Tuesday, August 25, 2009

Health care-what the revolt to freedom requires

Once we shift the focus of the health care discussion from caring for sickness to preserving health, one thing becomes clear immediately. If we wish to remain a free people, health care cannot be the government's business. Though would-be tyrants like Obama want us to forget it, lawful coercion (the force of law) is what ultimately distinguishes government work from other group activities. It makes sense to say that we will force people to be healthy only if our concept of human integrity (healthy human life or existence) includes slavery. But as Americans we long ago rejected this possibility because it is inconsistent with respect for the God ordained unalienable rights that are an essential aspect of human being, i.e., what it means to be what we are. Slaves may or may not have healthy bodies, but slavery cannot be a healthy human condition.

By beginning with this observation, we are led to reflect on the comprehensive meaning of human health- one that goes beyond the material condition of the human body to include the mental and spiritual aspects of human life. Undoubtedly, many diseases appear to be the result of merely material causes. But which merely material cause makes the difference between one person with the will to eat right, resist health impairing habits and keep up a healthy level of physical activity, and another who lacks the will? What merely material cause makes the difference between one person doggedly determined to battle cancer or infection for the sake of life, and another who confronts the same physical threats with despairing lassitude, or peaceful acceptance?

Sickness may be a material condition but health is also a state of mind. As such it is susceptible to material, mental and spiritual influences. These days it's not uncommon for people to pay lip-service to this fact. But when we consider the main preoccupations of the so-called health care proposals being debated at the moment, do any of them take it seriously in a positive way?

To do so requires that we respect the role that human will, conscience and spirit have to play in the critical decisions that influence a person's state of health. It requires that we accept individual choice and responsibility as the first premise of any health care approach. Though many opponents of the Obama faction's proposed socialist takeover decry its implications in this regard, how many of them are honest enough to admit that the third-party payer system it would replace just as surely eviscerates the exercise of responsible individual choice in any meaningful sense?

Responsible choices take account of both the benefits derived from a decision, and the costs it involves. But the third party payer system puts individuals in no position to do so. Sure, they choose an insurance plan. But at the point of delivery, they lack both the information and the incentive to react effectively to the relationship between the service they receive and the price set for it. This deficiency has at least two bad effects: a) Providers have little incentive to respect the power of individual clients; b) individuals have little incentive to resent or appreciate the price paid for the quality of service they receive.

Since it breaks the price/perceived quality ratio, the third party payer insurance system abandons a vital prerequisite of any free market system. It breaks the cost governing mechanism that generally allows the market to achieve equilibrium at a point of price efficiency that reflects informed, responsive decisions by the individuals whose activities make up its existence. These individuals are replaced by corporate (or government) bureaucracies driven by control/management and profit/budgetary preoccupations that have, at best, only a coincidental relationship to the actual price/quality ratio of any particular service transaction. How can it be anything but coincidental when it excludes from reckoning the perceived experience of the particular individuals involved.

As the result of what we might call this coincidental price structure, system resources are distributed with little or no regard for perceived cost-effectiveness. It's like running a restaurant based on aggregate decisions (how much of what kind of food to buy, how big a wait staff to hire and at what wage, how much to charge for each different menu item, etc.) that take little or no account of how individual patrons react to the service or the taste of the food. Meanwhile, individuals pay a flat fee to eat at the restaurant, choosing from menus with no prices on them. (The bill is sent to a company that insures access to restaurant services. Doubtless it began as a provider of starvation insurance for the cooking impaired.)

All these reflections point to what ought to be the first set of goals for a health focused approach to health care:

  • It must respect the mental and spiritual as well as material aspects of health, beginning with the human right to liberty i.e., responsible individual choice.
  • It must therefore be based upon a resource collection and distribution system that respects the requirements of liberty i.e., responsible individual choice.
  • As things stand in America today, this means a) rejecting any socialist, single payer, government administered system; b) establishing a health insurance system that respects the prerequisites of a true marketplace; c) abandoning the third party payer approach in favor of one that recognizes individuals the as owners of the dollars expended for the health care services they receive, with full responsibility for the disbursement of those dollars at the point of service. This requires that individuals perceive themselves as directly gaining or losing value from all such dollars as they are expended.
In my next posting, I'll discuss some of the features that might be part of an approach to health care that reflects these goals. Be advised, though, that I won't be offering "my" health care proposal. The notion that people like me, whose main vocation has to do with the responsibilities of citizenship (the proper definition of politics) should be the source of remedies for health care is a symptom of how far the totalitarian socialist mentality has corrupted our common sense. However, because considerations of justice are relevant to all human affairs, I can try to make a useful contribution to thinking about how the possible features of a health care approach relate to the principles of justice that inform our identity as Americans. Stay tuned.

