A moral issue

August 27, 2009 at 12:55 pm (Uncategorized) (, , )

I have mellowed in my old age. I am much more able to see opposing points of view, and much less likely to get out my soapbox and start ranting, but with that said, I truly don’t understand the health care debate. I’m not being disingenuous, I promise. I sincerely don’t see the other side of the argument. Why is there a question about universal health care? Of course we need it.

It’s not that I’m totally surrounded by pinko commies, either. I have friends, family members even, who don’t believe that we should enact universal health care. They are loving parents and daughters and sons…and I just don’t get it.

This is a moral issue. This question is no less than “Who do we want to be as a society?” Do we believe that when a person gets sick they deserve medical treatment? Or do we believe that poverty is somehow your “fault” – that you’re lazy if you’re poor, and you deserve what you get? I am terribly afraid that that’s the truth of it.

And if that’s so, geez, we’re in trouble. Because what about “whatsoever you do to the least of my brethren, you do unto me?” Not to mention that it’s “easier for a camel to pass through the eye of a needle than for a rich man to enter the kingdom of God?” If you’re a Christian and that’s not keeping you up at night, I don’t know what’s wrong with you.

And don’t feed me that old saw about it being the individual not the government that should provide charity either. For one thing, this isn’t charity, this is a basic human right. If you are sick, you deserve access to health care. Period, end of story. For another, two hundred plus years of leaving it to the individual to take care of this hasn’t worked very well. Let’s try another method, shall we? And finally, for now anyway, these people are not strangers – they are my friend who went through a bad divorce; my babysitter who’s putting herself through college…in short, THEY are US.

I think that must have been for Ted. Rest in peace, Senator.

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9 Comments

  1. Kevin Waterman said,

    As someone opposed to the idea of universal healthcare (at least as most people use the term), I’ll do what I can to explain the opposition.

    To begin with, what makes something a human right? There has to be a firm definition of what lets something classify as such or the term expands to such a point that it becomes meaningless.

    I would contend that there are pretty much two commonly accepted definitions of what constitutes human rights.

    The first is that human rights are the components of the human condition that exist inherently in the state of nature. Basically, that which we would have, in the absence of state and society, by sheer virtue of being human.

    The second is that human rights are those things necessary to life and the human condition. This obviously includes things like food, water, and shelter, but can also be stretched to include things like freedom of conscience and freedom of speech since they are integral to the human condition.

    I think these are both strong, legitimate means of certifying whether or not something is a human right. Although if you disagree, I’m always interested in hearing well-reasoned competing arguments.

    Moving back to the question of universal healthcare, it does not meet the threshold of human right according to either definition.

    Using the first definition, it falls short since there is no guaranteed healthcare in the state of nature beyond what you can provide for yourself. Even more problematically, government provision of such a thing requires weakening or eliminating certain property rights claims, a serious problem as property does exist in the state of nature (at least according to a Lockean understanding).

    Using the second definition, it also falls short. This is a more complex and somewhat counter-intuitive argument. People frequently argue that access to healthcare is necessary to life, however simple logic and history prove this false. If something is necessary to live – food, water, and oxygen all come to mind – we will not live without it. As you pointed out, our approach to healthcare has left some people lacking for quite some time. For that matter, how long did humanity exist before it developed any concept of healthcare? Clearly healthcare is not necessary to life, it is just highly desirable and beneficial to life. But so are a lot of other things, and none of those are human rights either.

    Now then, none of this means I stand opposed to universal healthcare. Our healthcare system is screwed beyond all belief. I just don’t want the government to try and provide universal healthcare, both for the rights considerations and other worries I have about such a course of action (I’ve written on these points some here and here).

    There are plenty of market based approaches that could do quite a bit towards making healthcare universal the same way we’ve made salt universal – by reducing costs. These range from the typical points of removing the bias towards employer-provision of health insurance and increasing competition in the insurance market to the highly innovative, such as health-status insurance, http://www.cato-at-liberty.org/2009/03/31/health-status-insurance-provides-real-alternative-to-universal-care/

    Hope that helps clarify things. Let me know what you think, I’d be interested in carrying on the discussion.

  2. Amy said,

    Amen, Emma. I could say a lot more, but I quickly become too upset. This is too important to me, personally, and to us as a nation.

