I would ass a fourth reason: health is a very much a public (as in collective) issue, not a sum of individual medical problems. Something that is fundamentally at odds with the dominant ethos of how to deal with problems in america in the past 50 years or so.
For some reason this has become a political issue rather than a health issue. At the moment Americans are living in an extremely toxic environment where everything is either right or left. Not right or wrong.
As a non American, I wonder what brings US to a (relatively) extreme position on Health. Technicalities aside, most places consider health as part of the suite of public responsibilities.
Does a significant portion of the opposition to the public assuming responsibility for health also oppose the public assuming responsibility for education? I ask because it seems a close parallel.
Starts with a culture shift : society should care about its citizens health. It's just not the case in many countries, especially in the US. I guess the maths are simple : keeping more people alive and healthy is less profitable for the people involved..
I see your point, and concede that some "root causes" should be out of scope for the medical field. I believe that solutions to problems should be sought by the appropriate groups at every stage of progression and every level of abstraction. However, during an actual patient/doctor visit, public health "root causes" should probably be at least discussed.
The counter argument to this is that there are so many health conditions that are getting increasingly bad which we have no explanation for since so many things changed at the same time.
Personal responsibility is overrated. In almost all of the examples you mention, direct government intervention can and does lead to positive health outcomes for individuals and for the whole of society. It just seems like that's almost a taboo thing to say in the US.
Health is a mess, and we're further advanced than ever in history. Education is a mess, and every person has all the knowledge of the world literally in their pocket.
My issue is the unequal application of insurance. We don't care about the reasons for poor health and instead treat it. I never once said "muh freedom" was the issue, and in fact point out that people don't wear masks even today. The problem is the culture of freedoms and personal responsibility has completed deteriorated.
Preventable illnesses like obesity, smoking are ignored as personal freedoms, and are allowed to run rampant while their preventable illnesses clog up the system.
Why is only helping the sick focused, at the middle of the story as if there is a predisposed amount of illness, and not on the circumstances that lead to it? People worry about single mothers but don't worry about them before they become single mothers. It's baffling.
I am not emphasising the economic causes. I am saying precisely the opposite: this is a public health issue being solved by a civil servant like it is a problem in an economics textbook.
And yes, the issue is cultural. But that doesn't really matter either way (and if the issue is cultural then you can't solve it by increasing costs any way...you are just taxing people who have a problem).
reply