9 comments:

chiu_chunling said...

Essentially a simple point, but very profound. "Health" is considered a good because it consists of making the body fully responsive to the mind and spirit. In other words, we prefer to be healthy rather than sick because it increases our tangible freedom.

Thus trading liberty for health care (leaving aside the fact that Obamacare won't even provide real health) simply doesn't make any sense. It's like selling your house to buy closet organizers...what is the point? But of course freedom is more valuable than a house...even one with organized closets.

Foxwood said...

Do you believe the Constitution is the rule of law? Do you believe in the original intent of our founding fathers? Do you want to reform Congress? If your answer is yes, we have to work together to make this happen.

http://animal-farm.us/change/constitution-project-575

gilbertabrett said...

If the government really wanted to help, they would require that anyone who says they are going to INSURE you would use a common sense approach to the word. IE - don't blow money people have paid you for their future medical (or other insurance) needs on the stupid things these companies do, and THEN do not want to pay up before having you fill out 92,000 forms or making you wait until your blood pressure is through the roof and you have to go BACK to the hospital. They seem to run these companies like Ponzi schemes. They are more worried about fancy advertising and the perks all this money brings them (like our government) instead of remembering where the money came from, for what and for whom (like our government). It seems to me they are ALL a bunch of crooks (like our government), feeding on all of us who work hard to make an honest living AND who pay for those who cannot OR WILL NOT pay their own way.

I have to agree with Dr. Keyes and the example of people who will fight a disease, as opposed to those who wait for the death angel with a smile on their face. It is a person's CHOICE whether or not they eat right, exercise, etc. And it is a person's choice if they want to pay for health insurance. It is a person's choice to go to the doctor THEY want to go to - not the one the government decides - or like many people nowadays, are TOLD they can go to in a certain insurance plan.

We have just been laid back for so long in this country, resting on the laurels of our forefathers that we will take most anything large corporations (like our government) dish out to us.

We have forgotten who REALLY holds the power in this country and may end up reaping what our parents helped us to sow. If not, then it will surely be our children. You know what the Bible says about the sluggard... and the prideful...

Derek P. said...

How does the person who cannot afford health insurance "revolt"?

A few months back I was sitting in a (Las Vegas) pub having a discussion with the owner about this very topic. The owner stated to me that he wished that he could afford to purchase some sort of group health plan for his employees, but that the cost made such an endeavor prohibitive. Yes, he could provide the employees with a little something, but that not so little something would eventually lead to the business being non-existent and the employees without health care insurance and a job. Dilemma?

And what about the employees? I have a casual relationship with nearly all of the employees of this establishment. My conversations with them have clearly indicated that they would like to be able to participate in some kind of health maintainence plan, but that it is cost prohibitive for them as well. They maintain their health as best they can, and they pray that they do not become significantly ill.

One thing is for certain - those people want a choice that they currently do not have, but would like to have. Yes, the government is a piss-poor option to turn to. But with no other options available where else can those people turn? How can they "revolt"?

Is this a matter of the 'Haves' and 'Have Nots' with the 'Haves' trying to convince the 'Have Nots' to continue to do without? Maybe the solution is to do away with private medical coverage and let every man fend for themselve. Then there would be no excuses. We would all have that "individual freedom" that is being spoken of.

chiu_chunling said...

Well, those independently wealthy enough to "self-insure" generally already do so. Insurance is designed and sold to the less well-heeled, since (as Gilbert points out) the inherent inefficiency of the system does not strike the fiscally acute as a wise investment.

