”

    The problem with is claim is that you have bought into moral hazard, which is a contortion of the basis of health. If we have empirical evidence, as we seem to, that “unlimited care” is NOT uneconomical. That health “care” starts with prevention (again, any systems view will consistently show that it is considerably less expensive to stay fit than to fix). But in places throughout the world, where universal health care is provided, it is not uneconomical. The cost of poor care is EXTREMELY expensive, which is one of the major problems the USA confronts – it is a significant portion of the GDP.

    But you must know this. How can you argue about the economics of health care when what we have by all accounts is unsustainable. Incrementalism does not change that. You can’t be half pregnant.

    But, the will, the moral fortitude is not there to tackle this problem, because, I would argue, and have, that the very nation that engages in endless war is incapable of thinking this problem through to its moral core.

  25. Max Shields said on September 4th, 2009 at 8:18am #

    On the incrementalist approach, it is valuable WHEN there is a holistic solution that is implemented incrementally, assuring that say, people are not dying for lack of coverage because the time to implemented did not prioritize coverage. But again, there needs to be in place a holistic (not piecemeal) solution being undertaken. You never a solution if you treat it in a piecemeal fashion – what you call “realistic”. The vision does not take it to the necessary end game.

  26. bozh said on September 4th, 2009 at 9:23am #

    To me there are no ifs, buts, maybes, other precondition top receive healthcare that a country can afford to give.

    The key appears: share. If there are 10 people and ten loafs, each get’s according to one’s needs one’s share.
    If there are two loafs, people share once again.
    But plutos have been using force for 10-15K yrs to get a larger share of everything; includes also heatlh care. Tnx .

  27. Obstreperous said on September 4th, 2009 at 1:28pm #

    Isn’t disagreement a wonderful thing? Just remember…Primum non nocere.
    Have a good weekend all.

  28. Max Shields said on September 4th, 2009 at 2:16pm #

    Radical problems need radical solutions.