If healthcare were like mail, we’d all be a lot happier

Healthy people take less time off from work. This is part of why eradicating communicable diseases like polio, malaria, measles, etc., from the United States and other developed nations was so important. People who aren’t getting sick from dirty water or infection are people who are better able to consistently engage in economic activity. If you have a business where you aren’t sure when or how much of your labor force will be able to show up, that uncertainty is going to affect your bottom line.

Additionally, people who are able to take care of their sicknesses and injuries immediately or when noticed early make it much cheaper to treat overall because many conditions become more complicated and expensive to cure as they progress. If you catch cancer in the beginning stages, not only is the prognosis better, you also don’t need to spend anywhere near the amount of resources to cure it compared with a cancer that’s only caught after it’s metastasized and its symptoms are more obvious.

Because it’s less expensive to treat, many fewer people will have to declare bankruptcy when they choose to save the lives of themselves and their loved ones. As of 2009, 62 percent of all bankruptcies were medical-related. Obamacare didn’t solve that problem or perhaps go far enough, but people who have to close their business or pay off medical debt aren’t spending money to invest in their community or grow its economy. Some people do become wealthier, like breaking windows benefits the glass repair company, but overall, society does not become wealthier.

Finally, children who suffer from preventable and treatable illnesses won’t be as productive economically as they grow older, and adults who are injured or die from something treatable are wasting the investment of education and experience already put into them. Even viewing people completely cynically and without moral compassion, you’re squandering resources by allowing economic engines to break and disregarding their entire future productive capability unless they have the wealth immediately to repair themselves.

More fundamentally and in the long term, by tying health-care access to wealth, it deepens the divide between rich and poor, lowers overall economic productivity, and weakens the social contract.

If poor people believe they live in a society where they’re unable to feed, clothe, and provide lifesaving care to their children, they aren’t going to be very invested in that society or trust in its authority. So you would also expect crime, drug use, and general social turmoil to rise.

Does your waitress friend live in Texas? I imagine the state rejecting the Medicaid expansion meant to cover lower-income people has a lot to do with her experience.

That’s sort of like someone saying you can’t ride a bicycle, then jamming a stick into your bicycle spokes and saying, ‘I told you so.’

I hear you, but while you’re horrified by the Veterans Affairs medical facilities, I think it would be much more horrifying to tell veterans, ‘The free market is good. Go pay for your own private health insurance’. A months-long waiting list for a hearing aid sounds horrible, but if you don’t have an income or insurance, it might take years if ever you can save up enough money to afford it.

The problems with the VA seem to argue for doing a better job funding and broadening where veterans can get treatment, not expecting health insurance companies to have in mind the best interests of veterans who will need treatment for tinnitus or prosthetic limbs for the rest of their lives. 

Having a gun to your head, or to your spouse or child’s head, does not make it easy to make rational, thoughtful decisions about them. You can’t tell the ambulance, ‘No, take my husband to the hospital across town that’s in-network’ or ‘That procedure isn’t in our coverage plan; let’s just chance it’. Medical care is not like buying a car. Medical care is like buying water in a refugee camp; when you need something to save your life, the market is not anything resembling free. 

A compromise might be to have private competition, sure. But though UPS and FedEx exist, they usually don’t service small, rural areas where it would be uneconomical for them to operate or their services would have to be prohibitively expensive to break even. The Post Office often does operate in those place because part of the social contract is that, as a member of civil society, you deserve to be able to send and receive mail, and drive on paved roads, and many other things, even when it costs more to do them than it’s worth and you don’t know a wealthy patron.

A Medicaid Part E, similar to the National Health Service of the United Kingdom, would not be perfect, but it would be less expensive and would increase life expectancy. 

Yet I think making sure every person in the U.S. can get life-saving coverage without going bankrupt, regardless of how poorly they chose their parents, is a non-starter for anyone who regards themselves as conservative, so I also don’t have any faith in a bi-partisan solution, even if it makes more sense, would be cheaper, more equitable, and is demonstrably more effective elsewhere.