Your Health Is Your Life. Or Else
I have often tried to do a comprehensive essay about my opinions on universal, single-payer health care proposals. Unfortunately, when addressing a general audience, I am likely to come off as a right-wing kook screaming about the downfall of American society. The fact is, like any welfare option, I simply dislike the idea of helping others, especially in an area of my life which I feel has required lots of work and direction on my part to get to a point that I feel secure about my own health. Therefore, what I give you here is more a disjointed rambling - I welcome comments to pull it together, but since I’m not trying to be persuasive as much as merely argumentative, this is the best I can do for now.
Michael Moore's newest dimwitted campaign has me flinching in every conversation which I take part on the topic. This big fat guy is trying to tell me all about how poor health care is in America. This begs the question: has he tried all other avenues of controlling his health and now lobbies the government for assistance as arbiter of last resort? Or is he simply looking for a health nanny to go along with the road nanny and social security nanny? Shouldn't a spokesperson for universal health care be someone who seems more in control of their health? It would make a bigger impact on my opinion of the issue, at least.
If it is implemented in the next decade, any universal health care legislation will be a politically expedient, wishy-washy patch on a broken system. I absolutely guarantee you it will not solve any problems. My observations of and conversations with individuals from outside the US has convinced me that their "universal health care" systems are no better in terms of quality of care or efficiency of bureaucracy than America's current mish mash system. They aren't really worse either. That's the point of my writing this: universal health care won't change anything.
As a consequence of the above opinion, I also doubt that implementing universal health care would be the fall of Western Civilization that many conservative pundits argue. The fact is, I don't think it will really do anything, except maybe making it even less worthwhile to be attentive to your health. Americans aren't sickos because we lack universal health care - we're sickos because we are hedonists and care about the pleasures of this world; and then on top of that, by and large, we don't take care of ourselves. The kind of health care legislation our leaders are politically capable of passing won't change that.
The reason I don't support universal health care is that I think being on top of your health needs is exclusively the domain of the individual. I don't want to give any advantage to those who want to turn over control of their bodies to someone else - be it the state, an HMO or an employer. I won't kick and scream if it happens, I just don't think it will change my own experience as I go through life; so why should I support it?
In most states with universal health care, the basis of the health care system is the idea that citizens feel obligated to care for their countrymen - that they are all interested in being a part of one another's health and well-being. I agree that this is typical of all welfare legislation in democracies. The fact that so many people really believe this is one of the reasons I don't whine *too* much about welfare legislation in general. I would *much* rather have a welfare system like most Western democracies have than a Stalinist redistributive system which is based on paternalism - that the men in power know what's best for you and you'd better heed it and love your comrades. Or else!
But social welfare is a cult. It's a religion used in wealthy democracies to replace the god-fearing religions of scarcity. It creates a mass purpose in a state characterized by success, plenty and optimism - things diametrically opposed to the standard beliefs of theism. By and large, wealthy nations enact welfare programs at the insistence of the electorate. Whilst I think the electorate is often misled or logically flawed in how much their society will actually benefit from this legislation, I can't argue that it's acceptable as an outcome of democracy (nevermind my skepticism about the ability of the majority to rule themselves).
Many people will call bullshit when I say things like this, but I don't believe people when they say they care for their fellow countrymen and that that is why they want to help them with welfare programs - whether we're talking about health care, direct subsidy, tax breaks, etc. I think the fact that people want the government to administer these programs reveals the fact that individuals want nothing to do with administering this help themselves. I think the majority of people have one or more of the following in mind when calling for various social legislation:
•We must help the poor or they will riot and kill us (fear)
•We must keep people healthy because our society created the factors making them unhealthy - our evil capitalist greed created big tobacco, for-profit health companies, toxic lakes and soils, etc (guilt)
•I am uncomfortable with what I had to do to be where I am today so I must "give something back" (shame)
I don't think fear, guilt or shame are justifiable reasons for helping people. Perhaps they’re justifiable reasons for obeying people... But there's a difference there and acknowledging the difference is vital in differentiating oneself as an involuntary slave versus a voluntary one.
