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Kurtis R. Ericson 140 Beacon Street, Apt. 1F Boston, MA 02116 President Barack Obama The White House 1600 Pennsylvania Avenue NW Washington, DC 20500 May 18, 2009 Dear President Obama, I am writing you today
regarding healthcare in our country and the implications of a single-payer
solution. To underscore my point, I ask you to first consider a rather
provocative (and admittedly unsavory) question: is marriage Marxist? To begin, I would like to
introduce two key pieces of information. First, in the 1875 work Critique
of the Gotha Program, Karl Marx penned the phrase, "from each
according to his ability, to each according to his need." This idea sat at
the heart of the communist movement, and although Lenin and Stalin delivered
the auspices of a superpower via the former USSR, we now know it was nothing
more than a punishing veneer. Second, today as in
generations past, we celebrate marriage as one of life's greatest milestones.
Tradition dictates that the occasion be marked with an unforgettable oath: "I
offer you my solemn vow to be your faithful partner in sickness and in health,
in good times and in bad, and in joy as well as in sorrow." The virtues of
matrimony rest on the principle that the whole (the couple) will be stronger
and better off than the component parts (two individuals). Allow me to integrate
these historical facts for the purpose of understanding healthcare today. Through marriage a sort of
symbiosis is achieved. Two people pledge to balanced support and equal status
even while knowing that all experiences—any joy, any pain—promise to be
delivered in a generally unbalanced and unequal fashion. Through this
arrangement one person will help the other when the other cannot help
himself/herself. Both people recognize that sacrifices of the individual will
be made in deference to the wellbeing of the whole. In most religious contexts
this vow is delivered in such a way as to swear before God himself that the
couple will live as such until they perish from the earth. So, is marriage as a
collective condition ipso facto Marxist? Of
course not. In fact, marriage can become mutualism at
its finest. So why then do social conservatives, who often trumpet the sanctity
of marriage as an institution so pure that its privileges cannot be extended to
gay men and women, suddenly shrivel away from the same virtues applied to other
humanitarian contexts—notably healthcare? The idea of a single-payer framework
is so reviled by this group because it delivers a collective financial burden
for the wellbeing of the population. And yet, marriage itself enshrines that
exact partnership and mutual dependency. To the logical observer such a
position is clearly contradictory. Why would such an honorable virtue apply
between but not among millions of couples? The same critics often say individualized
decision making and free market mechanics will deliver the most streamlined and
efficient healthcare system. And yet, that market has produced an excessively
fractured and highly inefficient system. The problem is that the
rational decision maker—so beloved in the theory of unfettered free markets—has
little incentive to hedge against the relatively small risk of any given
illness or condition (to say nothing of the opaque nature of information
required to make such a decision). The damning truth is worse yet: in sickness
there is little freedom—for an individual, or a couple, or a society. Faced with a life altering
situation cost becomes irrelevant, for the rational thing to do is preserve
life at any cost. There is no time to compare prices or gather reviews, no time
for proposals or cost-benefit analysis. The closest hospital is the closest
hospital. An anecdote provides the clearest insight. Imagine you are suddenly
overwhelmed by severe anaphylactic shock—an allergy you never knew you had. As
your body convulses and organs begin to fail you face an option: an in-network
hospital 40 minutes away or an out-of-network hospital 10 minutes away. 40
minutes means death. 10 minutes means life. The purist would say death remains
a choice. Maybe, but not one the rational human being would ever make. Reconciling this cognitive
dissonance—this oddly selective application of human virtue—thus becomes the
challenge. In pursuit of consistency
perhaps our culture should demonize all forms of collective social sharing:
marriage, community sport clubs, elderly care volunteer networks, etc. But
every American, of every stripe, can agree that such demonizing is culturally
damaging and ethically wrong. Thus, perhaps it is more accurate to suggest that
principles of mutual dependence provide a critical and timeless pillar to the
American way of life. The socialist state failed
because it is impossible to centrally plan the intricacies of a national
economy on a grand scale. For the same reason the stock market can never truly
be tamed, a single entity cannot effectively nor efficiently understand and
predict the complexities of the macro-economy, especially in the age of global
markets. But that fact alone should not preclude us from a more sophisticated
understanding of healthcare in specific. That is to say, certain components of
our complex social structure, by virtue of the service they provide and their
vital input to the wellbeing of the citizenry, become the obligation of the
state. Three examples immediately present themselves: (1) education because the
value of an education cannot adequately be appreciated without an education,
(2) infrastructure—roads, water distribution, electric distribution,
etc.—because markets would produce too little to deliver the full benefit to
society, and (3) defense because the benefits of safety are realized more by
the community as a whole than by any individual. Healthcare as a single-payer
system, or at the very least as close as we can get to that arrangement, should
be a national priority. As a nation, we have been
well served to embrace mutual dependence where it was vital to the potential of
our society and economy. The time has come to extend the same traditions to our
health and well-being. Arguably, the most common misconception is that a
single-payer program means central planning, production, and delivery. This
perspective is incredibly inaccurate. Single-payer focuses on standardized
forums for delivery and institutional payment. The core cost inputs to the
system such as drugs, equipment, and support services remain in the throngs of
a competitive market, thus ensuring a sustainable spend structure. The ability
for a single-payer to deliver benefits in the form of price minimization,
streamlined processing, centralization of records, among many other
collaborative benefits, obliterates the specter of a socialist regime. A democratic,
capitalist-driven society is best when its populace is educated, safe, and
healthy. Please do everything in your power in pursuit of a single-payer
system. I appreciate your time and
consideration. Respectfully, /s/
Kurt Ericson A
concerned citizen |