  3. batsinthebelfry said,

    Kevin, thank you for your thoughtful response. I want to give it the attention that it deserves but back-to-school madness is getting in the way. Give me a day or so – I want to investigate the links you’ve provided as well. Just off the cuff I would direct you to Article 25, paragraph (1) of the Universal Declaration of Human Rights which states:

    (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

    Not that I think that will sway you. Anyway, to be continued.

    Amy, I know just how you feel.

  4. barkcpa said,

    I will not argue that our health care system needs some measure of reform. We have issues with people who have pre-existing conditions and those who cannot afford the cost of insurance for one reason or another. These issues need to be addressed.

    Having said that, I think anytime our government has decided to take something over they fail at it. The Post Office is set to lose $7,000,000,000 this year despite the fact that the cost of a stamp gas far outpaced the rate of inflation. The Social Security system is slowly running out of money in spite of the fact that the government receives 12.4% of most people’s wages. This means that for the family earning $100,000 per year the government collects $12,400. Imagine what that could have done in your 401(k) over the long haul.

    The main problems with the costs of insurance is that for someone reason we have made the choice that insurance must cover even the most basic costs. If a person who has insurance gets a cold, their office visit is covered by insurance. As such, the primary care physician must take a deep discount on the price they would ordinarily charge. In order for a physician to make money they must see as many patients in a day as they humanly can and they take little time with the patient to offer a proactive solution. The cost of doing business for a primary care physician is also high because most offices I do the accounting for have 2-3 people on staff who deal solely with matters of insurance.

    Then you add the costs of potential litigation to the mix. As doctors are so frightened of being sued they order as many tests as they feel necessary as they do not want to risk being wrong in a diagnosis. We’ve got to understand that doctors are human beings and can make honest mistakes without suing them. Litigation is concern for the doctors I work with and the costs of malpractice insurance are sky high.

    So how to fix healthcare.

    1) I would eliminate the notion of tying health insurance to a job. Instead of offering the tax deduction to the companies, I would offer it to the individuals. This would give people the ability to customize their health plans instead of going along with a company plan. This should work well for many people. I know the cost of my health insurance is significantly less as an individual then it was in a group plan. Make no mistake, when an employer pays you they do consider the cost of your health insurance.

    2) I would expand the deductions for health savings accounts. This way people like myself can choose to pay for our primary care out of pocket and have insurance in place to cover the big things. We have a high deductible plan and to be honest if most people had that type of plan costs would go down because people would be forced to spend some of their own money.

    3) I would offer tax credits to people with lower incomes so they could afford their insurance payments. If the cerdit is refundable, lower income people could pay for their insurance.

    4) I would create a pool that the government would help subsidize for people who had pre-existing conditions.

    In short, you can reform healthcare short of having the government take it over which a public option would lead to.

  5. batsinthebelfry said,

    Okay guys, thanks very much for your comments. I’m glad that we all agree that the current system needs reform. My main premise here was that the current crisis has created a moral imperative to act, and the fact that two gentlemen with (I’m guessing) very different political views agree that something must be done is truly, truly very encouraging to me. That said, I don’t agree with you about how we should reform healthcare.

    Did you see Bill Moyers on Bill Maher’s show on Friday? Here’s a quote, and I’ll see if I can find a link:

    We are the only western democracy that has not embraced universal health care as a means of social justice . . .

    Our health care system is run by the drug industry, the health insurance industry and Wall Street which means a relative handful of unaccountable executives and anonymous investors whose primary interest is in increasing the value of company share and raising profits. . . that’s a good business model . . but it’s not the way we should decide who lives and dies

  6. barkcpa said,

    I did not see Bill Moyers comments yet mainly because Bill Maher is one person I have a hard time tolerating.

    I think “universal” health care can be reached without implementing a system that will turn control over to the government. I’m just one who believes that the private sector generally does a better job of things than the government. We need only look at the differences between public and private schools, the post office vs. UPS and the debacle that Social Security will become. Most private charitable organizations do a better job of helping people in need than their social service counterparts in government. In short, I think we do a better job of things than our elected politicians many of whom I wouldn’t trust to run a lemonade stand be it Democrat or Republican. Yes, there are some good politicians, but because very few of them have any experience in the real world they have a hard time implementing solutions that actually work.

