I lived both under the real Socialism and Capitalism, so I have sort of 3D optics on the issue of universal health care.
Universal health care is one of particular implementation of equality. As such, I view equality very much like heavenly sex. It’s perfectly possible, people have experienced it, and everyone have pretty much the idea what it is like. Yet, it’s a very, very elusive animal. The problem is, it doesn’t last long, it’s very hard to get to, it’s often very impractical, and most attempts to get there are doomed to end up in an abject failure.
“Health for all”
With health care, you are in the same situation as with universal education, and universal security: there’s no way any society can have “too much” of it. Unlike good sex, there’s no natural limit to how much of it we can take before we say: “This is simply too good, we must put a limit to it.”
In addition, we’re all awfully unequal in health. Some people are born perfectly healthy, never catch as much as a flu, live to 100, no problem. Many more people are in need of health care throughout the whole life. Also, there are hypochondriacs. On top of it, there are too many people who knowingly try to abuse the system.
The Implementation Hell
Communists in the USSR hit the problem pretty much right away when they introduced the universal health care. As long as it was about pretty basic things like maternal care, shots for kids, fixing broken limbs and bandaging wounds, it worked decently. But once we went up in quality and scope, we ran into the same darned problem as the US:
- some people contributed much without getting back what they needed when they needed it
- some people needed much more than the system could afford to provide
- some people abused the system
- some people used their privilege to get access to more (or much more) than the contributed themselves
The Soviet experience suggests that health care issue is destined to remain a bottomless source of inspiration for populist politicians. It will go on as long as we won’t know how to make our bodies smooth reparable machines on a simple malfunction insurance plan.
Below, a poster from the 1930s: “He is a malingerer. He’s fine, but fakes illness, to shirk from work on insurance. He steals from the genuinely ill and fails the work requirements.”