Why, after seven-plus years, is the U.S. debate over how to afford adequate health care getting nowhere? The Republicans argue that you can redefine “adequate” and cut costs by reducing the level of benefits and the number of people qualified for help in getting them. The Democrats argue that we can extend the level of benefits to the poor by pumping more tax dollars into the needed subsidies. Conversely, the Republicans want to redistribute the wealth from the poor to the rich and from the sick and elderly, who need to buy health insurance now, to the young and healthy, who can wait till they get sick.

Meanwhile, no one is asking the obvious question of how every other modern industrialized nation has solved the basic problem of how to provide their whole population with decent health care. The reason this question is not asked by either side, barring the odd progressive like Bernie Sanders and Warren Buffet, is largely cultural. Americans are now taught from birth to think of themselves only as individual consumers of commodities and not as interdependent members of a national society. We have divided ourselves into winners and losers in the great cost-shifting game of seeing who can get the most benefits for the least money. I win, you lose.

As long as this game goes on, America will continue to fall behind other countries, where the game is how to make everyone a winner and nobody a loser. In short, the single-payer game. This is not a game you can play for free; but it costs a whole lot less in lost lives and money than the game we’re playing now.


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