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20 December, 2010

Free healthcare for children

The other day, I was having a conversation with a friend about healthcare for children.

Guess what? Healthcare isn't free for children. Who knew?

I'm being facetious, of course. Everyone with a child knows. And most everyone else knows, too. If you're dismally poor, then there are provisions in the government to provide. But otherwise, a child's healthcare is in a similar bucket to an adult's healthcare. It must be either paid for, at least to some degree, by some adult, or it is provided, at least in part, by some employer of said adult. This strikes me as "wrong." Children are not required or expected to work, of course. Nobody disputes that. Likewise, children are not expected to provide for themselves. It is expected that someone will provide for children. And proper healthcare might be imagined to fall under the general category of things that should be provided. And yet, it seems that parents are needing to make very tough choices about how much and what type of healthcare to provide, in cases where there isn't an employer-based plan to take care of everything.

I recognize I'm oversimplifying this issue dramatically. I recognize that someone needs to pay for it. I recognize that our taxes already have deductions for children that could be construed as provision toward healthcare costs, or other living costs associated with raising a child. It's a complicated one.

The problem I have is this: in much the same way that children are at the mercy of what their parents feed them, and how their parents discipline them, nurture them, provide for their education; children are also at the mercy of how their parents provide for their healthcare.

As I am writing this, I am recognizing the futility of my point. Healthcare is just one of many ways in which children are at the mercy of their parents' ability to provide. The truth is, children must enter the world, and develop in the world that is largely defined by the environment that the parents create. Children start off "innocent," and it would be nice to think that they have all the best things afforded them: great food, a great home, education, social opportunities, travel, healthcare, love. If they did, one can imagine that outcomes would be better in this world than they are. The part that is difficult for me is the idea that socioeconomic factors play such a major role in defining the nature of this childhood experience. It really comes to the question of "Is it the government's responsibility to level the playing field?" and if yes, the next question would still be "Is there an approach to leveling the playing field whose measurable success justifies the overall cost to society of doing so?" And the answers to those questions may define the fundamental difference between the left and the right. The left would rather see the effort made, even if it is a failed one, even if it is immeasurable or inconclusive, even if there is massive systemic abuse, in order to assert that the government takes responsibility for the welfare of citizens. The right would say that it is not the responsibility of government to do so, and furthermore, that there is not evidence that the cost to society outweighs the benefit.

Sometimes, I try to compare us to "the animals" and see if we're the same, better, or worse. The rationale in my mind is that we should at least be "the same" and hopefully "better" when it comes to how our civilization operates. Animals that are stronger, more genetically fit, more fortunate circumstantially, tend to thrive over those who are less so. And the animals that are more fit will have no hesitation whatsoever about exercising this dominance to provide for their own. For some animals, this occurs at the individual level. For some, at the group level. In most cases, a given species will exercise whatever actions it must, at the expense of another species, for its own survival. Humans don't really appear to operate at much different level, on average, than the animals do. The key differences are the presence of extreme outliers (altruists, barbarians), and the diversity of fashions in which one human or a group of humans may demonstrate "fitness." For humans, to be "fit" is no longer just a biological phenomenon. And fortunate circumstances can come in far more forms than exist in the animal kingdom.

I'd like to see society operate in a more altruistic fashion. Partly because I am idealist, I realize. But also, because I believe we have the capacity and the means to do so. But therein lies more idealism, I suppose.

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