If there is any lesson to be learned from the current pandemic, it is that the U.S. population has suffered unnecessarily because we have stubbornly refused to do what every other modern Western nation has long done: provide universal health care.
Not only have we resisted any version of a single-payer system, we’ve thrown five million plus people off health insurance during this pandemic. And the “very stable genius”–our idiot President–has weighed in on a Supreme Court case challenging the Affordable Care Act, asking the Supreme Court to strike down a measure that provides health insurance to some twenty-three million Americans.
During a global pandemic.
So what accounts for America’s outlier status? For decades, the accepted answer to that question was some form of our individualism or our devotion to a market economy. But that excuse never really held water, because–as most of the world’s market economies understand–some areas of the economy are simply not suited to market transactions, which require a willing buyer and a willing seller, both of whom are in possession of all information relevant to the proposed transaction.
That clearly does not describe medical services.
The real answer–the real reason American government has been so unwilling to provide universal health coverage–is the same reason the rest of our social safety net is both inadequate and deliberately punitive, constructed to “weed out” anyone who can’t adequately demonstrate both need and moral worth.
I receive Paul Krugman’s newsletter (no URL of which I am aware) and awhile back, he addressed the real reason for our disinclination to offer medical care and basic sustenance to all our citizens:
Non-American friends sometimes ask me why the world’s richest major nation doesn’t have universal health care. The answer is race: we almost got universal coverage in 1947, but segregationists blocked it out of fear that it would lead to integrated hospitals (which Medicare actually did do in the 1960s.) Most of the states that have refused to expand Medicaid coverage under the Affordable Care Act, even though the federal government would bear the great bulk of the cost, are former slave states.
The Italian-American economist Alberto Alesina suddenly died on March 23; among his best work was a joint paper that examined the reasons America doesn’t have a European-style welfare state. The answer, documented at length, was racial division: in America, too many of us think of the beneficiaries of support as Those People, not like us.
There’s a significant body of social science research that confirms Alesina’s thesis.
Americans are finally grappling with the institutional racism that has distorted our society. Unlike the civil unrest of the 60s, we’ve seen significant white participation in the Black Lives Matter protests. There is finally widespread–although certainly not universal– acknowledgment of America’s “Original Sin.”
It is also finally dawning on the “chattering classes” that America’s social problems are interrelated–that the reason Grandma doesn’t have health insurance might have something to do with the fact that Grandpa and his friends have always believed they are intrinsically superior to “those people”–people who definitely don’t deserve access to services funded by Grandpa’s tax dollars.
They’re willing to forego health insurance and other benefits of a social safety net if that’s what it takes to ensure that “those people” can’t take advantage of them.
America: where we cut off our noses to spite our faces–and call it “freedom.”