Monday, September 28, 2009

Health care two-cents-worth

 I've been observing a lot of the health-care debate and thought I'd post a few principles for Americans to consider.  I hope these point/principles will guide us as we sort all of this out.  Some of you may have more personal experience than me, whether you are a health provider or someone who has navigated the system through a major problem of your own or a loved one.  I appreciate feedback from anyone.

1.  Whatever Americans are mandated to do, absolutely must be mandated for members of Congress.  The best way to ensure that they will work to fix any future problems that arise (see Social Security) is to make them have a personal interest.  There can't be an exemption or gold-trimmed version of health care available for Congress.  I'm not optimistic about this happening.

2.  High quality medical care costs money, a lot of it.  The kind of medical treatment that is available to those who can afford it is hundreds of times better than what has been available to people throughout history.  The difference is mind-boggling.  In fact, until about 1910, an ill person was, statistically speaking, better off staying home than seeking the primitive medical treatment available at the time.  (This according to Lawrence J. Henderson, physician and medical educator of the early twentieth century).
But let there be no doubt, with all the sophisticated equipment and highly educated people who work hard and receive (deservedly) a high compensation for their work in research and treatment of disease, it costs money to receive sophisticated medical treatment.
It will always be hard for a group to consent to pay for one person's treatment.  We humans are sinners and selfish by nature.  We don't like to pay for something for someone else, especially if we are not sure if the group will step up and help us out if we need it (we may not need it either).  And we know that other people are sinners and will try to "beat the system."  The ill person will always want everything covered, and the rest of the group will usually look for a way not to pay for it.  Removing the decision from the shareholders by a proxy group, be it an insurance company or a "non-partisan government panel" does not take away this problem entirely, but if the group is not able to take a profit, it could help. 

3.  Mandating health insurance is not like mandating auto insurance.  "Many drivers can go without collision insurance if they like. If a hood is dented on the car of someone without the coverage, that person can drive around with a dented hood. But the only kind of health insurance Obama is talking about is collision insurance. If someone's body is a jalopy, he or she still has to get covered."  from Fox News.

Auto insurance is mandatory in many states because it covers "the other guy."  Here in Jordan, they actually call it ضد الغير "against the other."  If the accident is your fault, your insurance company covers the other person's damages.  Health insurance by nature doesn't work that way.

4. You may not like whatever government solutions are finally offered.  Not everyone in UK, Canada, Europe is happy with their nationalized health care.  Wherever you go, you can find people who have had major problems.  Can we do better?  Probably.  Do some countries have a better system?  Maybe.  But the chances of us coming up with a system now which, twenty years down the line, shows its faults, leaves people sick, dying and penniless, and raises up a new generation of Kennedys and Pelosis to rail against the injustices and inefficiencies, are pretty high.

5.  Nationalized health coverage programs in Europe and Canada may be more successful and affordable than an American one would be because they are subsidized by US military commitments to defend them.  European states, since World War II, have been able to spend less on defense and more on social programs, even though they have been at most risk (being on the doorstep of the Soviet bloc), because they know that the US will come to their defense.  Germany has hosted tens of thousands of American troops for over six decades now.  Maybe it's time to let Europe defend itself while we take care of our own problems.  (Of course, it's not only Europe; Japan and Korea have also hosted large numbers of American troops while building their economies).

6.  Government intervention often makes a problem worse.  If the government were so great at providing health care and coverage, then our veterans should be receiving treatment that is the envy of the world.  Alas, they are not.  The best thing the government could do may be to become less involved.  Government is already up to its elbows intervening in health care in our country.  By enabling employers to make contributions toward health coverage before taxes, they have intervened in the system in a big way and greatly disadvantaged alternative, free-market coverage options.  The law of unforeseen consequences.
Another solution may be for each state to develop its own plan, thus creating more competition as people may look out of state to find a better option.

7.  Any government "solution" will likely benefit the powerful and well-connected much more than the average citizen.  That's how things go in our nation today.  Those who have the ear of law-makers get what they want.  Contrary to much popular thinking, regulation does not hurt or even disadvantage big business.  They are very happy with regulation because they are large enough to send lobbyists to fight for regulation which disadvantages their competitors and large enough to hire lawyers to make sense of it all.  Insurance companies, medical providers, pharmaceutical companies are NOT going to lose their shirts in this matter, and are NOT going to lose business.  You can be sure of that.  But the average citizens may find themselves worse off.  And my generation?  Which mostly doesn't even bother to vote?  Why should we expect anything good to come out of this?

8.  More government intervention may take away many treatment options that people are currently taking advantage of now.   Herbal medications, home births, refusing immunizations for children, chiropractors, acupuncture.  We ourselves are pretty "traditional" as far as the medical treatment we pursue, but we have friends who pursue all of those various options.  Normal, intelligent people who decide to go against the ideas of the majority/establishment.  I'm concerned that the ideas being thrown around would restrict their freedoms.

9.  Many people are calling for quick action.  We must do something now!  President Obama has attempted to scare everyone into action/acquiescence by saying "more people will die" if we don't act now.  The truth is people will always get sick and die.  Rushing a solution may very well make things worse.
Have you ever heard of a government agency that was canceled because it was no longer needed?  Didn't think so.  Government programs never go away.  Never.  If there is one thing that bureaucrats know how to do, it is keep their jobs.  If we rush something now, we will be stuck with it, and in fact, the urgency of the problem will be gone and the motivation to seek a better solution will disappear.

10.  Due to our country's insatiable appetites and shameful impatience, we have dug ourselves into a chasm of debt out of which it will take generations to climb.  We need to save money somewhere.  I suggest pulling troops from a large number of our foreign bases.  See the following article:
 America's Unwelcome Advances
According to the Pentagon's 2008 "Base Structure Report," its annual unclassified inventory of the real estate it owns or leases around the world, the United States maintains 761 active military "sites" in foreign countries. (That's the Defense Department's preferred term, rather than "bases," although bases are what they are.)
Or this article from the Campaign for Liberty which claims there are at least 1000 US military bases overseas.

Many people speak of the need to bring troops home from Iraq and Afghanistan where they are in harm's way. Those are good arguments.  We also need to bring troops home from  places where there is little compelling need, and where our presence may be counterproductive.

11.  We need to search our hearts as a nation.  As humans, we will always struggle against the curse of death, until the return of the Lord.  God cursed humanity with death in order that they might turn to Him and live, not turn to a government which seems more and more eager to take the place of God.
Many people are hoping to reform health care to make it more just, affordable, and accessible.  I applaud those efforts.  However, others seem to want to get something for nothing, or at least something on someone else's tab.  I believe in some cases this is a sign of rebellion against God.  To whom are we looking for deliverance from sin and death?

Finally, for an expert's (expert on policy-making and medical treatment) view on the subject, see Ron Paul's statement before the US House of Representatives

Abu Tulip

1 comment:

Abu Daoud said...

The best thing I've read on the health-care debate in a long time.

Healthcare is not a human right, it should not be considered as one. There is profound emotional and spiritual problem with America though: fear of death and sickness. Death is part of life, unless your special (like Elijah), and most people are not special like that. We take the sick and elderly and segregate them, we keep them far away from us so we don't have to see them and interact with them.