In response to Warner Todd Huston's post entitled:
Lets have a look back at our history. Back in 1886 firefighting was mostly unregulated, and considered a private matter that had little government involvement. Home owners who desired to have their homes protected from destruction by fire had to pay private for-profit fire companies to respond and put out any fires that might start, which was not uncommon in wood-frame houses of the day that burned wood or coal for heat and used candles or oil lamps for light.
In those days fire insurance companies existed where a person could buy a policy that would cover the cost to put out any fire that might ensue on the property. Insurance companies would issue an insurance badge that was affixed to the front of the house so that any fire company would be assured of payment for their services. Home owners who didn't have a policy and a badge, and couldn't pay upfront for the services, had to fight the fire on their own and the fire company would stand by to ensure their neighbor's home (those who had insurance) didn't catch fire. Many people thought this was inhumane and called for a solution to this problem because the poor often could not afford fire insurance and as a result, it was the poor and uninsured who suffered the most from destruction and death by fire.
Eventually a solution for this problem was reached and I am sure you already know what it is. Private for profit fire companies and fire insurance companies were replaced by government run non-profit fire departments supported by property taxes instead of fees. Now I am also sure that by now you are beginning to see the correlation between 1886's fire companies and fire insurance companies with 2009's health care providers and health insurance companies. Some of the same arguments were made back then for keeping the old system, but I think we made the right decision to dump that system and adopt the one we have today,... for fire services that is.
Even though fire services and health care services are very similar in nature, we didn't adopt the same system for health care service, I think it’s time we did,
However, notice that the system of government run fire departments that has been so successful for the last hundred odd years is NOT a Federal government run system, but rather it is a LOCAL government system that is mainly funded on the local level with additional support from State and Federal programs, and also there was no longer a need for the old fire insurance companies anymore. They had to move on to insuring other things, like health care.
So, I think the local fire department model is a good one for a rational and nearly universal method of distributing health care services, except, since health care is a lot more expensive than firefighting, I think it should be a State and Local partnership with dollars coming mainly from the state level and doctors and nurses employed mainly at the local level.
Inevitably, someone will bring up the subject of market economics and competition to defend the current system, so let me point out that these are not lost on the fire department example, they become a factor of locale. Just like people want to know how close a fire house, or fire hydrant, or for that matter a police station is to their prospective new home, people will look closely at the kind of health care offered in one locale with those offered in another locale and choose the one that fits their needs.
And for those die hard capitalists who are opposed to health care reform, I ask you, if relying on private enterprise and market economics is the best and most efficient system, then why don't we get rid of “socialized” police forces and fire departments and interstates and rely entirely on private enterprise to supply us with law enforcement and fire services and have all highways privately run as toll roads?
Answer: It may be true that firefighting and police protection and health care are not "rights" per se, but in a modern civilized society they are universal necessities that we want everyone to have; and local government is the method that we have chosen most often in the past to provide such services.