Health Care: Programs and Policies
Everyone gets sick. This fact of life injects a very personal emotion into discussions of health policy. You may be indignant about public assistance programs, think job training should be available to all, and fume at the cost of housing in your community. But few other topics in social welfare policy get people going as much as the experience of racing to a hospital emergency room, only to be asked how they intend to pay for the necessary treatment. Perhaps that is why, more than any other issue, health care is something that grips everyone.
These feelings arise from the paradox of U.S. health care. On the positive side, health care in the United States has many admirable features. Patients who have some potentially life-threatening diseases are very lucky to be pa- tients in the United States: with their access to advanced medical technology, American women who have breast cancer do better than women with breast cancer in Australia, France, Germany, or Japan.1But if you do not have health insurance, spend hours trying to straighten out your medical bills, or must fight your health maintenance organization (HMO) to get the next treatment, then the U.S. health care system is likely to make you quite angry.
It is not hard to identify some good reasons for this anger. U.S. social welfare policy treats health care as a commodity. Whether it is housing, cars, or health care, a commodity typically has a price in the marketplace, with more affluent people able to purchase a better-quality good or service. To