A warning: this is a silly post on a silly subject. A response to a Facebook meme; hard to get sillier than that. Apparently Nancy Pelosi said that the Founding Fathers would be pleased with Obamacare. And this led to all kinds of mockery from conservatives, who continue to double-down on their ‘Obamacare will destroy America’ obsession. The Founders, it goes without saying, would never have agreed to a socialist takeover of American health care! Never in a million years. ‘The Founders,’ in this case, constructed entirely of freedom-loving Christian Republicans. Job creators, don’t you know.
Anyway, it tickled my funny bone, the idea of the Founders ‘opposing Obamacare.’ So I thought, I’d dialogue it.
Me: So. . . . do you oppose the Affordable Care Act?
FF: What’s an Affordable Care Act?
Me: Uh, well, let’s see. It’s basically a reform of the health insurance industry. Most people have health insurance, but there are around forty million who don’t. So it’s an effort to provide them with coverage.
FF: The US has forty million people? Where?
Me: Well, all over, really. The US stretches all the way to the Pacific. Ever since Jefferson bought Louisiana.
FF: Jefferson did what?
Me: Look, just take my word for it. There are about 300 million people in the country right now. 317 million, to be exact. And it’s kind of a problem when 40 million don’t have health care.
FF: What’s health care?
Me: You know, medicine. When doctors make sick people better.
FF: Doctors make sick people better?
Me: Yeah. See, lots of people used to die of diseases that we can cure now.
FF: How? Are you just better at bleeding people?
Me: No, we don’t do that anymore. See, diseases are caused by microbes. Uh, little tiny bugs, uh, germs, uh, just call ’em ‘creatures’, too small to be seen except by microscopes.
FF: What’s a microscope?
Me: Come on, guys. You’ve heard of microscopes. Galileo made one? You’ve heard of van Leeuwenhoek?
FF: All right. But you tell me that you can see these tiny disease-causing creatures? We can’t.
Me: Isn’t it reasonable to imagine that we, in the future, can build better microscopes?
FF: All right. We’re very scientific people, you know. Franklin even figured out that lightning is made of electricity. So you’ve figured out how to cure diseases. Like what diseases? Surely not cholera?
Me: No, we can cure cholera.
FF: Diptheria? Yellow Fever? Malaria? Influenza? Measles? Mumps? Dysentery? Gout?
Me: Pretty much. All curable.
Me: We’ve completely eradicated smallpox. Gone.
Me: No, we still get colds. Sorry. Did I mention we’d cured smallpox?
FF: Well, you live in an age of miracles.
Me: We do. Heart disease is still a problem; we’re working on it. Huge progress on cancer, though it’s still a frightening and dangerous disease. Those are the biggies.
FF: So what’s the problem?
Me: Well, it’s all very expensive. Doctors have to train for years to become doctors, and they charge a lot for their expertise. And diagnosing all those diseases is expensive. We have all kinds of amazing diagnostic equipment, but those machines are costly, and we have to train people how to use the devices properly. We also have lots of drugs that can affect amazing cures, but they’re also really expensive. There’s an entire pharmaceutical industry constantly coming up with new medications, but their research is also expensive. Anyway, most people can’t afford the more expensive procedures; in fact, hardly anyone can. So we created insurance for medical care.
FF: That makes sense. In fact, Ben Franklin created the first fire insurance company in the Americas.
Me: Right! Only, Mr. Franklin, you wouldn’t insure some houses, if you thought they were a fire hazard.
FF: Of course not. Insurance spreads risk around. But an insurance company can’t survive if people only buy it right before their house is going to burn down.
Me: Exactly. What we do is require everyone in the country, if they own a home, to buy fire insurance for it. And we also won’t let them build a house that doesn’t meet certain safety standards. That way, only a few houses burn down annually, and they are able to rebuild with the insurance money. And insurance companies can make a profit, because everyone with a house also has to buy a policy.
FF: Most sensible. That’s another way to do it. We had people who built foolishly, and their wooden houses burned all the time. So we just wouldn’t insure them. Insurance has to limit risk for the insurer and the insured. Same basic principle.
Me: Well, we applied the same principle to health insurance. If you have insurance, you can afford to pay for medical care for yourself and your family. But we had a problem. Really sick people would go to hospitals and get treatment, but couldn’t afford it.
FF: We have hospitals. Real nice one in Philadelphia.
Me: Right. Except that the hospital in Philadelphia wasn’t very good at making sick people better. Mostly folks just died there.
FF: You can’t have everything.
Me: No. Well, our hospitals are better than yours were; in fact, they’re kind of miraculous. And we didn’t want people to die just because they were poor. But when people couldn’t pay for their care, it was a problem. Mostly, costs just went up for everyone.
FF: Why didn’t you just throw people into debtor’s prison?
Me: We don’t really do that anymore. What we have instead is collection agencies.
FF: Sounds horrible!
Me: Yeah. But we thought; wouldn’t it be better if everyone had health insurance? And if we allowed all health insurance companies to compete in an open market for clients? With some minimum requirements their policies had to meet?
FF: So, what’s the problem?
Me: Well, you don’t approve of it.
FF: We don’t approve of it? George Washington died of a simple throat infection. Mostly, he died of being bled and given a powerful purgative at a time when his body was fighting off an infection. Our health care was a joke. If you know how to make sick people better, and have figured out a way to share the cost of it nation-wide, why on earth would we oppose that?
Me: I don’t know. Some people think you would have.
FF: They’re crazy. Wait, is craziness curable? Do you still have madmen?
Me: We do.
FF: Well, ignore them. We’re entirely in favor of this ‘universal health care’ thing. Whatever it is.
FF: Universal, though? Everyone gets good care? Even slaves?
Me: Yeah. About that. . . .