When you order a burger, the dude at the register doesn't ask, "Do you want health insurance with that?"
But it's in there, buried in the transaction: health insurance for restaurant employees perhaps, and those who processed the beef, the truckers who delivered it, and everyone else involved in getting the Triple BigSplurge from meadow to maw.
That's true of nearly every purchase you make. Paying the mortgage? Bank employees say, "Thanks for all the health insurance." Buying beer? Ditto. Purchasing a car? You may be paying more for health insurance than for the engine.
The socialization of health care in the United States didn't start with Obamacare, or even with the introduction of Medicare and Medicaid in 1965. It got rolling in 1945.
That year, thanks to federal price and wage controls and a shortage of workers, employers decided to start luring new hires with health insurance. It probably seemed brilliant when high-tech doctoring mostly consisted of mopping sweaty brows, chopping off malfunctioning body parts and saying, "Are your affairs in order?"
"How much can crutches and brow moppers cost?" corporate bigwigs likely said. "Just promise them health care, and we'll build the cost into the price of the massive console AM radios upon which our fortunes will rest for eternity."
The National War Labor Board agreed health insurance wasn't subject to the wage ceiling. President Harry S. Truman, that same year, proposed a national health care system that would be optional. In keeping with our solemn and proud tradition, he was branded a socialist. Employer-sponsored health insurance became the norm.
But then medical researchers started inventing wicked expensive drugs and multi-million dollar machines that make cool noises and keep people alive. The percentage of health care dollars dedicated to brow-mopping plummeted. The cost of health care skyrocketed.
And while we kept buying all our health care in the nation where it is by far the most expensive, we started buying many of our cars and toys and other products from countries where health care costs much less. Goodbye industrial competitiveness.
By now taxpayers at all levels of government cover about half of all U.S. health care expenditures. That's Medicare and Medicaid, but also care for soldiers and postal workers, librarians and teachers, trash collectors and city planners.
And the 46 million uninsured in our nation? We all pay for their care too. They don't get enough of it, or get it from the right places, or in a timely manner, and are thus 40 percent more likely to die prematurely than the insured. But hospitals can't turn away the truly ill and we all bear this cost.
Whether you like it or not, everyone's insurance is paid for by all. You can't choose not to provide health care for somebody when you buy Jet Skis, or Cream of Wheat or the latest issue of Hustler. Employees who get health insurance can't decide to use that part of their compensation for whatever they wish, as they can with cash, because Shop-a-Rama doesn't accept Blue Cross to pay for groceries.
Having established that the cost of health care is borne by all, for all, we are free to address meaningful questions: How can it best be delivered? What are we willing to provide each other? How do we stop spending so much on needless procedures with minimal benefit for patients in the last days of their lives?
The socialized health care ship sailed in 1945. We've all been paying the medical costs of its crew and passengers ever since. In fact we are the crew and passengers. The issue now is how to make that vessel seaworthy, before the fiscal whirlpool carries us under.
Lane Filler is a member of the Newsday editorial board.