Why We Need Health Care Reform
I’m going to give you some facts and figures about health care in a moment, but first I’d like the readers to answer, in their own minds, a couple of questions. What is the morally right thing to do about health care? Do people have a right to adequate health care or is adequate health care a privilege you get only if you can afford it? If you say “yes, people do have a right to adequate health care,” then be aware that there are millions of people in this affluent nation without adequate health care. If you answered “no, people don’t have a right to adequate health care,” then what do you do with these people when they get sick? Do we turn them away from hospitals or clinics? Do we let them get more ill or even die from an illness that might have been cured? What if they have a contagious disease (H1N1 or Bird flu), do we send them back out into the community to infect others? I think almost everyone wants all people to have adequate health care. I believe most of us see adequate health care as a basic human right.
Now, there is a morally reasonable argument against guaranteed health care. I first read this argument in a book titled “The Conscience of a Liberal” by Paul Krugman. Krugman, of course does not agree with the argument but he states it for his readers. It goes like this: Life is unfair and some people get sick and some don’t. If you get sick that is unfortunate, but it is not the government’s job to tax others to help you relieve your misfortune. Some people inherit genes that make them prone to illness. That is a stroke of bad luck, but the government has no right to place burden of coping with your bad luck onto others. It is just too bad.
Clearly, I don’t agree with that argument and frankly I don’t think most Americans do either. As Krugman says, you never hear this argument in a political debate over health care. The reason you don’t is because it won’t fly politically. Most Americans think that people who get sick should get care. Instead, Krugman argues, you hear a claim that doing what is morally right is impossible or at least way too expensive. That is the argument with which I’d like to deal.
If providing health care to all our citizens is impossible, why is it that every industrialized nation on the planet but the United States manages to do it? They all do the impossible, but we Americans cannot. I’m not buying that and I don’t think you are either. Well, I can prove that a government funded health-care insurance program can work and do it adequately and cheaper than a private company can. Medicare covers seniors and some others who are too poor to afford private insurance. Medicare serves these people adequately and does it at a lower cost that any private company. The reason Medicare costs less than private companies is because Medicare operates with only a fraction of the overhead incurred by private companies. So don’t argue that the government cannot run a health Insurance program efficiently.
I have heard some say that America has the best health care in the world and we should not mess around with it. Let me correct that impression right now. America does not have the best health care in the world. We are way down the list. What America has is the most expensive health care in the world. You can find the following figures on the internet. I found them is only a few minutes. I compared “life expectancy” (the best measure of a nations overall effectiveness of its health care) to the amount a nation spends per person on health care.
Country per person spending Life expectancy
United States $4,271 78.11
Germany $2,697 79.26
France $2,288 80.98
Sweden $2,145 80.86
Canada $1,939 81.83
United Kingdom $1,675 79.01
Japan $2,243 82.12
As you can see the United States spends almost twice as much per person for health care and is fairly near the bottom of the industrialized nations in life expectancy. All the nations on this list provide adequate health care to all or almost all of their citizens.
Now we must mention that some of the nations on the list I have given have a socialized or close to socialized system. We are not going to have that kind of system. However, the data are clear. The United States is being beaten hands down by every industrialized nation on the planet in providing adequate health care to its citizens.
Since I mentioned the term “socialized medicine” let me clear up another misconception that I often hear. Many people I speak to really don’t know what a socialized system would look like. Socialized medicine is a system like in the United Kingdom. The hospitals and clinics are owned by the government and the doctors, nurses, and other health care providers are employees of the government. They work on a salary. Even Canada does not have a fully socialized health-care system.
The United States will never (let me repeat that) never have a socialized medicine system. It might indeed be the best system, but we are never going to have it. What we can do is make the system we have better than it is now. We can provide adequate health care for all (or practically all) out citizens. (notice I said citizens, I did not say illegal aliens) and we can do it a lower cost than we do it right now. Think about it folks: better health care, for more people and at a lower cost per person. That is what Democrats and the Obama administration is trying to bring about and what Republicans seem bent on sabotaging.
- Bob Hertzog's blog
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I think the whole debate is an opportunity for the species to come face to face with some inconvenient truths.
I think it was Andrew Weil on The Larry King Show who recently said that more than 80% of all disease is directly caused by the unhealthy choices people make. I'll give you a real life example.
A friend of mine said that yesterday he served a couple of women lunch. Not only did they eat huge portions, and asked for dessert, but one woman asked for a second oversized portion of dessert on top of it. These women were grossly obese and ate more than 2 days' worth of calories at one sitting. Tell me why I should be responsible for the probable heart, circulation, vision and other problems she created for herself? Tell me why I should be responsible for cancer surgeries and therapies which could have been avoided if only someone had chosen not to smoke~!
