... the most important single issue to me is which system encourages research and development. - Glenn Reynolds, agreed with 100% by AS ("every word")
I'll give Andrew a pass on this seemingly outre concurrence. Sometimes, people just think they know more about an issue than they do. (Not that I suggest that I'm an expert on health economics, but still I hardly think the central political, economic, or moral issue is research incentives ...)
A rebuttal, of sorts, for the knee-jerk Conservatives:
As the American economy has changed, so has the link between employment and benefits. Since people often no longer work for a single employer until retirement, jobs no longer provide "stable platforms for health care arrangements." Entire sectors of the economy, such as manufacturing, timber, and fishing, have disappeared, leaving many of those people with neither jobs nor benefits.
Because medical, insurance, and pharmaceutical industries operate on a for-profit basis, health care costs have soared. For those who have insurance, there are no guarantees that they will continue to be covered.
As costs increase, employers look for ways to cut health benefits or to stop providing insurance altogether. When a person loses job-related insurance, most of the other options available are prohibitively expensive.
As a result, people enter what Sered and Fernandopulle refer to as the death spiral, the inability to manage one's health and one's employment:
Because employment adversity is so thoroughly entwined with medical adversity, those caught in the spiral cannot amass either the bodily or the financial resources needed to break out. Descent through the death spiral, for millions of Americans, leaves irrevocable marks of illness on their bodies and souls.
There are any number of ways a person can enter the death spiral: divorce, corporate restructuring, plant closing, accident, disability, and chronic illness, to name a few. Anything that threatens employability affects health insurance.
The negative aspects of job and insurance loss can multiply, particularly if others relied on the insurance and income. If one is ill or becomes ill, the lack of insurance creates its own Catch-22. If one is sick and cannot afford care, this can lead to chronic illness, which decreases the chance of finding a job, which in turn decreases the chances of being insured.
According to Sered and Fernandopulle, people who lack or lose access to health care become a separate caste. They use the word caste deliberately and in its traditional sense to describe a group of people who are characterized "by the absence of mobility" and by "recognizable external markers." When health affects employment and appearance, people lose the middle-class markers that define success in this country:
In a broader sense, the death spiral serves as a metaphor for the deep changes taking place in American society as the demarcation between rich and poor -- a traditionally fluid distinction in our society -- hardens into a static barrier between the caste of the healthy and the caste of those who are fated to become and remain sick.
Teeth are one of those caste markers. Healthy, white teeth are a sign of middle-class success. Almost everyone in the book said that if they were suddenly given health care coverage, the first thing they would is go to the dentist. ... [cont]
