Health care is socialist
Disease is a natural disaster. The only way to make it work economically is to spread the risk, tax everyone, and save for the rainy day that's coming for each of us.
by Dave Winer Wednesday, March 8, 2017

A few years ago I wrote that The World Is Socialist

It was meant to be a provocative piece. Get you thinking. 

Along these lines...

In the US we always try to make everything fit into a market. 

But some things resist that treatment.

For example, if it were to snow two feet tonight in NYC, how would you treat that with market economics? When I go out my front door, would I have to contract with a shoveler to clear a path for me to the subway? But if I did that, the people following me would get the same service for free. So the natural thing is to pool our money and pay a shoveler to clear a path for all of us. That way each of us pays a fraction of what it costs. You can see where this is going. Pooling our money is another word for tax. It's been given a bad name by persistent marketing, but it's still a good idea, and for natural events like snowstorms, any other approach is basically unworkable.

It takes a little imagination to see disease as a natural disaster like a snowstorm, but that's the best model for how it actually impacts a community. We don't know who will get sick, or when. So rather than take a risk that you'll be the one who gets the expensive disease, we pool our resources to pay a share of what the treatment would cost each year. And either way we're lucky. If we don't get sick but paid a small tax, we're happy. Not so happy if we're the one who gets sick, but at least we get the treatment we need, don't die, and also are not be bankrupted by our misfortune.

I'm not going to go into all the detail here, but every way you look at it, disease follows the pattern of a natural catastrophe. So the only reasonable way to fund treatment is to pay taxes, and that's it. In the U.S. we've privatized the insurance, but maybe it's time to fully bite the bullet and just make it a tax. That's the debate we're having, over many decades, under all the noise. 

PS: When I teased this piece on Twitter I suggested an alternate title.  :-)