The counter point to this perspective usually consists of "sick people aren't my problem"

This is a common enough argument... i'm not sure it reflects the mainstream, or maybe i just hope that it doesn't. Social programs get the same treatment, of course.... "poor people aren't my problem."

I think we could have a culture which supports both universal health care *and* social programs, but we're behind the ball on the language here. The stigma of socialism (undeserved, as it may be) makes a real discussion difficult, because a large percentage of people simply turn off and resort to, as you said, "SOCIALISM BAD!" Simultaneously, we've gotten to a point where "TAX" is a four letter
word. You say it, and all useful debate becomes moot, because, like socialism, all taxes are bad. Americans also tend to have an inherent distrust for government (and this carries over to all large bureaucracies). Certain political factions have exploited this philosophical underpinning and both expanded and distorted it to the point where the average guy resents paying his taxes, even when he well knows what services it pays for and is in favor of them. I think it's become so implicit that bureaucracy is wasteful and inefficient that we are crippled to even accept the notion that it may not be so.

Certainly I'm all for ensuring that the maximum of my money goes to provide actual services and if we can minimize overhead while providing the same level of service, I'm for that. Does that make me a fiscal conservative? I can't tell anymore. I've checked on charities before and given to one over another because more money gets to the people who need it. That's smart (i think), and applying similar metrics to the gov. should be encouraged.

At any rate, what this article shows is that health care is becoming less good at redisribuing wealth... and that the trends we are establishing, far from reducing the burden, will increase it. It's not insurance if it doesn't provide what i'm going to need. But, you know, redistributing wealth is just a fancy way of saying "Steal from the rich..." right? That mentality is going to be hard to overcome.

The article also touches on issues of preventitive care vs. urgent or critial care. I can't recall a study that doesn't say that staying healthy is cheaper than getting fixed. But we have a mentality in this country that it's a waste of time and money to go to the doctor when nothing is wrong. If nothing else, i don't think a massive economic study is necessary to posit that if we get everyone doing preventitive medecine, our costs will go down *substantially*.

Ultimately, I think the health care issue will reflect itself in other economic sectors as we either lose, or fail to gain, good jobs and smart people because they won't risk their family's health.

RE: The New Yorker: The Moral Hazard Myth