Healthcare Thoughts

I just watched an interesting Frontline documentary about the healthcare systems around the world, and it reminds me of the cultural assumptions that underlie every policy choice we face in America. We see free primary and secondary education as essential for our citizens, but health care as something that is up to each individual to find and afford. I know this parallel is drawn a lot, but I can't get over it! The assumption must be that if individuals aren't responsible for their own health care, then the government will be, and they will be corrupt and inefficient at it. What is absent from this logic is the fact that individuals do not choose their own healthcare in the US as it is. Individuals are constrained by social, economic, geographic, and political realities, while the diverse interests in the healthcare industry are able to profit from divided consumer power. By charging the individual with finding their own healthcare, we have given insurance companies, pharmaceutical companies, and hospitals the motivation to pander to the healthy and rich, rather than the sick and poor.
We claim moral objectivity by trusting in individual choice despite the fact that individual choice is constrained by resources that are allocated by factors other than need or even merit. Does Bill Gates deserve to make hundreds of thousands of times the amount that an office worker, construction worker, or goverment employee makes? Did he work harder? Perhaps harder than some, but certainly not by a factor of 100,000. What is really going on is that we reward people for being the right person with the right idea in the right place at the right time. This, we claim, is the secret to motivation and innovation, but the majority of those factors are determined not by work ethic or entrepreneurship, but by birth, socioeconomic status, and luck. Is that really what we want as a moral base for our economic and healthcare system? I hope not.