Accepting Realities

A short history of health care.

Slate column sort of reviewing New Republic editor Jonathan Cohn’s book Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price that is refreshingly honest about the state of healthcare in the United States.

“The problems inherent in the U.S. system of health care are literally killing people.”


“The overall trend—the gift of an increasingly market-driven health-care system—is to undermine the very idea that the cost of illness should be spread out among the general population, healthy and unhealthy alike. In this sense, the private health-care market is too efficient. Assigning health care costs to sick people is what the market wants to do.”

The notion that we should pay our own way in healthcare has been expressed in alarming ways on this site and on others linking here.

“I don’t want to pay for anybody else’s choices or illness” is a common U.S. notion. Until we get back to a non-profit, non-market driven insurance concept or something that doesn’t deny care to those that need it, those of us who “don’t want to pay for Ms. Jones cancer” or “don’t want to pay for somebody’s bad choices” are in a state of denial about the very nature of insurance. If you want the status quo, which will be less and less coverage even under an employer subsidized plan, you are still paying for those things. Maybe you won’t pay for my choices, but you are paying for choices of those in your plan. Look in the next cubicle or two. You are paying for their choices and their illnesses.

It is clearly time for a new way of talking and thinking about healthcare in the United States. This column on Slate is a good start.