My own moral compass being what it is, it's against my nature to be obedient without at least some protest. Personally, I think if the wealthy weren't such sniveling, guilt-ridden, paranoid slaves, they could come up with quite an exquisite revolt if they really wanted to. Any enslavement of the wealthy these days is a voluntary one. Which once again brings us back to my original point: My opinion on this issue, and others, doesn't make much difference, because I don't think we're in danger of seeing much change in society in either direction any time soon.
But why rely on your government, whose ability to act is based on its legally-sanctioned right to kill, to administer humanitarian relief? If you really care about people, you administer it yourself. No oversight needed, no annual reports, no scandal, no waste. The help goes to those you honestly care about, not mean ingrates. You aren't relying on the same organization to keep people healthy that also bombs foreign countries. Stop saying I'm the meanie and ask yourself why you think your government is so much more effective than you would be doing the same thing - if it's important to you...
But I look like a freaky right-wing kook when I use this to justify opposing health care or welfare politics, so to get back to the original point, here I am trying to emphasize that the love-hate relationship Americans have with their government, and the politically expedient options available for changing our current welfare system, will most likely result in some chimera that pleases no one, and thus, though I oppose universal, single-payer health care, that opposition will not really affect how I vote or which politicians I support.
In terms of my concept of community action, involvement and obligation: sure, I love my neighbors: living in two cities means I have two neighborhoods. I do neighborly things like trade home-grown produce with my neighbors, chat with Miz Putnam about how her incontinent mama is doing, solicit restaurants and stores and well-run businesses in my neighborhood before filling in the blanks with outside ones. I don't think in my case it's a conscious decision based on 'potential self-interest' (eg, I may need this someday) so much as knowing what’s in my current best interest (eg, I need socialization, and I want a tight community so that my property values are kept up).
In any case, if I trusted the (federal or state) government to be efficient or effective at anything other than violence, sure, I might consider it an acceptable way of taking action in the cause of community needs as determined by general consensus. As it is, I see the actions of the US government (domestically) as generally violence directed by a majority of voters against a perceived minority, or at worst a disenfranchised and unvocal majority. I thus view all actions of government as happening at the point of a gun. Sometimes this is good, in such terms of law enforcement and defense. I consequently view all government activity beyond the police, military and judicial sphere as contrary to the principles I equate with America's political foundations (with the possible exception of municipal government, which I think is more responsive to the local population and more capable of operating as a non-coercive community organization). Maybe if I lived in a different country I'd change my perspective, but that's an experience I'll probably never have, alas.
Finally, remember that different countries cannot have interchangeable systems. They possess different cultures and different people. Not to mention that they are each of different size. Canada is 1/10th the size of the US; Germany is 1/4th and Britain is 1/6th; so there are some inherent efficiencies other governments can take advantage of due to that size. Any effort attempted by the Feds here would be so gargantuan it would eclipse all other efforts taken anywhere in the world to date. Even if it was only at the state level, there are over a dozen states with as many people as Sweden.
Lots of Europhiles fail to notice that one thing other welfare states have going for them is their small size. It's hard to duplicate the inclusiveness and community cohesion of Scandanavian countries when you're enlarging the template to 1500% or so... Lots is lost in the translation.
Then there’s the cultural dimension. In the US, government is seen as a necessary evil, to be kept as small as possible and which the individual strives not to depend upon. This is based on the history of the US as a haven for those fleeing excessive statism and seeking civic bonds outside the state or the government. The durability of American democracy is based not on the power of the government but on the ability of people to freely associate without government sanction. Where these freedoms do not exist, government usually has to step up to the plate, and I would argue that this is not necessary in the US. In many European countries, free association is dangerous because integration is so superficial, and too much unsanctioned civic association could lead to destructive forms of nationalism. Therefore, government is seen as a public good - to be judged by its efficiency rather than its size.
American exceptionalism will out.