When your house is on fire, what do you do?
If you’re like most people, you call the fire department and ask for assistance. And they come and put the fire out, and possibly investigate the cause, and at the end, do you get a bill? No. Because fire departments are recognized as an important community service. Putting out fires, in other words, directly benefits the community, and so do other services offered by most fire departments, like inspecting buildings for safety, conducting search and rescue operations, and so forth.
The President seems to have shoved reform of the health care system in America to the side in the interest of handing out free money to banks and American corporations, but Americans haven’t forgotten the need for health care. We are still going bankrupt from medical expenses, and we are still struggling to bear the cost of medical treatment, even for those who are privileged enough to have health insurance.
Why aren’t we viewing health care like we view fire departments?
If a house is on fire, the fire could spread to other houses, that’s what makes fire departments different. Actually, a standalone structure fire might not necessarily spread to homes or properties, but fire departments won’t refuse to go out on a call to such a fire. They also won’t send a bill. And, in fact, health care is a lot like a house fire in a crowded region. If someone has a contagious disease, he or she could spread it. If a disease is caused by environmental exposure, a single patient could be the canary in the coal mine. And even if a disease isn’t contagious, might even be congenital, the patient could suffer from lost work and earnings, and the community would be deprived of the patient’s skills, personality, and services. So, actually, the need for health care is a lot like the need for fire departments.
Some fire departments have volunteers who provide their services free or at low cost. So do some medical clinics and hospitals. In fact, the only way for a lot of Americans to get health care is to use a free clinic staffed by volunteers who are willing to donate time and energy to helping other people feel better.
Controlling fires is necessary for public safety. And so is health care. Healthy communities are safer communities, in addition to being more productive communities. And not just from a public health standpoint.
The fire department model has been working really well in the United States for a really long time. In fact, we pretty much invented the volunteer fire department. Early versions of fire departments were indeed paid, and firemen would either charge after the fact, or refuse to attend fires until they were paid, or if the fire took place in a building that belonged to someone who wasn’t a subscriber to the department.
But that model, it was determined, didn’t work. Providing services only on the basis of ability to pay turned out to be damaging in the long term, and therefore this system was abandoned in favor of a system which provides services to everyone who needed them. Rich and poor alike, people get help from the fire department for free, because some things have an intrinsic value which is too important to wait for money.
People who commit fraud against a fire department can face legal penalties, including fees, just like I think that people who commit fraud against a health care system should. But beyond that, the service is free, and the same level of care is provided to everyone, which I find delightfully egalitarian. Models seem to suggest that the current system is in place because it works, and because it’s cheap.
So why aren’t we adopting a similar model for health care? We need single payer nationalized health care. Call it socialized medicine. Call it whatever you want. But that doesn’t erase the fact that we need it, collectively as a nation and as individuals.
People should not be seeking medical treatment under a false name so that it won’t show up on their medical records. They should not be ignoring medical problems because they know they can’t afford to treat them. They should not be sacrificing everything to pay for health care, or going bankrupt due to inability to pay. The costs of maintaining the current system have spiraled out of control. We need to dismantle it, and start all over again from the bottom.
Doctors need an incentive to practice, and to practice well. They cannot cower under the fears of huge student loan debts and monstrous malpractice premiums. Hospitals should not be making treatment recommendations on the basis of how much they can wring out of patients. Patients should know that when they seek medical attention, they will get attentive, personalized care from a provider who really cares, and will make recommendations based on need, not quotas and billing.
Now more than ever, with the threat of a pandemic flu on the horizon, it’s time to get serious about health in America.
Mr. Obama, it’s been 100 days, and so far I haven’t seen you do a fucking thing for the American people. Time to pony up with all that change you clamored about. Time to put the fire out.