I have to wonder how it’s possible to determine how to create an economic system that “works” without first agreeing on its goal? Should the goal be to create a system that has the ultimate goal of sustaining as many people in as comfortable a fashion as possible, without also destroying our planet? Or is it the goal of the system to create opportunities that ultimately allow the few far in excess of what their needs require, while the many remain at their mercy and charity?

It seems to me that our thoughts on the creation of a fair economic system are tainted by an undue focus on the potential that in a more egalitarian system there may be some people would not contribute equally. But, in reality, this happens already in our so-called “free market” world. And the results seem much worse than the possibility of supporting a few free-loaders. Very few of those who break their backs doing the hard labor of the world actually receive any benefit beyond their own meager subsistence, while millions of people who were born into great plenty hold enormous portions of the world’s wealth. But where is the outcry at this great injustice? Certainly, pity seems to be a poor substitute for outrage.

Similarly we worry, obsessively, that any system containing an element of “wealth distribution” would fail to encourage the innovation, creativity and determination that has produced our modern industrial society. But what were the motives of Edison, Bell or the Wright brothers? No doubt the amassing of vast wealth was very low on their lists - if it appeared at all. Instead, the evidence suggests that true genius is self-motivating and, to a great degree, self-rewarding.

If the goal is to create a society in which everyone willing and able to make a positive contribution is afforded a decent standard of living, including an excellent education and the kind of real heath care that is actually beneficial, there’s no question in my mind that we’re entirely capable of achieving that goal. But in order to do so we must put aside the unreasonable fear that the powerless might take advantage and replace it with the hope and belief that we can find a way to create a good and just world to leave to all its children, even if every human system is, in some respects, imperfect.

Why am I saying all this? I guess it’s because I continue to hope for real and meaningful change. So when I hear about things like corporate “bail-outs” in the billions, using money borrowed from our children, I have to wonder whether such schemes are actually the product of thoughtful reasoning, propelled by hope. Or are they only symptoms of fear and panic – as well as examples of the same sort of short-sighted thinking that created many of our troubles in the first place? And do these schemes and these great expenditures of money that we don’t have really help to put us on the road towards a good and just society - or do they only place us further down the road to ruin?

I really have to wonder.

Do we really want to make sure everyone gets a portion of the ridiculously expensive slop currently on the menu? Or would we rather fire the chef and shop for some fresher and more healthful ingredients?

Fortunately, in my life, I've been able to afford health insurance. I say “fortunately” though only because it’s comforting to know I have the ability to get treatment, if really, really need it. Like, for example, one time I had to see a doctor because I was in agonizing pain for weeks and my foot was hanging from my ankle like a limp fish. Through magnetic resonance imaging, it was determined that I had a ruptured disk, which was useful to know. But certainly, I dread the thought of ever needing to go again. And it’s not just the illness itself that scares me.

To me, the thought of having treatment meted out by the current, profit-based system is even more horrifying than having to rely on a "government run" system - as some people seem to insist on calling it. If it were up to me, I would call it a single payer system "patient run." We’re all potential patients, after all, and share a common interest in the availability of good and necessary treatment. And if we really wanted to, we could construct a system that would, at least, have the health of the patient as its primary goal, even if it could never be completely perfect.

The point is that there seems to be an unwarranted assumption that the only major flaw in the current private insurance based health system is its lack of universality. It seems to me, however, that the problem is much more fundamental. Moving from Woody Allen to my mother: "If you want to make really delicious soup, the first thing you have to put into the pot, is lots of good will." But where is the good will in a health care system that’s based almost entirely on the profit motive? One the one hand, there's the cost-conscious insurance company, trying to spend as little money as possible on your treatment, and entirely uninterested in your well-being. And on the other hand there are the hospitals and physicians, at least some of whom, may also be motivated by maximizing their own profits through surgeries, procedures and tests du jour.

Did I really need back surgery, or would I have been better off lying flat on my back for a couple of weeks? I still wonder, but will never really know. And, by the way, are there really cancer drugs that are worth $50,000 a year, as I just read in a recent newspaper article. Or are some very greedy drug companies, in effect, praying on sickness and desperation in pursuit of unjust profits?

Before we all decide to pay for something that’s going to consume a good portion of our nation’s resources, it seems to me that we should assume some control over what that something is and also ensure that we have some say as to how much we will or will not pay - before we are faced with no choice because of illness or injury. The only real way we can do this is by implementing a single payer health care system that has good will, rather than the profit motive, as its first and most important ingredient.