If you are going to saddle me with the burden of caring for these kinds of problems which I did not cause, then you had better give me some control over them. You had better give me the ability to rein in these kinds of choices OTHER PEOPLE make which affect my bottom line.
But wait a minute......does that mean we are talking of restricting someone's freedom of choice? Damned right it does. Is that fair? Sure it is, if you make me responsible for their choices. It would be the morally right thing to do.
So what do you want? Freedom of choice with the attendant responsibilities, OR will you grant me the right to control others' choices? In this case, Bob, you cannot have your cake and eat it too. It is not the morally right thing to do.
- Thomas Paine
Why would somebody spend over 10 years to become a doctor just to have the government set the price (or salary) that his services are worth.
Medicare is cheaper because they just do not pay what the bill says is due.
I hope that you have a great day today and I that your tomorrow is even better than you can imagine..
Hey Bard... Thanks for the comment... You do make a good point and one which is difficult to answer. However, there are a couple of points I'd like to make. You seem to be accepting the argument that I observed in my original post that goes: "Well if you get sick too bad it is not my responsibility." I know that some people don't seem to deserve our help, but they are human beings. If you take health care as a fundamental human right, as I do,then even the people who don't deserve our sympathy have a right to health care. Take an analogy if you will: Suppose there was a person who spoke words with which you strongly disagreed, words that you thought were foolish and simply insane. Would you deny that person the right of free speech? My guess is that you would actually fight for that person's right to speak, because if that person's right is denied, later it might be your right which is denied. I see health care in the same terms. Yes there are people who I believe don't deserve health care (the ladies in your story are examples), but if health care is a fundamental human right, then we must provide them with it. And, in my view, it is your responsibility, and mine, to protect that right as you would other "unalienable rights."
This is a bit of an aside, but let me offer it. A top-notch health care system would encourage (and offer incentives for) people to lead a healthier life. We are talking about health insurance here, so people will purchase a policy. People who lead healthy lives and exercise regularly, can be provided lower premium prices or some other incentive. The health insurance I have now, pays half of my health club membership. It is not much but it is something.
Hi Rusty... Thanks for the comment. You're partly correct about Medicare, but in fact, private health-insurance companies have about 15 percent of their cost in the overhead. Medicare overhead is about 2 percent. That's quite a saving. And yes they do pay physicians a little less.
However, every nation in the world pays their physicians less then we do. Ours can get along just fine on a little less. They won't like it much at first, but they'll get used to it.
So lets say you were making 20.00 an hour and the government takes over you industry/service and the government cuts your wages to 10.00
Hey it is not my wage I say go for it and I do not care if you spent years and years going to college and have massive student debt to pay.
That is exactly what you are doing. Make yourself the one the government wants to take control of and post what you think of that.
I think some doctor that give a simple physical is entitled to the same as a brain doctor
I hope that you have a great day today and I that your tomorrow is even better than you can imagine..
Hey Rusty.... General Practitioners don't get the same today as brain doctors do today, why should they get the same under a new system? I will admit that if I were a physician, I would not want the government messing with my wages. Nevertheless, as long as I was paid adequately for my work, I would not have real complaint to register. However, that's really a side point. The real point is that physicians under a reformed system will make a very nice living. Under the system Democrats are trying to promote physicians still get a reasonable fee for their services and the government does not set their prices. What the government will do, if the Democrat's reform eventually passes, is create competition among health-care providers which will allow the market forces to bring down the cost of healing. Democrats want to do this within the free market system. I would think conservatives would love it.
I don't know, Rusty, if you realize it or not, but if you have a private health-care policy, your premiums have gone up 13 percent since the middle of the 1990s. That is more than inflation and a lot more than wages. If you have a policy from your employer, the employer's costs have likewise risen, so much so that employers are dropping health care for their employees. Pretty soon everyone will be stuck with purchasing health care from the private companies, who can raise their prices as they see fit. Premiums are going to continue to rise and rise and unless we have reform there is nothing we can do about it.
Hey Bard... Thanks for the comment... You do make a good point and one which is difficult to answer. However, there are a couple of points I'd like to make. You seem to be accepting the argument that I observed in my original post that goes: "Well if you get sick too bad it is not my responsibility."
No, that isn't what I was saying, you have completely altered it. I was saying that if you make choices which you know in advance are unhealthy and unjustifiable, then you shouldn't expect anyone else to pay the consequences. Some responsibility MUST accrue to the individual who makes the bad choices. There is no defensible logical reason I should be responsible for another adult's bad choices.
I know that some people don't seem to deserve our help, but they are human beings. If you take health care as a fundamental human right, as I do,then even the people who don't deserve our sympathy have a right to health care.
