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June 23, 2010
What Healthcare Is Like
R.R. Reno makes a fair point that our pre-Obamacare healthcare system ultimately created "an ad hoc mechanism for extracting payments from the insured to finance a haphazard effort to provide at least emergency and critical care for the uninsured as well as decent care for the underinsured."
Seeing this as socialization, Reno argues that something like the individual mandate is preferable, to explicitly provide general care (cheaper than emergency) to the uninsured and those with preexisting conditions. I'm not so sure, first of all, that forcing the involvement of young adults and others who opt not to insure themselves — effectively looking to one segment of the "uninsured" to pay for another — will make for an even swap.
More to the point, though, I don't think avoiding the excesses is possible when government gets involved. We're sure to find, for example, that those young adults will be permitted onto their parents' plans at ever older ages. We're also sure to see mandatory coverage expanding, redistributing wealth from the healthy to the ill (and those who treat and advocate for the ill). Given Reno's reliance on "political realities" for his argument, that he doesn't anticipate this response and address it in greater detail suggests that some of his premises require reconsideration, such as:
Think about getting hepatitis or breast cancer. The risk of suffering from these misfortunes is similar to the risk of being mugged or shot. It's a life-and-death matter, and if human government has any justification for its power over citizens, then surely it rests in its unique capacity to pool resources to protect life. As Albert Camus recognized, one moral source for solidarity can be found in our common struggle against the dehumanizing power of suffering and untimely death.
In circumstances of interpersonal violence, government is arbitrating between people. That's not the same as arbitrating between a person and a virus or cancer. That government can exert force to stop individuals from doing the same in an acute act of assault does not mean that it's appropriate for government to step in as a life manager.
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Justin,
If you and others want to get an idea of what is most wrong with our system, please read this article. It is completely non-partisan - written by a caring daughter.
http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html
"I watched them lose control of their lives to a set of perverse financial incentives — for cardiologists, hospitals and especially the manufacturers of advanced medical devices — skewed to promote maximum treatment. At a point hard to precisely define, they stopped being beneficiaries of the war on sudden death and became its victims."
I think this should be required reading for anyone who cares about anyone else.
Posted by: Stuart at June 23, 2010 11:39 AMAs if we needed another reminder about the system Monique and you so love:
http://finance.yahoo.com/news/US-scores-dead-last-again-in-rb-1463924538.html?x=0
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WASHINGTON (Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.
The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found
"We rank last on safety and do poorly on several dimensions of quality," Schoen told reporters. "We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care."
The report looks at five measures of healthcare -- quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.
Posted by: Stuart at June 23, 2010 5:06 PMStuart,
If you are going to talk about how poorly the United States does with healthcare compared to European nations make sure you leave Hawaii out of the picture.
The state Obama was born and grew up in instituted healthcare reform close to 40 years ago.
The state is closest to providing universal healthcare to the total state population; has one of the highest percentages in nation of population covered by healthcare insurance; has extremely low healthcare insurance rates (I pay $100/month less than in RI for same BC/BS plus Delta Dental and prescription drug plan); great access to medical care and doctors in Hawaii widely practice preventative medicine; has one of the longest living populations; has one of the least stressed populations and has a state population with the highest ranking of wellness.
Posted by: Ken at June 23, 2010 9:28 PM