A fair number of people are opposed to any significant health care reform because they believe that the government shouldn't take on such a huge part of the lives of its people. That's a reasonable abstract philosophical position, even if it contributes to all the silliness that we've been seeing.

Silliness like the woman who berated the Prez for advocating "socialized medicine" even while demanding that he not touch her Medicare. People are afraid of change, even when it's all for the good--or even when they're already living the change they fear.

What we really need to decide is whether or not full access to health care is a right or a privilege. And before we get started talking about the tens of millions without health insurance, let's do acknowledge that emergency care is already guaranteed almost everywhere. Emergency care is useful, but routine care is what makes for a healthier nation. And making sure that all Americans have access to routine care should be one goal of reform.

As to the right or privilege question, I was being somewhat facetious. Plenty of folks argue that health care should not be guaranteed. And yet every single one of those folks has easy access to care. Some give the brusque capitalist brush-off ("I earned it"), and most simply deny that all people deserve what they themselves enjoy. This is an arrogant and, frankly, inhumane argument.

I haven't met anyone who wants to get rid of health insurance. Sure, most of our plans suck, and we'd change our particular plans in a moment if we could get a better one at a better price, but no one wants to go without. So I'm thinking that deep down, most folks think of health care as a right. Or, at the very least, a human necessity, which is pretty much the same thing.

And if all those "Let them earn their health care" dorks really believed that health care isn't a right, then they'd have been hounding the Bush Administration to file trade grievances with the WTO. After all, just about every one of our trading partners have some form of universal health care. That's an astounding subsidy for the businesses in those nations. If we really believed that health care is a privilege for the landed gentry (or whatever), then we'd be duty-bound to attack our friends for aiding their businesses with the illegal subsidy of health care.

We would lose, of course. It's a crazy argument. Plenty of business types know this. There are an awful lot of corporate honchos who would love to see national health care. Remove the health care element of contracts and the pensions for the auto industry would rebound significantly. For that matter, removing health care costs from any of our industries would be a huge boon.

The financial benefits of this subsidy would be most appreciated by the largest companies, but small businesses (which rarely provide health insurance for employees) would do well, too. Access to routine health care makes for a healthier work force, and a healthier work force is more productive. While I find the "billions of dollars lost due to illness" statistics to be absurd, as most folks simply make up work when they get back, nonetheless I am sure there are economic benefits to having workers at work more often.

Even if we know the answer to the "privilege or right" question, most don't want to speak the answer out loud. Fine. Let's call national health care what it really would be: A subsidy for all of us. Guaranteed health care removes the stress of scraping for health care when you lose a job. It shaves billions of dollars (if not trillions) from the budgets of businesses across the nation. It also shaves trillions of dollars off the budgets of municipal, county and state governments that pay for emergency indigent health care at public hospitals.

A lot of those savings would be offset by new taxes, but not all of them. If the government takes over health care, less money will be spent on health care. Insurance companies make significant profits (often as high as twenty percent and more). Just whacking that overhead would save just about everyone a load of cash.

But that doesn't matter. We won't have national (or single-payer, or universal or whatever you want to call it) health care after the current reforms are passed. We'll have to wait. The Prez is an incrementalist, and I can dig that. But I think it's time to change the terms of the debate.

We're not talking about socialized medicine. We're talking about subsidized medicine. I think that's a phrase we can all live with.

Jon Worley lives the subsidized life.