Sunday, August 23, 2009

Public Health Care Is Like Public Education

A public option in health care, combined with a mandate for everyone to carry health insurance is like the combination of public education and mandatory attendance laws. The reason to have both of them is not only because they provide individual benefit, but also because they provide positive externalities for society as a whole. Finally, both can be justified as positive rights from a philosophical point of view.

Just like health care, education was once a completely private undertaking. The poor did not get any education beyond what they could get for themselves, and the rich had private schools and tutors. Public education, where it existed, was a patchwork of various local and state institutions. It looked rather like the health care system today-- completely private, with vastly differing levels of access depending on how wealthy one was.

All that changed with the rise of the Progressive movement. The Progressives made the pushed the concept of universal education into the public consciousness with a two-pronged argument: education is necessary for citizens to exercise their rights, and the social benefits of universal education outweigh the costs.

Today it is plain that a basic level of education is necessary for citizens to make informed decisions regarding their elected leaders. Yet, it was not always the case. In the Gilded Age of the late 19th and early 20th Century America, education was viewed as a luxury. It was something that was nice to have, or necessary for particular specialized skills. It certainly was not something that was necessary for the laboring masses. The Progressives challenged this view by asking how citizens would be able to make informed decisions about their political leaders without at least a basic level of education. They pointed to the growth of machine politics as the inevitable result of the lack of education amongst the majority of workers. The corruption of these big-city political systems was seen to be a result of working classes being taken advantage of by a sophisticated, educated political class. In essence, the lack of education amongst the laboring proletariat made it impossible for them to exercise their rights without being co-opted by more educated political leaders.

There is a strong parallel between education and healthcare in this regard. Just as one cannot exercise their rights if they do not know what those rights are, they also cannot exercise those rights if they are too sick to do so. Just like the machine politicians had a vested interest in destroying any sort of reform that could erode their power, the insurance companies and drug manufacturers are laboring mightily against any health care reform. They do not want a health care reshuffle, because, once citizens see the advantages of a system that works better than the one we have today, any chance of going back to the present system will be lost forever.

The second part of the Progressive argument towards public education was that education would have social benefits that would compensate for the costs of setting up an education system. This too has parallels in the health care field. Widening healthcare benefits will improve the productivity of the American economy -- just like widening educational benefits. If workers have portable health care, and the option of an affordable public plan, they will not stick to "dead-end" jobs just for the health insurance. A major obstacle to labor mobility will be removed, freeing workers to find jobs that best suit their interests and abilities, even if those jobs don't provide health insurance.

Government intervention in the health care market would help businesses too. By putting more health care control into the hands of the individual, a health care market with public option would lessen the burden of choosing, managing and paying for health insurance. Of course, businesses that wished to provide additional insurance (as a competitive advantage) would still be free to do so. But, by making health insurance an optional, rather than necessary employment benefit, the current health care reform proposal would allow businesses to provide a greater diversity of side benefits. For example, some businesses might take to providing flexible schedules, or child-care credits with the savings they reap from health care reform. The cost of providing health insurance has been an ever growing burden on the American economy. Once the government option limits this cost growth, businesses will be able to reap more of their own profits, rather than having to send it to the coffers of the insurance companies.

Finally, the arguments that a government option in the health insurance market would lead to socialism are laughable. The same charge was leveled against public education. Conservatives of the era decried the education reform movement as an attempt to indoctrinate "socialist" and "subversive" values into the nations youth. Yet, here we are today, where no politician, on either side of the aisle would propose reducing funding for public education. Health insurance is a similar benefit. It may be controversial now, but, in the future the opposition in today's debate will appear hopelessly out of touch with historical trends.

Health care reform with a public option is necessary for our economy and polity in this century, just as education reform was necessary in the last. Lets recognize this necessity and get health care reform passed as soon as possible, so that the United States of America can maintain its position as an economic and political beacon for the rest of the world.

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