A Modest Proposal for a National Health Care System
But tied to this lottery is another feature, being financially responsible for the necessary medical care to treat these misfortunes. Since having the misfortunes in the first place is a lottery, so is being financially responsible for them. But because the two lotteries are tied in this way, if you lose, you lose twice. Not only do you get sick; you have to pay for the treatment too (or your insurance has to).
So, here's a proposal. Uncouple the two lotteries. When someone gets sick (through no fault of their own), somebody else is picked at random to pay for it (or to have their insurance pay for it). Everybody's total risk stays the same but it would be spread more evenly. And if you got sick, you wouldn't also have the misfortune of being financially responsible. (People who get sick should be excluded from the random process employed to chose who will pay for them.)
As is already the case, one can buy health insurance or not, as one chooses, and buy better or worse grades of insurance with higher or lower premiums, co-payments, etc. If you buy insurance which is cheaper because it excludes organ transplants, for example (a common exclusion), you'll be fine if you get stuck paying for someone else, unless you get stuck paying for an organ transplantation. And so on.
My proposal is (if we iron out a few inevitable kinks) just a fairer version of the current system of insurance. But I'm guessing no-body will like it. The alternative? A national health care system.
I have a feeling that your tongue is planted firmly in your cheek, but still, I want to bring up some points:
Assigning blame (or fault) is a dangerous game. Colon cancer risk is increased by certain dietary habits; also diabetes, heart disease, obesity, celiac disease, etc, etc.
Athletes such as long-distance runners are prone to joint diseases. Breast cancer risk is increased with alcohol consumption.
Infertility is higher among women who have had pelvic infections; sperm count is lower among men who use tobacco.
Fetal alcohol syndrome (pretty obvious) is a terrible, chronic problem for the child (victim), but it is someone's FAULT, nonetheless.
Strokes and renal disease often occur in those who are not compliant with medications to control their blood pressure.
I could go on, but you must get my drift. Illness and injury are more than a lottery; how can we deal with this effectively -- is the question.
UNIVERSAL SINGLE-PAYER HEALTH CARE -- is the answer.
May 10, 2009 8:43 PM | Reply | Permalink
Oh, just when he had me convinced! ;)
May 10, 2009 8:46 PM | Reply | Permalink
CVille Dem,
Of course I agree with you completely. I'm a philosopher and we're used to stipulating away messy complications in thought experiments. Put it this way: if (perhaps per impossibile) we could isolate a class of cases for which people were clearly not responsible, then my proposal would be better than the current insurance system for those cases. (Though as you sense, this whole exercise is a reductio of health insurance and an argument for UNIVERSAL SINGLE-PAYER HEALTH CARE, may it come speedily, in our days.)
May 10, 2009 9:00 PM | Reply | Permalink
Amen!
May 10, 2009 11:22 PM | Reply | Permalink
If you are uninsured and does not have insurance, you should check out the website http://UninsuredAmerica.blogspot.com - John Mayer, California
May 16, 2009 1:48 AM | Reply | Permalink