    I also believe that most people are fairly happy with the way healthcare is delivered in this country. It does not need to be completely overhauled rather it needs to be tweaked to ensure that people do not fall through the cracks and a safety net is provided. You can subsidize the insurance premiums of people who lack the means to buy insurance or have pre-existing conditions by offering refundable tax credits. Healthcare can be subsidized without being taken over.

    If a public option is created by charging employers an 8% payroll tax if they do not provide health insurance a mass exodus to the public option will begin and there will be no way for the private sector to compete. The mass exodus will happen because most employers spend between 12-15% on health insurance right now. There will be no reason for most employers to offer health insurance anymore. This will mean a whole lot of people who are happy with their insurance will now be in an option they did not choose.

  7. Kevin Waterman said,

    I don’t listen to Bill Maher very often (I find him to be obnoxious and the few times I’ve seen his show it was a jumbled mess of everyone talking at once), but I listened to Part I of the links in your most recent post, which is what I assume you’re referring to.

    One of me big issues with Moyers’ argument is in line with what I was trying to get at earlier. He says healthcare is a right, that we have a moral imperative to offer it to everyone, but he never establishes why that is so. However, we’ve covered this ground pretty thoroughly already, so we’ll set that aside.

    Correct me if I’m wrong, but it seems the point you’re making, with reference to Moyers, is that something is fundamentally wrong with healthcare being provided on a for profit basis (and particularly on a for profit basis by corporations) because it is a human right.

    Now then, if we accept this as true, that things we consider rights should not be provided on a for profit basis, healthcare should not be very high up on our list of priorities.

    After all, I think everyone can agree there is a much stronger case to be made for food as a human right than there is for healthcare as a human right. And our food is pretty much completely provided on a for profit basis.

    Now, there’s a lot on the policy front that can be discussed, but I think it’s more important to get the philosophic foundation determined first.

  8. batsinthebelfry said,

    Okay, you guys are making me think! And it’s sunny outside!

    Mike, can you clarify this, because the way I’m reading it, I disagree strenuously:

    “Most private charitable organizations do a better job of helping people in need than their social service counterparts in government.”

    And I also disagree that most people are happy with the way health care is provided in this country. I don’t think there would be this serious movement for reform if that were the case. (As an aside, do you know that I was charged “room and board” by the hospital when Lucy was born? Exactly what “board” did the hospital provide, because I hooked her up to the milk truck myself…but I digress…)

    Kevin, I appreciate you getting at the philosophical underpinnings of this debate – you and I are framing it in different ways. I do view health care as a human right rather than as a commodity. I’m not sure what value is to be gleaned from creating a hierarchy of human rights. I suppose the right to life is more important than freedom of speech or religion, but I don’t want any of the above taken away from me. I like FDR’s classification, myself (big surprise) – how about we shoot for freedom of speech, freedom of religion, freedom from want and freedom from fear?”

  9. barkcpa said,

    I used to be an auditor for the City of Milwaukee. My role was auditing the Community Block Grant organizations. SDC is probably the most recognized of these organizations, but their are many others. I have also had an opportunity to audit several 501(c)3 organizations which are private. In almost every circumstance a higher percentage of the private organizations money went to the end person instead of being swallowed up by payroll and benefits. Maybe this is not empirical evidence, but I always feel better when I have donated to a private organization because I know from experience that more of the money will get to the people in need.

    I do know how much it costs to have a baby which is why we maximize our health savings account every year. Maybe it’s a bit harsh, but I feel that if you want to bring a person into the world it isn’t asking too much to help pay for the birth.

    I also do not believe there is overwhelming support to nationalize healthcare. If there was, the Democrats have the majorities they need to get it done and there’s not a thing the Republicans can do about it.

    I do feel most people think that some changes need to be made in healthcare, but I also believe people look at the deficits most governments are running and look at the mess entities like the post office are and wonder if government is the answer. You can already take a look at the impending mess that Social Security is becoming despite being funded by 12.4% of most peoples earnings and it’s fair to ask just how much of our money the government wants.

    I think the goal of making sure all have access to healthcare is one we share, but I think there are better ways to get it done

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