Healthcare, Not Health Insurance

It's really simple, but I think this essay identifies the biggest flaw of healthcare reform as it's presently conceived. How can we end hunger?

Providing food to those without is simple, really: we'll just pass a strict law requiring all hungry people to buy some, and if they don't, fine them harshly enough to persuade even the most recalcitrant ones it's in their best interest to eat something once in a while.

Now change "food" to "health insurance," and behold: you have what Congress and President Obama want to inflict upon hapless constituents like me.

Forget health insurance – what sick or struggling Americans need is healthcare. They're not the same thing.

The essay presents an anecdote about a woman who, following reconstructive surgery on her face by volunteer surgeons, complains that the Oregon Health Plan denied payment for the procedure on the ground that it was cosmetic:

I do not want my healthcare decisions made by bureaucrats who think that having a face with a nose you can breathe with is no health issue but a mere matter of vanity.

In fairness she doesn't say "government bureaucrats"; many health insurance companies would make the same determination, if they could not deny her care on the basis that her condition was preexisting. There will be similar denials under any system of health insurance, be it single payer, entirely private, or some form of hybrid.

One of the many hazards of trying to fashion a "one size fits all" bill is that you'll end up with a suit that fits quite poorly on pretty much everybody, but unfortunately that's what our present political culture demands.