Some Thoughts on Health Care “reform”

  1. We want (a) excellent, high quality health care, (b) in a timely manner, (c) available to all,  (d) at a low cost. Each group seems to major on one point while assuming the others. I don’t see how all four of those can happen at the same time.
  2. Some people have the resources to fund their own health care and some don’t.
  3. Some people have health care covered by insurance while some don’t.
  4. Some have insurance paid for by employers, some pay themselves, some through government programs.
  5. It is a good thing for people to work hard and provide for themselves and their families. Some DON’T do this, and others CAN’T do this.
  6. Compassion for others is a virtue in Christian thought. I’m surprised the Nietzscheans and Malthusians haven’t attacked this as a church/state issue, given their preferences for getting rid of the weak for the sake of the strong or the good of the whole.
  7. Many people do not like to be coerced to be compassionate.
  8. I don’t think I’m the only one who complains that his insurance costs more every year, while at the same time it pays less.
  9. Our current system SEEMS heavy on lawyers, accountants and bureaucrats.
  10. A fair percentage of Americans lack the desire or will to live healthfully.
  11. It is often a good thing to allow people to make decisions about their own lives – even if the decisions they make are stupid or unwise. At the same time we want to protect the people we love from the consequences of their bad decisions.
  12. When I take responsibility for someone else in some way, I usually gain at least some say over what they do in that area. If “we the people” (i.e., the Federal Government) take responsibility for the health care of everyone, we (the Government) will get a say over what others do and or receive when it comes to health care. We tend to be ok with that to the degree we are the ones having the control rather than the ones being controlled. We also tend to be ok with it the more we trust those who have control.
  13. Commanding (or legislating) trust is not the same thing as gaining trust. In fact, commanding trust may be antithetical to gaining trust.
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2 Responses to Some Thoughts on Health Care “reform”

  1. Mark Byron says:

    That last statement is very good. The President seems to be pleading with us to trust him, which makes the skeptical even more so.

    On the “Nietzscheans and Malthusians” front; the former would lean towards right-libertarian and might low-ball the passive eugenics of the current system in fear of ticking off the pro-lifers. A lot of the problems people have with the current package is the prospect of rationed care as government becomes more of a health care provider and decision-maker; the status quo rations care on price, but that’s a bug, not a feature.

    As for the Malthusians, abortion and later marriages are shrinking the growth rate in the US enough as-is. Most of them are spending their energies on climate change; for them, health care rationing would be a feature, as would the slowing down of the US economy that the extra taxes and employee mandates would cause.

  2. Kim says:

    It’s such a complicated issue. I think that allowing health care to evolve into a third-party payer system in the first place was the huge mistake, and how do you go back from that? Everything is now so expensive. And a huge part of why its so expensive is the industry created to pay for it. When you pay for something directly, you are more thoughtful about how you use it, you are quickly/immediately aware when there is waste, you become proactive about keeping costs down. When you pay an insurer, month after month and year after year, perhaps for just the possibility you will need medical care, you are not as on top of what is happening with the system. So there is a disconnect between “consumers” of the services and the forces that drive up costs. I don’t know how we go back from this. I hear doctors saying that they could cut their charges by 50% if they didn’t have to accept unacceptable low negotiated caps on payments by entities such as Medicaid and Medicare. Also entities like private insurers, although those caps often aren’t as onerous as the government-run ones. They do cut costs by at least 20% usually for cash patients. The whole industry is out of control. I don’t see that more government control is going to solve this problem; I agree with Reagan that big government IS the problem. However, how do you step back from the mess we’ve got now? It would be nice if we could pinpoint just one area that was the problem. But we’ve got an insurance industry, a legal system still in need of overall tort reform, a medical system trained to cover themselves legally by ordering and performing defensive medicine, a big percentage of the population that cannot or will not use health care benefits responsibly (e.g., using the ER as if it were a primary care office, drug seeking, and many other ways to abuse services) … and then you just have the proliferation of new treatments/previously unimaginable advances in medicine over the past century that keep us alive in situations that were once certain death. Then there’s the whole societal thing, where we don’t care for our loved ones at home (and don’t expect to be inconvenienced by illness) and so our elderly need more paid-for care by health care providers. It’s just a mess. I just wish that somebody in this whole debate would acknowledge that its a lot more complicated than just the big bad insurance companies taking advantage of people.

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