A no-peeing section of the pool

Once upon a time, you could specify whether you wanted to sit in the smoking or the non-smoking section of an airplane. It was a choice between between being surrounded by smoke or merely having it waft by you in smaller doses. Incredible as this now seems, the rationale for being able to smoke cigarettes while in flight was a common one: what I do shouldn’t affect you, so get over it and let me make my own choices.

But the problem is that my choices sometimes do affect you, and my viewpoint often depends on whether I’m the doer or the one dealing with it. I want to be able to lead my own life and not consider you. On the other hand, I don’t want you to be able to shoot off guns near my property, litter in the street or keep roosters next door. (I don’t mind your chickens, but I’m not listening to that damn rooster for six hours every morning.) You get the idea. I want all of my freedom and your good behavior, and we all feel that way.

So, as a society, we must compromise. In the Unites States we err towards personal freedom; it has been a cornerstone of our culture. Recent fear mongering has pushed some of us into demanding that all new-comers “act like us,” which, if you think about it, is a very odd demand. Anyone who acts like themselves is behaving like an American, aren’t they, here in the land of individual freedom?

Some areas are less open to compromise than most, even in the U.S., particularly those that involve caring for our common safety. My right to dump my toxic waste, to create fire hazards, or to drive as fast as I like all collide with your right not to die an timely death. Yet, reasonable people can and still do disagree about where these lines should be drawn.

The one area in which we are unarguably linked together is in the realm of insurance. It doesn’t have to be that way. We could live in a world in which if your house burned down, or you were in a traffic accident, or you were diagnosed with cancer, then you and your family were simply screwed. End of story. The 90 percent of us for whom everything was going well would feel bad for you, we really would, but hey, that’s the way the cookie crumbles.

But that’s not our world. Some enterprising people came up with the idea that if we all paid a little into a pot called car insurance, or home-owners, or auto, or health, or life, then the lucky people would keep paying into the pot and get little to nothing for it. That’s right, the lucky ones. The unlucky would get back far more than they put in, but as they dealt with illness, devastation and loss, they would not be rendered penniless as well. And, of course, the insurance salespeople and their companies would make a nice bit of profit as well. It has been a wildly successful idea.

Consider that insurance is quite contrary to the American concept that my choices don’t affect you. Once we agree to insurance, we agree to be part of a larger pool. So enter health insurance. Like life and auto insurance, some people are deemed higher risk than others and not everyone pays the same. However, if payments (commonly called premiums) are allowed to deviate so wildly that those most likely to use the insurance can’t possibly afford it, then something in the system is out of whack. And it is.

Perhaps part of the problem is the cost of the medical care itself. We may have evolved a system in which we simply spend so much on our health as a society that even when we spread out the costs, we still can’t afford it. Maybe it is because of more expensive procedures and medicines, or a bloated system supporting too many employees, or individuals or institutions demanding a larger profits. Maybe it is a little bit of all of the above.

Maybe part of the problem is the health insurance industry, too. Has this group become too large for us to sustain or has the cut demanded by the insurance industry itself become too high?

Perhaps those with little need for health care now ( young single healthy males) would rather pay far less or nothing and not worry about the needs of families and aging until they have families and are feeling the effects of aging themselves? That’s understandable, when viewed through the eyes of ones own needs.

I say males, because women have additional health needs based on their reproductive systems. Contraception, check ups, prenatal care and childbirth are issues for the vast majority of females. It might be easy to say, well, that’s your dumb luck but not my problem. And in fact, some of the modifications being proposed to health care in the U.S. do say exactly that, to females, to those who are older, to those with pre-existing conditions or mental health needs.

But is that a wise thing to say? I once had a similar argument with someone who had no kids and therefore didn’t want to pay for public education. “Don’t you think that living in an increasingly ignorant and illiterate society would make your life worse?” I asked. “And do you really want to grow old depending on these people you refused to educate to keep your groceries coming and your lights on?” Public education benefits all of us.

So does basic health care for everyone. Contraception? Prenatal care? Whether you are male or female of any age, do you really want to live in a world with more unwanted children? More unhealthy children? A world in which those needing help with drug addiction or mental health issues cannot get care? By carving out pieces of health care and making them expensive add-ons, we bequeath ourselves a society that is worse for us. Not for those other people. For us.

I once read that having a no-smoking section in an airplane was like having a no-peeing section in the pool. Exactly. Those of you who want really low premiums for a health care system that provides you with almost no services, you can go stand over on that side of the pool, and just pay for what you need. The rest of you, well, you stay on this side here and do the best you can with this broken system. And if you just can’t help getting a little pee in the water, I’m sure those folks over there won’t mind.