Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.
Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.”
A reader, John Dowd, sent me this comment: “In Europe generally the populace in the various countries feels enough sense of social connectedness to enforce a social contract that benefits all, albeit at a fairly high cost. In America it is not like that. There is endless worry that one’s neighbor may be getting more than his or her 'fair' share.”
So, to the extent such attitudes are in fact to blame, we can say that hundreds of thousands of Americans suffer or die each year from lack of health care due to the simple, shameful fact that millions of us are using the moral-reasoning algorithms of a six year old. ("But Mommmm! I don't wanna share!")
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