Thursday, September 06, 2007

A SICK FEELING. Having been highly uncharitable in a previous post, it pleases me to notice there is a sane discussion of health care costs at Dean Esmay's site, at which I am accustomed to hear only ravings. The post is inspired by one by Marc Cooper about a weird discrepancy Cooper observed in his medical bill between what the insured and the uninsured might be charged for the same procedure.

As some commenters notice, an uninsured individual might by various means get a break on his higher price. But the large numbers attached to medical procedures stir sober feelings among nearly all of them, and many have personal reminiscences that inform their tone.

I lately noticed myself the growing concern with health care as a policy issue, and I think this discussion gives a clue as to why that is. Anyone who has looked at a medical bill with his name on it and compared the cost to what he pays for the other necessities of life might experience a memorable moment of terror, even if he is at the moment protected by the blessing of insurance. Health care coverage is, for a lot of us, contingent on employment, and in this groovy entrepreneural era we have learned to think of job security as a joke. Having carried post-employment COBRA payments myself, I know how the nervous feeling increases as one drifts further from the corporate zone of protection. I've gone without coverage, too, for long stretches, but that was back when America and I were younger; we are both greatly changed.

In general, I think this has a lot to do with the recent decline in Republican vote counts. Scandals, bad war management, and other factors aside, the GOP has been pushing its Ownership Society message for a good long time now. Americans have gloried in self-reliance since well before Emerson blew "a whistle from the Spartan fife." But when the numbers run so high against so many, when bankruptcy laws tighten and the possibility of washing the slate clean and starting over in another town is rendered laughable by computer-assisted tracking data, when a mortgage can so easily become the instrument of a working family's catastrophe, even a Spartan may begin to feel that the fix is in.

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