This is the question that Princeton Professor Uwe Reinhardt poses in the comments section of his recent New York Times column on health care entitled Rationing Life Years.
Even those of us who follow Reinhardt don't always read all the comments. Therefore, I wanted to reblog this comment in full because its application is much broader than the original subject of the column, and because it goes to the heart of my despair over the dismal state of current political discourse in the USA and many other nations.
Immigrants such as I remain confused about the question whether or not America is a genuine nation or just a bunch of individuals sharing a geography and, yes, allegiance to a relatively vague document called the Constitution over whose intent, as we are learning once again, even expert legal minds argue incessantly and cannot agree.
Canadians have always viewed their health care system as part of the cement that forces a group of people sharing a geography into a nation. Europeans view it that way, too.
Many Americans would like to view our health system that way too, but just as many (and perhaps more) do not. They think of health care as just another transaction between individual A (the "consumer," formerly "patient") and individual or company B (a doctor or a set of people in a hospital).
My doubts about America as a nation were strengthened by the remarkable way we have conducted our wars in Iraq and Afghanistan. A few individuals, recruited mainly from the lower income strata, do the fighting and the bleeding and dying, while the rest of the nation gave itself a tax cut and goes shopping, on the advice of the President, no less. Unemployment among veterans remains high, and we lack sufficient capacity to treat the mental health problems of our overtaxed warriors.
If we cannot come together even on sacrificing collectively for our wars, how will we ever come together on health care?