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Sharing: is it going out of style?

January 12, 2017 at 9:12 AM Leave a comment

Photo by elPadawan

Back when I was in college in a small school in Indiana, I was in a fraternity, like 85% of the kids who attended there.  All the guys in my house slept in one of two “dorms”, or mass sleeping rooms in the back of the house.  The freshmen slept in the “rookie dorm”, and the upperclassmen slept in the other dorm (there wasn’t another name that I recall).

But over time, my fraternity brothers started building lofts, or sleeping platforms that went over their desks, for their rooms.  This allowed them to sleep in their study rooms, rather than in the communal space.  I’ve been back to that fraternity house in recent years, and the dorms are altogether gone, replaced by more spacious rooms that include both study space and bed space, like more traditional college dorm rooms.

Why did my friends build their lofts?  The dorms dated from the mid-20th century, and looked like what was familiar to that post-war generation: barracks.  It was a bonding mechanism for pledge classes, that they had to live, eat, and sleep alongside one another.   Partially as a result, I still have friends from that pledge class, and I still feel loyal to them.  But sharing space also meant listening to each other’s snoring, or gossip in the middle of the night.

I think about this experience now, because that drive to not have to accommodate to others is pretty human, and very American.   The lofts allowed people to have their own schedules, and not have to cooperate with one another on quiet time, etc.  But since then, we’ve essentially become a country where lots of kids grow up with a bedroom to themselves.  But it makes me wonder if we aren’t worse off in some ways, because having to depend on and accommodate to one another made us know one another, with all our quirks and faults on display daily.  (Believe me, some of it wasn’t pretty!)  I wonder if in a society based on individual empowerment we aren’t losing some of the glue that holds us together in community.  Freedom is great, but perhaps some experiences that force us to accommodate to one another wouldn’t be all bad.  Indeed, sharing a health care financing and delivery system appears to be one of those shared experiences that will remain for the foreseeable future.

This has relevance in the ongoing debate on health care reform.  Should we have community rating, or should it be experience rating?  In other words, if I smoke and am obese, should I pay more for health insurance?  If so, how much more?  In essence, how much can and should we depend on others’ money to bail us out when we get sick?  What if it’s a disease that I’m partially responsible for causing through my behavior?  What if it’s something that I couldn’t reasonably prevent or control?  Are there circumstances under which I don’t deserve to be able to buy insurance, because I didn’t paid into the pool when I was healthy?

As we watch a new administration unfold, these questions are going to be terribly relevant.  Clearly the Obama administration’s answers to the questions above were toward the community side.  Community rating, guaranteed issue, the individual mandate, and outlawing lifetime and annual maximums are all in line with the thought: “We’re all in this together.  Everyone should pay into the system, and it should be there for everyone, even if you are in some part responsible for the disease from which you are now suffering.”  But reading some of the Republican plans, there is more emphasis on individual responsibility and taking consequences for not living a healthy life.  Which is better?  The results of the past few election cycles tell me that we don’t agree as a country on the answer to this question.

Entry filed under: Uncategorized. Tags: #healthcare, #healthcare reform.