Public Health and Politics

Richard A. O'Keefe
26 January 2016

During the summer holidays I've been reading some left wing blogs and some rather tepid right wing blogs. More than ever I am convinced that there is nowhere for me in politics. Both sides seem to be obviously right about some things, obviously barking mad about some things, and to be half right about other things, but to have the wrong halves, and sadly, being unable to put them together due to detesting each other so much.

One of the things that has shocked me is the hatred from some of the right wing blogs for the idea of a public health system. I've lived in New Zealand, Australia, and Scotland, all of which have more-or-less functional public health systems. I've also lived in the United States, which did not. I have been sick in all four countries. The United States was not the country where I got the best care. So why do people think a public health system is obviously evil?

There is an argument from some of the more thoughtful people on the right that I want to address briefly.

• Doctors will serve the interests of whoever pays them.
• If you pay the doctor, that's you.
• If the State pays the doctor, that's the State.
• You want the doctor to look after your interests, so…

When I worked in the United States, I had health insurance, paid for by the company I worked for. Thus, in the first instance, the doctors were paid by the insurance company. The insurance company was paid by my company. My “payment” was the money that my company paid to the insurance company instead of to me. If the logic of the argument above is valid, my interests would have come a distant third for the doctors.

So what is the difference between company insurance and a public health system?

• One way, I was terrified that losing my job would mean one illness could wipe me out financially; the other way I'm not.
• One way, the system was governed by faceless bureaucrats out to make a profit, over whom I had no influence. The other way, the system is governed by bureaucrats I have some influence with through my MP. I can even stand for election to the local health board.
• One way, I had affordable cover as long as I don't need it; the other, I have cover throughout my life.
• One way, I had to go to a doctor chosen by the insurance company chosen by my company (and when the company changed to a different insurer, that meant a different doctor for me); the other I can go to any GP in the city.
• An insurance company representative admitted on an Australian TV program I was watching that the public health system was more efficient.

If anyone ever figures out how to combine the virtues of the free market with the virtues of a public health system, I will be happy to vote for it. Until then, I feel more free with a public health system.

I invite any readers to remember that infectious diseases are infectious. Do you want to catch something from a poor person who couldn't afford medical treatment? Do you want your children catching something from a poor person's child? Do you want a sick waitress coughing over your food? If you don't want these things, then you have an interest in seeing that the poor get adequate medical treatment.