Recently there have been some great diaries looking at different aspects of health care policy and justifying why a single-payer universal health care system is the most efficient, equitable approach.
I'd like to take a step back and consider the question: Why is universal healthcare MORAL in the first place? Why do progressives believe that access to care should be a right for all citizens, not a privilege for those who can afford it?
Our perspective on all sorts of issues--including health care--comes from a few fundamental progressive values, and it is critical that we identify these values and explain them when arguing for change. This means articulating a moral alternative to the conservative every-man-for-himself approach to health policy. Once we explain how the current state of affairs fails to satisfy these values, we can lay out our goal for health policy and convince people of the best way to get there. I'll take a look at some of the key values on our side of the health care debate.
The Facts Ain't Enough
Defining our goal is not just a matter of economics or statistics; it's a matter of values, and people have an easy time ignoring facts if they're not explained in the context of a particular set of values.
In his diary examining the cost-effectiveness of single-payer systems, bonddad writes:
As the facts demonstrate, single-payer health is cheaper (don't Republicans like that?) more efficient (isn't that an important economic goal?) and it makes business more competative.
The problem is that many conservatives will simply refuse to accept these facts because they don't make any sense within the conservative worldview. Those with an entrenched belief in Adam Smith's Invisible Hand believe that the competitive nature of unfettered capitalism will always produce a better result than a cooperative, public approach.
Fortunately, there are plenty of Americans who would be persuaded to agree with us if we did a better job of offering our own worldview, a moral system in which these facts do make sense. If we get those in the middle to accept our premise that universal health care is morally justified, we're far more likely to get them to believe our supporting evidence.
Democrats cannot afford to waste an opportunity to provide our worldview by talking about the policy in neutral (or worse--conservative) language, especially if most voters are already inclined to agree with us on this particular issue area. If we succeed in revealing this comprehensive value system to voters, it will serve as a lens clarifying how Democrats look at a host of other issues.
Below, I've listed what are (in my view) some of the progressive values that are particularly important in our desire for universal health care. This is by no means a comprehensive set of progressive values, and there is some overlap between them. Feel free to add more in the comments!
(Note: I've stayed away from details/statistics about current conditions and proposed solutions because they are treated well elsewhere. Also, check out rmgustaf's suggestions for responding to conservative arguments on health care.)
HEALTHY VALUES
1. Public Solutions/Institutions: When we come together as a nation, we can achieve far more than we can on our own.
(This is probably the most critical tenet of progressivism as far as politics is concerned. Democrats have to be able to explain over and over again why we believe this--catchy slogans aren't enough.)
2. Optimism/Efficacy:
Democrats are the party of hope. If we Americans set our minds to it, we can make our country and our world a better place.
Naysayers who claim that a universal system wouldn't work, would cost too much, etc. (a) haven't looked at the facts, (b) should take a look at Medicare and the VA, and (c) should have more faith in American ingenuity--especially since we're the only industrialized nation without universal health care. We've shown time and time again that when we dedicate ourselves to a task, we get results; this issue is no exception.
3. Opportunity: Access to basic care is essential if all are to have the opportunity to pursue the American Dream.
Our Declaration of Independence stresses the puruit of happiness as an "unalienable right," yet one tragedy of the current system is that the most disadvantaged have the hardest time improving their lives. They routinely face impossible choices like whether to go to work if it means losing coverage, or whether to spend money on food or drugs. People ought not to have to choose between two very basic needs.
4. Children are our future: A system which shortchanges some of its adult citizens is inadequate; one which doesn't care for its children is deeply immoral.
Under no circumstances should a child be unable to see a doctor or have an infection treated because of her parents' income. Under no circumstances should a parent be prevented from getting a job because it would mean losing converage for the kids. Our public education system shows what we can accomplish when we invest in our children now so they will have a bright future.
5. Strength: A healthier America is a stronger America.
Ensuring everyone has access to basic care will strengthen families, businesses, and communities. If employees (or their children) are sick, this hurts productivity; with a single-payer system, companies will be more eager to do business in the U.S. and won't feel pressured by exorbitant insurance premiums. And we all know that households, schools, and communities are hurt when people are sick. We need to invest in preventative care as well as treatment in order to keep our communities at their best.
6. People are our priority: Keeping Americans on their feet should be at the top of the list in deciding how best to use our resources.
Rather than the trickle-down approach of corporate welfare, we believe in empowering people to succeed, and that doing so will cause businesses and communities to thrive.
7. Good public policies are ones that maximize the public good, are pragmatic, and are sustainable.
A single-payer system will be a vast improvement over current conditions for most Americans, as measured by: cost of coverage, efficiency of administration, percent of costs going to actual care, quality/flexibility of coverage, percentage of bankruptcies due to health expenses, number of people covered, etc.
8. Fairness:
Health care is a basic need, and all are equally entitled to it. Costs to patients and compensation rates for health providers shouldn't vary irrationally from city to city, as they do now because of market factors; companies shouldn't have to choose between competing in a global economy and providing decent benefits to employees; patients shouldn't be locked in to plans for which the insurer is free to eliminate benefits at whim (as has happened to some Medicare Part D recipients).
9. Democracy:
Patients should have a say in how their money is spent. With the current system, that influence is severely limited--it comes only if there are many reasonable plans competing for the same customers. Since many Americans are covered by their employers, they may have little or no input in selecting the plan. Even for those who do choose their plan, the market is often such that there are no good options with reasonable prices. In a single-payer system, all citizens will have a say by virtue of the democratic process, and (depending on the implementation) individuals might have additional options as well. Providers of coverage should be responsible to patients, not shareholders, and should not be allowed to take advantage of patients.
Again, please discuss/add to this list in the comments.