Pundit Country

or, more aptly titled: “Why the public option is doomed to failure because it evades the real problem facing health care.”

On tonight’s season finale of Real Time with Bill Maher, the issue of the health reform debate was again brought up and Maher pointed out that according to some independent research, about one-third of medical procedures conducted in the United States are unnecessary. So, as a question to the panel, he asked if health insurance reform was enough. Was it not also an issue with people who abuse the medical system?

While his question did not resonate with the panel all that well, I think he raised a point on the issue between how Americans view health care and how the Canadian and British system do and why the legislation being proposed doesn’t quite address the real problem with health care in this country.

The single payer system, used in both England and Canada, starts by looking at the patient as a member of society first, and as an individual second. This frame starts the care of the person in a direction not even envisioned in the American version. Care is paid for by the patient, not the procedure, meaning the person takes some measure of responsibility for their own well-being rather than relying on doctors to solve everything.

Here we pay by the procedure and have insurance companies decide whether that system is profitable for them (and in the cases of major procedures, often times, it is not). It’s a system based on the needs of the individual first and society several steps down. That’s the problem the public option will not and cannot address, and the point that Maher was attempting to make.

I would also argue it’s the single biggest obstacle facing American society across several issues. We see ourselves as separate from the populace we live around. It’s the attitude of “if I don’t need, I don’t want to pay for it”. This attitude is particularly noticeable (and taken to the extreme) by the both the very vocal right-wing fringe of the major players in the Republican Party. You name the issue, taxes, health care, the social safety net, there are fewer and fewer issues that can’t be framed in the need of the one over the need of the many (to barrow a phrase from Star Trek).

While the public option certainly makes it easier and more affordable for people to have access to medical professionals, it doesn’t place the burden on them to play a leading role in their own care, which I believe dooms the entire system. Until we have that debate, this issue is long from being solved.

Nice little hat tip to the Ned Lamont CT Senate race from 2006 here too. Well done.