Monday, August 24, 2009

Health care needs a revolt to freedom, not socialist 'sickness care' reform

For years I have made the point that the key problem with discussing our so-called health care system is that we don't have one. The system focuses mainly on taking care of people when they get sick. It's a sickness care system. This system ends up producing two things: more sickness and ever-increasing costs. This makes sense, since the people who own and work the system mainly derive their income from sick people.

Think of the old Maytag commercials, featuring a Maytag repairman with too much time on his hands, because Maytag washers rarely break down. The manufacturers could afford to make a joke of his idleness. Demand for their products didn't depend, in the first instance, on mechanical breakdowns, but on the endless supply of dirty clothes. But the sickness care sector is rather like the repairman. Its income depends on the possibility and frequency of breakdowns.

Unlike the demand for washing machines, however, the demand for a properly functioning human body doesn't rise in relation to some other product. The body has an intrinsic value, like the human being whose existence in this world depends upon it. But just as they take existence for granted until it's threatened, people generally tend to take the body for granted until it's ailing. Then they seek the services of someone who can restore its proper functioning. This obviously complicates the incentives of the person who has the necessary expertise. Though he gets paid to make people well, they are by and large only inclined to seek his services when they get sick. In which does he have the greater interest, their sickness or their health?

Considered simply as a matter of selfish calculation, the medical expert is likely to profit most from a situation in which people who are prone to get sick see him as the source of a sure and effective remedy for what ails them. As Socrates points out from time to time in the Platonic dialogues, this leads to a dangerously ironic situation for his potential clients. The medical expert has the knowledge to cure them, but he may also have a strong motive to use that knowledge to make sure they don't stay healthy. Oddly enough, the result would correspond to the one we've been getting from our sickness care system- people clamoring for what they perceive as effective care while overall becoming more and more susceptible to disease. Meanwhile, budgets are strained as more and more money flows toward the sickness care sector.

Of course in ancient times this result was not as pronounced as it is today because medical experts weren't so good at dealing with sickness. Once someone got sick, the experts soon reached the limits of their ability to do more than palliate his suffering. The techniques of modern science have produced breakthroughs in sickness care that allow contemporary experts to do a better job of treatment in many areas, particularly those susceptible to surgical intervention or the use of antibiotic drugs. But this success has produced another less desirable result: medical expertise that focuses on sickness. Because ancient experts were less successful at dealing with sickness, they put greater emphasis on keeping people healthy. They focused more attention on understanding the dietary and exercise regimens that increased health and vigor. Though pain relief and sickness cures certainly played a role in their livelihood, the best advertisement for their wisdom was the strength and health of the people who followed their advice, not the excited praise of those they cured of disease.

More limited knowledge led to greater humility. They ascribed miracles cures rather to divine power than their own sophistication, which gave their profession a tinge of something more akin to religion than what we today would call science. Medical experts were seen as followers of a divine path or way, with a mystical component that also addressed the issue of trust implied by the double-edged quality of their motivation. They were oath bound not to follow the promptings of cynical calculation, and therefore to place the good of their patient above their own selfish advantage. These days we still assume the existence of this moral framework. Given the elite embrace of moral relativism, and its quiet contempt for religious truth, God knows why we do.

Be that as it may, these reflections help us to understand the fatal flaw in the present debate over the future of the medical services sector: it takes a deceptive rubric of analysis as the basis for discussion. This is due in part to the deceptive language characteristic of the discussion. We talk about access to health care, when sickness care is the real product. Terrified by the economic implications of its rising costs, we tacitly accept the deadly necessity for rationing, now going so far as to propose targeting the elderly and infirm to bear the burden of budgetary constraints. Suspecting the profit motives of those who own and work in the sickness care sector, we are also increasingly tempted by socialist proposals that would enslave them to our needs, allowing us to keep costs down by dictating the terms of their remuneration. Meanwhile, we neglect even to discuss the true source of the cost push- which is the rising tide of sickliness (preoccupation with disease), that increases the demand for sickness care despite the much touted breakthroughs of medical science.

I have long argued that we won't arrive at, or even conceive of, approaches that turn the situation around until we reject the assumption that sickness care is an acceptable product for the health services sector. The rubric and aim of health services should be health. The measure of success in the health sector must cease to be the amount, distribution and financing of treatment for sickness. Instead, we should focus on what keeps more people healthier for longer periods of time; what strengthens them in mind and body; what feeds and encourages their will to live, and their understanding and implementation of the discipline needed to serve that will effectively.

