Scott Kirwin asks: How is fire protection - a recognized public good today (it always wasn’t) - different than health care - which we currently do not recognize as a public good?

Here’s one difference: providing more fire protection will not cause more fires whereas providing more health protection will cause more people to regularly use that “free” benefit. That is, people won’t call to report fires just because they have protection, although people will go see a doctor more often for increasingly minor complaints the better their health coverage is.

The government isn’t--or shouldn’t be--in the business of simply providing benefits because it sounds like a good idea. Nationalized, universal health care would be so tremendously expensive that it would require a massive tax hike to fund--a tax hike that would stunt economic growth and would likely still fall short of the actual cost of the entitlement.

Here’s another difference: while pretty much all fires can cause a danger to the community at large, not all health issues are community issues. Your broken bone, your migraines, your non-communicable health issues aren’t my problem. Scott makes it sound like every health care issue is a public one when that simply isn’t true.

Is there a health care crisis? Yep. But proportionally America spends more on health care than it has at any time in history. The better coverage they have, the more often they go to the doctor, the more drugs they take, and the more expensive the technology they use to help diagnose problems. Shifting the cost from health care providers to the government won’t reduce that cost (in fact, it will drastically increase expenditures as each dollar filters through a massive bureaucracy) it will just put it on another part of the ledger.

Private companies will breath a sigh of relief because they will no longer have to deal with the constant health care cost increases. Until they see that extra tax hit them every quarter and each and every American sees that extra tax hit them with every paycheck.

So the crisis isn’t in the number of dollars spent on health care, the crisis is in consumer expectations on those dollars spent. Everyone thinks that they are entitled to their pills (no matter how much they cost companies to research and develop) for a five-dollar co-pay. Everyone thinks they are entitled to visit a highly educated and trained doctor for a co pay less than they are willing to spend on Jiffy Lube’s “Best” oil change.

These aren’t necessarily insurance issues. Pills are planned expenses and so are a lot of doctor visits. Your yearly check-up isn’t something you need to be insured against in the same way that your radiator coolant flush and transmission service aren’t things you need to be insured against. Yet no one is lobbying for nationalized car care insurance so that you never have to pay more than a $20 co pay whenever you rack up another 50,000 miles on the car.

I admit, health care is a more complex thing than car care and potentially wildly more expensive. That doesn’t magically make it the same kind of public interest as fire and police departments or a standing military. Our health care system is failing us precisely because we haven’t come to the right solution that balances the “insurance” aspect with the fact that planned expenses increase faster when people have no incentive to control costs.