Social Justice and Universal Health Care

I want to commend Rabbi Josh Yuter at YUTOPIA for an excellent article on the Jewish concept of Social Justice. After reading his article, I did take issue with one, minor, throw-away comment regarding universal healthcare. After taking the time to craft a comment, I figured I'd also post it here:

Excellent and well-written article. However, like the previous commenter, I wanted to nitpick on this one sentence:

"For example, a policy of universal health care may assist some of the currently uninsured but will most likely result in negative unintended consequences for other patients, doctors, hospitals, insurance companies, and drug manufacturers."

This is a huge oversimplification of the issues surrounding universal health care, the uninsured, and other affected parties. Universal health care has many iterations as can be seen by the widely varied approaches to universal coverage taken by nearly every other industrialized country in the world. The purpose is not merely to provide insurance, but to make access to affordable and quality healthcare a guaranteed right. Like the rights we have in this country to a free education (at least through high school), or to paved roads, or to 911 summoning emergency personnel to our homes or vehicles as rapidly as possible.

You've correctly pointed out that providing additional coverages for the uninsured will affect other stakeholders in the healthcare arena such as other patients, healthcare providers, pharmaceutical companies, insurers (as well as, medical device companies, employers who provide insurance, the expense to government-funded plans, and ultimately the taxpayer too.) But to say the effects to these other parties will "most likely" be "negative", seems to reject the notion that there may be positive effects to those parties that may equal or outweigh any negative effect.

For example, it's true that universal health care often leads to rationing and waiting periods for some procedures. This would be a negative effect for other patients. But it's also true that many so-called insured patients are rationed now, some by HMO approvals, some by excessively high co-insurance payments which makes them hesitate to seek necessary care, and some by provider availability. Yes, even under our current system. Further, a universal health care plan may save current patients thousands to tens-of-thousands of dollars in health insurance coverage costs, which they may see as a greater benefit to offset giving up the immediate care they may currently enjoy. Moving further in such analysis, other patients' employers may save significant monies on their own healthcare expenditures, which some studies claim would reflect a dollar-for-dollar increase in employee paychecks.

Doctors? Some may make less money, some may make more money. Some may hate dealing with a new bureaucracy, but others spend all day dealing with existing insurance red tape, and may find a new system less frustrating. Again, not exactly a "most likely" to have "negative" consequences scenario.

Insurance companies? Juries out there too. They may make less money, or they may find it's more cost-effective to get into the health administrator business, or compete for privatized government funded plans like the current Medicare Part C. Drug manufacturers? Look at Medicare Part D. There's no telling what the likely result will be. Besides, I don't think your arguing for the welfare of corporate entities here, I think you're talking about the welfare of the people involved in such entities, and strong arguments can be made that the overwhelming majority of insurance employees and drug manufacturing employees would be better off under another, far less wasteful system.

Obviously, I've also engaged in much oversimplification above, but I hope it only helped illustrate my point. These issues are complicated, and there's no obvious winners or losers in universal healthcare nor is there only one flavor. It all comes down to the careful, reasoned analysis of each such proposal that comes under consideration.

To end my comment more positively, I only harped on this point because I enjoyed the rest of your article so much. Keep up the great work!