This amounts to a Copernican shift in the way we conceive of and analyze the health sector challenge. Tomorrow I'll outline a number of relatively simple and straightforward goals that come into focus as a result of this shift, goals that provide a basis for a true revolution in the meaning of, and provision for, our society's health concerns. The key to that revolution is responsible, individual freedom, not a socialist takeover.


l. said...

jesse helms once said that we should not look for red army tanks or planes to attack us .No , the socialist will attack us from within ..
he was dead right......

Anonymous said...

an ounce of prevention is worth a pound of cure, or something like that. Our responsibility belongs to us, not doctors. The church is to have elders pray and use the olive oil of our people when someone is sick. The Golden Rule is what we need to live by along with the Beatitudes. no wonder so many people are sick today, they are loving their neighbors as themselves, selfish.
our moral responsibility should not be through taxation! We should be willing to feed the poor without taxation! We need to come to the conclusion what exactly we need to be taxed for and allow for that only. God only asks for ten percent, is uncle sam greater than God?

jephfree el

Anonymous said...

Herein lies the problem, Alan-even if we got doctors to take better care of their patients, how would we get the patients to seek their care? Most people don't take their cars to the mechanic until it starts pinging. The automotive industry has been telling us to get our cars checked out every 30,000 miles-how many people do? The medical industry has been telling people to get yearly check ups or even better every six months just to keep themselves maintained. How many people do? How many people seek out the dentist until their mouth is in pain? This is what needs to be fixed. You are going to have a tough time convincing people to go to the doctor when they feel fine considering even Jesus said in Matthew 9:12 But when Jesus heard that, he said unto them, They that be whole need not a physician, but they that are sick. And while I am sure Jesus would be the first one to advise us to maintain our health, even he saw the doctor as someone you go to to get better not stay well. Just something to think about.

gilbertabrett said...

When I was a little kid, you used to see the Tidy Bowl Man, Mr. Whipple and Madge on commercials. Now you see a pill for every little thing. By observing statistics, seems as though only two or three people in the whole country are not on drugs...

JESUS was speaking of HIMSELF when he referred to physicians. Though HE knew people went to physicians when they were sick and HE sees that today, He was not speaking directly or indirectly about "health care." Neither is Dr. Keyes implying that we go to doctors to stay well, unless I missed something...

People are simply to the point of they do not care anymore. We have everything. We are comfortable. We are smart, rich and powerful. We can do what we want and are very proud of it. Despite our moans and groans about racism, stealing land from Indians and Mexicans, unfair taxation and the griping goes on and on, we are the best people at everything on the planet. Or so we think...

Our government is going to see to it very soon that we are taught who is boss unless we are able to show them first. I still see Rev. Wilkerson's warning in my mind and believe it is getting closer and closer. I know many others who smell it in the wind as well.

I pray to GOD that HE will be kind to my family and tell me what to do to protect the older members of it.

I try to eat right and sleep well. I do as my Granny says and eat in moderation, thanking and asking GOD'S blessing on the food. I do not go to a person who is paid to tell me what is wrong unless I am REALLY having trouble. I take my vitamins and do research on herbs and foods to cleanse and nourish the body GOD put me in. I stay away from processed foods and try to stay away from foods with chemicals, hormones, antibiotics, etc. although it is hard in the USA.

The way I see it, you will spend money to eat right or pay for eating whatever you wanted to. It is just that simple for me. I do not know about others, but some people seem to think I am weird or funny and then turn around crying on their way to spend money at the doctors.

We really better get ourselves together in this country and soon. A lot of what I am hearing, seeing and reading is not good and will lead to destruction. We really better get it together...

OH! And y'all BETTER stay away from those rotten eggs the government is calling a vaccination in the fall... I'm just saying...

Anonymous said...

I'm a little nonplussed.

So I will deal with the entirely tangential question of the implications of what Jesus said.

"And when the Pharisees saw it, they said unto his disciples, Why eateth your Master with publicans and sinners? But when Jesus heard that, he said unto them, They that be whole need not a physician, but they that are sick. But go ye and learn what that meaneth, I will have mercy, and not sacrifice: for I am not come to call the righteous, but sinners to repentance."

There is actually a rather pointed comment here...unless we now supposing that Jesus thought of those Pharisees as being sufficiently righteous that they were in no need of repentance. Whether this has anything at all to do with the debate over health (or sickness) care, I cannot say. I cannot even specify why I cannot say.

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