Sandy Szwarc has a new post decrying the latest insanity from the UK: the idea (sponsored by bariatric surgery peddlers, of course) that people with a BMI over 40 should routinely be offered weight loss surgery if they “fail” at dieting (which is nearly inevitable) and that it should be pretty much compulsory for anyone with a BMI over 50. (Source)
I am SO INCREDIBLY FUCKING ANGRY at this I can’t even write about it now.
This post is actually about who supplies the health care. I don’t agree with Szwarc that government-funded health care is necessarily a bad thing. Pointing to Britain and its freaky nanny state policies is a bad example of a national health care system. Actually, I think there’s (at least) two kinds of government-funded health care and she’s lumping them together. There’s the nationalised kind such as in the UK, where health care is provided by the government but is dished out according to variable government policy and whim and leads to horrors such as previously mentioned. Then there’s truly universal health care, such as in a number of European countries (such as France and Sweden), where you get treatment no matter what. There’s a good basic description of France’s health system in The Boston Globe. Apparently the French scoff at the British system.
Here in Australia it seems to be somewhere between those two models. but unfortunately leaning towards the UK side of things thanks to continual federal government cutbacks – though the current Liberal coalition (that’s the capital-L conservative Liberals) would rather like to see it go towards a user-pays USA-style system. At least I haven’t heard of anyone fat being refused a knee replacement or being ordered to mutilate their GI tract. Yet.
The problem with having a system of non-government, private health insurers and care providers is that corporations are inevitably run by the profit-motivated. It’s not in their interest to insure or treat the sick or “high risk” groups. It’s not in their interest to provide low-cost help to low income earners. So, if the government mandates that these private providers must insure everyone and must be affordable, and offers reimbursement or subsidies or other incentives so that affordable and some free care is available, it doesn’t seem all that different to me from a directly government-funded system anyway: you’re just cutting out the middleman. I do realise that governments certainly aren’t immune to greed and corruption and other such things, but once a good universal health system is legislated and implemented, people tend to realise it’s actually quite nice and are very reluctant indeed to let governments change it. There are places where a lot of health care is run by private charities, but then you’re subject to the philosophies and dogma of that charity: try getting contraception at a Roman Catholic hospital, for example.
You could sum up my opinion as: Actual universal health care good, government health care sometimes good sometimes bad, user-pays and private nearly always bad.
(Yes, I realise there are holes in my argument. But it’s the best I could do when INCOHERENT WITH RAGE.)