I would prefer that insurance become less prevalent, but am yet loathe to abolish it by force of law. With certain exceptions, namely insurance policies that essentially pay out in the event that the policyholder is accused (or convicted) of a crime. I refer particularly to malpractice insurance. That's like selling "murderer insurance", to pay for an expert legal defense (and your bail) in case you happen to be accused of murder.

Banning malpractice insurance would rapidly fix much of what ails the medical profession, even without tort reform (which is a difficult and potentially dangerous undertaking, however necessary). Medical malpractice is a crime. It should be treated as one, rather than as a liability issue. Conversely, if a doctor didn't do anything criminal, there is no excuse for that person who seeks to profit by bringing an accusation.

Much...not all.

I do not carry medical insurance, and...I used to wish for cancer or some kind of horrific accident all the time (I cannot say I was ever quite sacrilegious enough to pray for it). So of course I have a rather different perspective on the entire health care debate. A number of my family members also forgo insurance for various reasons, from personal wealth to poverty to ethical or scientific disagreement with current medical practices. Most of them do pray for good health, and I try to respect that.

In a free market, low-cost catastrophic insurance should be commonplace. The reasons it is not are almost all directly related to existing government regulation of the insurance market. So I'm not easily persuaded that the answer to a lack of affordable insurance is to have the government be even more involved. And of course the actual policies being espoused in Washington are not particularly reassuring in that respect.

The "public option" (and the regulations which will force similar provisions into ostensibly "private" options) being described hardly seems like 'insurance' at all in the traditional sense of the term. "We'll gladly provide your health care...if we feel that you're sufficiently valuable to society, meaning us, according to whatever criteria we wish to apply without your consent." That is not an assurance of any kind.

But then, I neither want nor desire the 'care' they they would like to refuse to provide. So the entire issue is more of an abstraction from my point of view.

larry white said...

While staying tuned here, some relevant passages from Pastor Douglas Wilson's great blog, BLOG and MABLOG (from last November):

Even Using Both Hands
Topic: Obama Nation Building

I have been arguing that the central response of Christians to the ongoing disintegration of our culture must be to return to the worship of the triune God in such a way as that it becomes the seed of a renewed and rejuvenated Christian culture. That end cannot be accomplished by political means, as Scripture teaches, and cannot be accomplished by political means, as a brief commonsensical glance around the political room will tell you. When it happens, there will be political results, but political means will not have spiritual results. Christ is the Savior of our culture. Christ does not need our culture to rally around to save Him. [snip]

We cannot get anything right in the political sphere until we get it right in the Church first. When we get it right in the Church, other areas will follow. When Christians are worshipping God rightly, in spirit and in truth, we will then be in a position to reform an existing party, or establish a new one. Until then, we will continue to have trouble locating our own rear end, even if allowed to use both hands.

Now when the reformation in the Church comes, it may result in establishing a party very much like what the Constitution Party ought to have been, or it may result in the restoration of one of the corrupted mainline parties. We shall see.
[snip]

And complete outsiders, like ourselves, you and I, need to worship the Lord tomorrow, and we need to sing the psalms, hear the sermon, and come to the Table. Rise up, O Lord, and scatter Your enemies.


http://www.dougwils.com/index.asp?Action=Anchor&CategoryID=1&BlogID=6026

group health insurance plans said...

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chiu_chunling said...

You know, some jobs don't need to be outsourced to non-English speaking people...and I'm thinking that making random plugs for insurance on blogs is one of them.

NorthPal Communications Corp. said...

Alan the whole health care must be adressed at the foundation. The AMA-Rockefeller strangle hold that controls medical schools limiting the supply of doctors. The oil based pharma monopoly that curtails homeopathic medicines ie. banning hemp products.
The most important changes must first be addressed to even get to any of these things.
The decertification of the corporation UNITED STATES FOR AMERICA. The re-establishment of the United States of America with the organic Constitution with the original 13th amendment, and go from there. Kill the 14th amendment which made newly freed slaves the first (wards)federal citizens of the corporation and created corporations with the legal rights of a super citizen. All Americans should be Sovereign Citizens with no entity nor man only the creator above them. Therefore any government exists at our pleasure not the other way around.
I know its a big struggle.
“I would rather have a big burden and a strong back, than a weak back and a caddy to carry life's luggage”

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