November 18, 2009

Healthcare -- the debate goes on.

Below is a long counterpoint I have offered in what I believe is a very good dialogue over at Cosmic Navel Lint. I post it here only because my comment is so lengthy. Please read this post and the comments, then this post. I know you do not like to click links, but I think you will find the arguments interesting.

Before I begin my counterpoint, I want to be clear that I do believe there are issues in our current healthcare system. I do believe we need some reform. Where we disagree is what shape that reform should take.

To Erin’s example, people sometimes do not get the treatment they need. It happens, even though it shouldn’t. If the Doctor in question was a true practitioner of his Oath, he would have helped the patient. Again, while not the best solution, the emergency room was available.

To your point regarding the Harvard study. The report acknowledges that part of the results could be that the hospitals and care were unequal, that it may have little or nothing to do with the availability of insurance:

The hospitals that treat them also could have fewer resources.
"Those hospitals tend to be financially strapped, not have the same level of staffing, not have the same level of surgeons and testing and equipment,""That also is likely a major contributor."

Again, it should not be that way. If we spent ½ of the proposed spending to provide insurance for all on upgrading the healthcare infrastructure those result would very well change.

You discuss in detail the denial of coverage by HMOs. You might be aware that HMOs were the brainchild of Ted Kennedy and designed as the 1970s version of reducing the cost of health care in the US. We also have numerous examples of those who are covered under Government Healthcare in Briton, France, and Canada who come to the US for care because they are denied coverage, or the wait times are too long. So let is not pretend those issues will disappear under the current proposals. For those of you who think care will improve under a Government plan, look at the Breast Cancer screening recommendations issued by the Government this weekend. The report allows that by changing screening recommendations 1 in 1.900 women will develop untreated breast cancer. However you do the math, that equals anywhere from 30,000 to 50,000 American women per year. But we save a few bucks! The reality is every system will have cracks and denial of service. Let us not pretend otherwise.

As far as the numbers of uninsured, that 40 million number is not even accepted by the White House any more. There are some, like Brook that fall into the category that needs to be addressed. I have been in the same situation. When out of work I could not afford the COBRA payments. It is tough to wake every day praying that your kids do not get sick. I think there is a way to help those people. I have stated so at my site many tomes. I have no issue with vouchers or even a plan to help those who have pre-existing conditions or portability issues etc. I just do not think we need to throw out the baby with the bath water.

We agree the cost of healthcare is too high. You maintain it is because of the HMO/Insurance companies. I ask you, which is more efficient, a company beholden to stockholders and owners or a Government entity with no reason to hold down costs? If we were to open the health care insurance industry to intrastate competition costs would go down. We have evidence in the reduction of premiums when the auto insurance industry was deregulated. If we can strip the onerous requirements applied by the states we could also reduce the costs. For example New Jersey insists all insurance plans cover the cost of hair transplants. I should not be forced to have that coverage if I do not want it. I should not be forced to pay for that coverage just because New Jersey says I should (Yes I know this will be contradicted later, but I am demonstrating how costs could be reduced with out the Government providing health care).

I completely disagree with your Ford Pinto example. If you remember as the reports of exploding Pintos hit the news, sales of the vehicle plummeted. In fact, even after the redesign Ford was forced to abandon the platform. The free market would have accomplished the same as Federal regulations. Do you really think the engineers at Ford purposely designed a dangerous car? Do you believe all corporations are inherently evil? I have more faith in my fellow man. Yes, the examples of corporate greed are legion, but usually a good person will step in and blow the whistle. Governments are also capable of unspeakable evil – we can find examples from Hitler’s Germany to the Tuskegee Airmen to Agent Orange.

You believe the Constitution is an outdated Georgian artifact. I see it as a reflection of true genius. It contains the means to change the Supreme Law of the land. It is adaptable to modern times. I challenge you to show me one case where it is not applicable to today’s society. I, and a majority of Americans (see any number of polls that shows Americans are primarily conservative) believe in a limited Federal Government. You might argue that such a form of Government does not allow for universal health care (And by the way, quoting Keynes is not a good way to convince me; his economics caused the Great Depression to extend by many years). You are right; the founders did not envision women voting etc. But they planned for it with Article V. I stick to my original point; the purpose of the Constitution was a Federal Government with limited powers. You cannot dispute that fact. The 9th and 10th Amendments leave such issues as healthcare to the States. You may not like that Government Design, but you can always create a new Constitutional Convention, or propose and ratify an Amendment granting such powers to the Federal Government. Again, you have not shown where my Constitutional argument falls short, other than “well, Hoose, it shouldn’t be that way”. If you can show me where the Constitution is antiquated and does not fit with today's World, please show me. The fact it does not allow for a strong Federal Government only proves my point -- that was its intention.

I am unclear how another individual’s inability to buy insurance is reason enough to force me to pay for my own insurance should I not want it. You might argue that we are forced to buy auto insurance. I would offer these counter arguments:

1. We are forced to cover the “other guy”, not ourselves or our own vehicle.
2. Driving is a privilege, not a right
3. The requirement for auto insurance and the levels of coverage are State mandates, not Federal mandates. If the individual States want to create a universal healthcare system, I have no issues. In fact, several states have such a plan (Massachusetts, Tennessee, etc.)

Let us follow your logic. You cannot deny that basic housing and food is even more important than health care. Why is there no cry for universal basics of life provision? Sure, I wish everyone on earth had a nice house in the suburbs, three square meals a day, a big screen TV and chocolate cake on their birthday. Wouldn’t that be grand? But nowhere is there a Universal Right to take forcefully what is mine and give it to someone else.

Life is not fair. Some are born stronger, faster, smarter, and healthier. By weakening the strong, slowing the speedy we do not advance the human race. By offering an equal opportunity to succeed to best of our abilities we open the World to freedom, to prosperity, to happiness. Will some fall short of these lofty goals, sadly yes? Should we offer a hand up when our fellow man see hard times? Most Americans would agree. But there is a big difference between a hand up and hand out.

The United States has spent trillions of dollars since LBJ declared his war on poverty. More than forty years later exactly the same percentages of Americans live below the poverty level. The only difference is now we have generations living on welfare, the family structure is in disarray and living conditions for many are worse than they were in 1966. Is that a shame? Absolutely. Do I have the answers? No. But I do think it is clear that big government solutions are not the answer. As I have asked many times in the past, besides the basic duties outlined in the Constitution (defense, interstate commerce, printing currency, etc.) is there anything the Government does better than the private sector? No one has yet given me an answer.

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