Monday, October 19, 2009

Health Care Op Ed…

Here is my attempt at promoting the position of “the other side.”

Conservatives argue against just about any version of health care legislation proposed by the President or Congress. It is true that many millions of Americans have little or no health coverage – Democrats want to do something about it.

Many in our capitalist society are not “socially responsible.” Many thousands of companies hire “contract” employees as a way around providing a health care benefit to their workers. Or they cut costs by hiring part times help – sometimes up to 39.9999 hours per week to avoid paying health insurance costs. And what about the unemployed, underemployed and those between jobs? Most of these millions are without any form of health coverage.

Conservatives argue that the government and special interests such as unions are simply legislating a power grab. They call it a “control issue.”

Proponents of a health care overhaul argue that providing some form of universal coverage is the moral and right thing to do. That is hard to argue against. The current system favors those among us who are fortunate enough to work for companies that offer and supplement the cost of good coverage. The “haves” have it – the “have nots” don’t.

Practicing Christians and others who strive to act civilly and morally would have to conclude that the current system is selfish. If we are to feed the hungry and clothe the poor and take care of widows and orphans, why are we not also called to care for the sick and infirm? The churches aren't stepping up. Other non-profit organizations are not equipped and able to assist the millions who can’t afford health insurance. This being the case, what is so wrong with the federal government filling this gaping void through creation of a mechanism to fill the health insurance black hole wherein millions of Americans are lost?

From a moral perspective: Proponents – 1 Opponents – 0


Not willing to let a good argument lie peaceably, I am compelled by some inner wonkiness to present a counter argument. A good op-ed deserves a good op-op ed.

The moral argument is a good and valid one. But let’s peel back the morality onion one more layer, because there are other aspects of morality that are being ignored.

We’ll look at this from two perspectives:

  1. The role of government, and
  2. The responsibility of individuals, including employers, employees, and others

First, the role of government. Since when has health care in this country become the responsibility of our government? Once they are responsible for our health care, how far will it go? Will government provide everything the patient needs? Will they mandate what treatments can and cannot be provided? Will they reduce the quality of coverage many now pay for and enjoy?

If the resources of government were unlimited; if the efficiency of government was award winning; if the ethics of government were above reproach; then there would be little to argue about. Health care is one of those services where the cost can be infinite – a bottomless pit. We never cease hearing the plea “what is the value of one human life?” There has to be rationing. Should the government be doing the rationing?

Fact check:

  • The resources of the government are limited.
  • The efficiency of government is not award-winning.
  • The ethics of government are not above reproach.

The government as middleman and arbiter of who gets coverage, what kind, how much, how often, when and at what cost does not sound like the way to go. The governments role should be limited to three things:

  1. Promoting efficiency - enacting tort reform to eliminate costly lawsuits and reduce medical malpractice insurance costs.
  2. Promoting competition – open up competition across state borders for example
  3. Prohibiting coverage discrimination – eliminate “preexisting condition clauses” while allowing premiums to be higher for those who have avoided paying for coverage during their healthy years.

These are legitimate functions of government. They are things they can do reasonable well because they involve minimal bureaucracy and taxpayer funding.

Second, the role of the individual. What should be the responsibility of the individual for his/her own health care? Should they rely on government? Should they rely on their employer if they have one? Should they rely on their insurance company for 100% of their health care needs?

Sometimes there is no employer or insurance company. Should he rely on his own resources or just leave things to chance? What if the individual simply chooses to be irresponsible by being indifferent or remain in ignorance? Is it the government’s job to make him responsible?

We are responsible for feeding and clothing ourselves. The great majority do a decent job. Able bodied people are responsible for productive work and earning a living. Why shouldn’t able bodied people be responsible for providing for their health care needs? Is it the government’s job to bail out people for irresponsible health care decisions the same way it bails out banks from irresponsible financial decisions?

The responsible individual will do whatever it takes to provide for her health care – self insure if she has the money; get a job with an employer that has a good plan; or sacrifice and prioritize to pay for her own coverage. Pop culture “necessities” drain away the personal resources that should go toward our personally responsible health care. Personal priorities are often upside down. Ahhh, it’s so much easier to let the government do it.

“Oh, the cost , the cost. It is too great,” they cry. That is because most people, especially the ones who can’t afford it, expect health insurance to cover everything – with $15, $5, and zero dollar co-pays and low out of pocket limits. Insurance is designed for catastrophic events, not every little cold and sniffle. Many ignore the current option for major medical coverage. Major medical is quite reasonable – a fraction of the comprehensive coverage most seem to expect. A $1,000 a month plan can be reduced down to $100 a month with many major medical plans. This greatly reduces the numbers of those who claim they can’t afford it. Prioritize better. But at the same time, don’t penalize those who CAN afford more comprehensive plans.

Here is the ultimate moral question:

Who should be responsible for your health care decisions and priorities? You or someone else?

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