I get it. Why don't you?

So, let me get this straight ...

You like your health insurance company so much, you'd rather pay more than twice as much per person than any other industrialized country for system that routinely fails nearly half of all Americans (well, the half of those not already on some sort of subsidized health insurance program).

Is that right?

I get it, I get it. You like your doctor. You like your therapist. You abhor the thought that some bureaucrat in Washington might tell you that you can't get a certain prescription drug or medical procedure or that you can only consult certain doctors ... I get it.

But you don't get it because your insurance company does that now. Your insurance company routinely tells patients which procedures they can have and which ones they can't, which doctors they can consult and how often. Your insurance company routinely bases prescription drug coverage on which big pharma companies they have contracts with.

In fact, your health insurance company is in the business of denying your claim, in assuring you get the cheapest drugs rather than the drugs you need, and in making sure you stay away from expensive medical procedures, even when they could save your life. If you’ve never had this happen to you, you are either extremely fortunate, have a premium policy or you are much more well off than you realize.

In other words, we already put up with most of the things you say you don't like about health care reform.

Oh, I get it. You don't want to pay for "socialized medicine" or for all those poor people. But, you already do. Roughly 40 percent of Americans have some sort of government subsidized health insurance whether it's because they are government employees, on Medicare, Medicaid, S-Chip or eligible for VA benefits. And, despite the occasional hiccup, most of those people seem to appreciate that coverage.

And, we subsidize the truly indigent because we won't turn them away from treatment of the last resort — the emergency room. (And, don't think for a minute they eventually pay for that treatment — taxpayers pay for it in the form of taxes to our cities and counties.)

In reality, we're not talking about making anyone change insurance companies (meaning you can avoid the dreaded government bureaucrat) or doctors (unless your current insurance company forces you to change) or limiting coverage (other than the limitations your insurance company already imposes).

In reality, this debate about the value of social medicine versus private insurance we're having is really about making sure everyone in this country has some way to afford needed health care.

In reality, our entire economy is hostage to the concept of employer-provided health insurance. It hamstrings entrepreneurship because people are locked into their jobs because that's the only way most of us can afford any health insurance whatsoever — good or bad.

It hampers small businesses because small companies can't afford to offer the same kinds of benefits (read: health insurance) as the mega-corporations and some mega-corporations (can you say: GM?) have experienced some rather catastrophic problems as a direct result of legacy health insurance costs.

In June, Pres. Obama asked why, if the free market was all that, insurance companies should fear the competition of a public option?

As long as insurance companies are for-profit, our health care delivery system will be no better than Cuba's (and you can make the argument that theirs actually provides for all their citizens). The bill the U.S. House passed last week is the best hope our country has ever had to ensure the vast majority of our citizens enjoy this particular liberty.

Insurance: it's the wrong debate

It's clear the events of the last 18 months have thoroughly discredited the "small government" approach. I'll grant that there is something particularly Jeffersonian about the concept ("the government that governs best governs least") but the common good simply is not served.

It's true, government can't solve all our ills ... nor should it be expected to. However, it can (and should) be able to address those issues that serve the common good.

I have several conservative friends (yes, I do). They hold some pretty strong opinions on health care, opinions I absolutely do not share.

My opinions are pretty strong as well. There is nothing anyone can do or say that will change my belief that our health care system sucks. Excuse me, our health care DELIVERY SYSTEM sucks.

Cubans have better access to health care than the average American and certainly poor Cubans have better access to health care then poor or lower middle class Americans. My personal experiences will trump your Cato Institute anecdotal study ...

Further, the latest studies are clear that US mortality is among the worst of industrialized countries at a per-capita cost that is orders of magnitude greater. In other words, everyone else in the industrialized world has greater access to necessary health care at significantly lower personal cost than Americans do.

Let me put this another way: even accounting for the higher taxes socialized medicine requires, nearly every citizen of nearly every industrialized country on this planet has better access to better health care at a lower cost than Americans do.

As long as the "solution" includes insurance companies, we'll never fix it because profits will trump care every time. Health care costs will continue to eat up an increasingly catastrophic portion of our GDP.

In fact, as long as the debate is about health insurance, we're holding the wrong debate.

It wasn't only shoddy products that brought down GM ... it was the way this country deals with health care (blame the unions, if you want -- and they deserve some blame -- but the way this country approaches health care offers one helluva an example on how to keep the great unwashed in its collective place).

In other words, I don't think Obama will go far enough ...

Call is socialism, whatever. I think affordable health care (notice I didn't say "affordable health INSURANCE") is a basic human right.

Any other debate is the wrong debate.