When I became ill, my perspective on health care reform shifted. But then comes the tricky part, the part of my experience that made me more right-wing. Because in the second phase of my illness, when I knew what was wrong with me and how to treat it, I quickly found myself in a world where the official medical consensus had little to offer me. It was only outside of that consensus, among Lyme disease doctors whose treatment methods didn’t have the approval of the C.D.C. or F.D.A., that I found real help and real hope for myself.
Libertarians are people who think the government should not be in charge of health care or medical treatment. This experience made me more libertarian in many ways.
Even tho the help I got was often expensive and not covered by insurance, this was true even tho I had to pay for it out of my own pocket. But if I can’t trust the C.D.C. to say that these treatments work, why would I trust a more socialized system to pay for them? Because in socialized systems, cost control often relies on a single group setting rules or guidelines for the whole system, like Britain’s National Institute for Health and Care Excellence or Obamacare’s Independent Payment Advisory Board, which never came to be. In fact, I wouldn’t expect an authority to be very flexible or open-minded about paying for a treatment they don’t think is good.
If you look at how health policy often trades off, you’ll see that more free-market systems have more inequalities but also a lot of new experiments, while more socialist systems have a lot more inequalities but also a lot fewer new things to try out. There is a lot of money spent on drug development in many European countries that we don’t have. Americans spend a lot of money on our health care system, and it doesn’t seem to be worth it. We also make a lot of medical breakthroughs in the United States.
Even tho I was mysteriously sick, I was also more aware of how important it is to have an equalizing floor of health insurance coverage. It also made me think about how important it is for researchers to be encouraged to try new things, as well as how important it is for doctors to have unusual personalities. Are American doctors paid more than their counterparts in the developed world? Maybe. Is it a good thing that American medicine is so profitable that it attracts weird Type A egomaniacs who like to go against the grain? Definitely.)
It doesn’t matter how much health insurance costs on a daily basis for the person who is ill; a cure for a disease that was thought to be incurable is worth more. It’s better for a cancer patient to get a single drug that puts the disease into remission than for a single-payer plan to cover a hundred drugs that don’t. The Epstein-Barr virus is thought to be the cause of multiple sclerosis, which was once thought to be a kind of “hysteria.” This is just one example from the world of chronic illnesses. If one day that discovery leads to a cure for MS, it will be worth more to people who have the disease than any insurance coverage the government might offer them now.
When it comes to health insurance, libertarians tend to downplay the uniqueness of illness, treating patients and medical insurance like any other benefit. Liberals, on the other hand, think that medical health care is a fixed pie that needs to be carefully divided, not a zone where huge benefits await outside the realm of what’s available.