When we talk about what a living wage should include, I think health care is the hardest to pin down. It’s fairly easy to know whether a person is clothed or has enough to eat. Housing is a bit more of a moving target – how much space does an individual *really need*?, we wonder; but still, “keeps me warm, dry, and safe” is a fairly straightforward criteria to assess.
Healthcare, though, is its own special world. Between the life-versus-death and quality-of-life type questions it poses, and the ever widening options for medical care, it is very hard to know and agree about what is the ‘right amount’ of health care. And if you don’t know how much your employees deserve, you can’t know whether you are compensating them adequately in this area.
Still, just because we aren’t ready to answer every question about health care doesn’t mean we shouldn’t try to answer a few to get started. Doing so may, in turn, shed light on further questions.
The other week Darwin posted A Case Study on Costs and “Basic Health Care”, and I saved it in my bookmarks for linking here. If you haven’t read it, you need to go read it. If you already read it once, go back and read it again.
[BTW, having given birth four times in recent memory, I can vouch for the reality of the situation he describes — lest anyone dismiss this as an isolated or extreme example. No, this is the birthing business as usual, pretty much the new normal in the United States.]
Here’s a quote that summarizes:
As it stands, our medical system is built around the assumption that cost is no object. And doctors are very heavily penalized based on any “avoidable” injuries or deaths that occur on their watch. The result is that instead of providing good, high quality “basic” health care, and using extreme (and expensive) measures only when necessary, we often require extreme measures “just in case”. This makes it far, far more difficult to provide “basic” health care to all.
And here is what I want to say: Wake up Republicans! Health care reform is waiting for you! When I talked about ‘structures of justice’ this is exactly the kind of thing I meant. Do not labor under the illusion that a just society – one in which the poor are not trampled underfoot – is the sole province of the dreaded far left. There are good conservative solutions to these kinds of problems, and if we as a nation were to actually enact them, well, the left would have a lot less fodder for their tendency towards grand socialist fantasies.
The living wage is not a left- or right- wing ‘agenda’. It is a moral imperative. You cannot be a just person if your profit or your comfort depends on other people giving you their labor, and you not providing them the means to live in exchange. The good news is, that if we are willing to care about the people who are too sick or too in debt or working too long of hours to be actively engaged in the political process, we can come up with sensible, free-market-compatible ways to create a just society.