The Public Imperative By ROGER COHEN

[Mass]

http://www.nytimes.com/2009/10/05/opinion/05iht-edcohen.html?hp

The Public Imperative
By ROGER COHEN

Published: October 4, 2009

NEW YORK — Back from another trip to Europe, this time Germany, where the same dismay as in France prevails over the U.S. health care debate. Europeans don’t get why Americans don’t agree that universal health coverage is a fundamental contract to which the citizens of any developed society have a right.

I don’t get it either. Or rather I do, but I don’t think the debate is about health. There can be no doubt that U.S. health care is expensive and wasteful. Tens of millions of people are uninsured by a system that devours a far bigger slice of national output — and that’s the sum of all Americans’ collective energies — than in any other wealthy society.

People die of worry, too. Emergency rooms were not created to be primary care providers.

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Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.”

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Yet that’s what Republicans’ cry of “socialized medicine” — American politics at its most debased — is all about. It implies that government-provided health care somehow saps Americans’ freedom-loving initiative. Some Democrats — prodded by drug and insurance companies with the cash to win favors — buy that argument, too.

I’m grateful to the wise Andrew Sullivan of The Atlantic for pointing out that Friedrich Hayek, whose suspicion of the state was visceral, had this to say in “The Road to Serfdom:”

“Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance — where, in short, we deal with genuinely insurable risks — the case for the state’s helping to organize a comprehensive system of social insurance is very strong.”

... . The best bit of his speech to Congress on health care was the last — and even there he left the most powerful words to the late Edward Kennedy: “What we face is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”
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He should have been clearer and punchier. A public commitment to universal coverage is not character-sapping but character-affirming. Medicare did not make America less American. Individualism is more “rugged” when housed in a healthy body.