Where There's Smoke

The debate over health care ultimately comes down to one over the proper role of government.

Take fire protection. As in most civilized countries, we have fire companies, supported by taxes, that come and put out the flames if our houses catch fire. I think nearly everybody would agree that this is a good arrangement. We don’t have a “right” to fire protection any more than we do to, say, having our streets plowed when it snows. But we’ve come to accept that these services are sensible, and we consent to be taxed in order to have them.

Protecting our health isn’t a whole lot different. People can take precautions to make sure they don’t get sick, just as they can to prevent fires. But accidents happen, and folks need access to health care just like they do to fire protection, or else risk tremendous loss.

Now suppose that fire companies could pick and chose whom they serve. Shake roof? Sorry, it’ll have to burn. Had a fire before? We won’t come next time. Isn’t that essentially what’s happened with health insurance? But while the agencies that provide fire protection are public services that answer to their municipalities and taxpayers, those that provide health insurance are profit-making corporations answerable to their boards of directors and stockholders. And as they have seen their product become less of an option and more of a necessity, they have come to have control over people’s very lives. Is any fire company in that position? If a fire razes my house, that’s a great loss; but if I carry fire insurance, I can rebuild. If sickness ravages my body and I’m unable to afford health insurance, I may not receive the treatment I need and could possibly die. So I take W’s advice and go to the emergency room and wait five hours for treatment – and if I can’t pay even for that, the hospital has to absorb the expense and health costs continue to escalate.

When lives are at stake, we the people – in the form of our government – can exercise the power that the Founders set out in the Constitution to provide for “the general welfare” (Article I, Section 8). And those of us in the liberal camp believe that the proper role of government includes providing health care just as much as providing fire companies. I recognize that in terms of dollars it’s a big leap from tax-supported fire protection at the local level to tax-supported health care at the national, but we need to shift spending priorities – cut out pork, discontinue farm subsidies, stop being cops to the world – in order to make it work.

We have already adopted – and accept – public health practices like garbage pick-up, vaccination clinics, and pest control. Why is providing security in the face of devastating medical bills branded “socialism” when spraying for mosquitoes that carry the West Nile virus is simply common sense? Conservatives’ fear of government-supported health care is so knee-jerk it’s almost comical and harks back to commie-in-the-woodpile paranoia. There’s no reason why what is already provided to the elderly, veterans, and civil servants can’t be provided to all.

This past Sunday’s NYT Magazine profiles Florida conservative Marco Rubio, who’s challenging Republican Governor Charlie Crist for a Senate seat. Rubio hit the nail on the head: “We are not debating stimulus bills or tax codes. We are debating the essence of what government should be and what role it should play.” And never the twain shall meet. It all comes down to winning over a majority of the electorate to determine which direction we take.

Health insurance may not be a right, any more than fire protection. But we can decide that all of our citizens are as entitled to good health as they are to having firemen on call – or to a financial safety net in old age or in periods of unemployment. It’s time to put out the fire that is our national health crisis. We can join the other industrialized nations as a more civilized people. And a more compassionate people as well.