They don't have the right to make me pay for it any more than people who take out second mortgages to pay for luxuries have the right to expect me to save their stupid butts and get them out of hock. You make the choice, you pay the price. It is indefensible to make someone else pay the price FOR you.
That is a straw man argument and not even remotely comparable, Bob. Surely you can do better than that.
Stop right there!! Show me where I said they didn't deserve health care. You can't. You put those words in my mouth. They deserve as much health care as they can pay for; read on for another option....
In the first place, I do not accept health care as an 'unalienable right'. Where in the Constitution or the Bill of Rights did it say anything about that? Show me.
Bob, that sounds insane. You want people to pay for extra health insurance, so that they can incentivize themselves to be healthy by getting back a little of the additional money they had to shell out on top of the extra taxes they had to pay for national health insurance? Wow.......
If you insist that it is the public's responsibility to pay for poor individual choices over which they have no control, then here's the fairest way to remedy that:
If you, Bob, weigh more than 10% over what you SHOULD weigh, then your tax burden should be increased commensurately. The more you weigh over a 'healthy' benchmark, the more health tax you pay. If you smoke, not only should your cigarettes be taxed, but you should pay a smoker's tax on top of it. If marijuana is legalized and you partake, then you should be heavily taxed for the health burden that will create for people who choose NOT to smoke dope.
There is more percentage in incentivizing people to reduce their tax burdens by getting healthy than there is in forcing healthy people who make good choices to pay for people who don't. That would be both fair and moral.
- Thomas Paine
Hello Bard... As usual, you offer some good points. I want to speak to one in particular. You write that our constitution does not say anywhere that health care is a right. Your are correct, of course. However, the Supreme Court has held that the provisions of the constitution contain unenumerated rights. I believe that adequate health care is one such right. Clearly, you disagree with that and I'm aware that a lot of very smart people would agree with your point of view. So, we have a difference of opinion here which, as I see it, is the basis for our disagreement over health care.
Now as for my "straw man" argument if I believe -- as I do -- that health care is a human right guaranteed by our constitution, in the same manner as our constitution guarantees free speech, then my analogy is not a straw man at all but an apt analogy. As I said, I respect your disagreement. I would hope you would give me the same respect, given Supreme Court decisions over the last 40 or so years. If you accept the premise on which my argument is based, it makes sense. If you don't accept that premise, then of course, we can never agree. That particular disagreement has been the heart of some major Supreme Court disagreements since the 1970s.
My goodness Bard.... I wrote something about my health insurance (private insurance company) offering me incentives for leading a health live. They pay part of my health club membership as long as I visit it a set number of times each month... I can see insurance companies sellingl lower premiums to people who don't smoke. I didn't say a thing about taxing. You implied that I wanted people taxed for smoking. Where do you get that from what I wrote. It would be simply good business for a health insurance company (private company not government) to offer monetary incentives to their policy holders to lead healthier lives.
Now if you'd like to talk about straw men, let me point out that your analogy involving mortgages is a straw man. While, at least it is reasonable to argue that health care is a human right, it is hardly reasonable to argue that we have a basic human right to a second mortgage. I would certainly not argue that people who take out irresponsible second mortgages are yours or my responsibility.
By the way, I do agree that people should be responsible for maintaining their own health. The best way encourage them to do this, in my view, is the include sensible monetary incentives in their health care policies for leading healthy lives. That is using the free market to accomplish something good for people and the nation in general.
You write that you should not be held responsible for people behave in unhealthy ways then get sick. However, if they don't have health insurance, you pay for them right now. These people go to emergency rooms and they don't get thrown out, they get care. Who pays for that? You and I do. If you have health insurance, that cost is part of your premium and if you pay taxes, that cost in included in your tax. Would it not be better to have these people on a health insurance policy, be given monetary incentives to lead healthier lives, have have their medical bill picked up by a private insurance company? I think it would.
Now as for my "straw man" argument if I believe -- as I do -- that health care is a human right guaranteed by our constitution, in the same manner as our constitution guarantees free speech, then my analogy is not a straw man at all but an apt analogy.
A Constitutional guarantee of health care is a presumption on your part. To my knowledge, SCOTUS has never ruled on this issue and I cannot imagine them actually delineating health care as a Constitutional Right. This would fundamentally change the nature of our government. This is a belief of yours, unsupported by any facts as far as I can tell.
We will never agree then. If SCOTUS renders a decision, we'll have to revisit it.
No, I didn't attribute any of those words to you. It surprises me that you interpret them that way. They were my thoughts on leveling the health care playing field and making it fair so that it didn't penalize people who make good choices.
I don't disagree, except that it seems you are advocating the need to buy private health insurance ON TOP OF national health insurance to get these breaks. That's unreasonable in my opinion, and makes no sense whatsoever.
It comes down to government bailouts with taxpayer money. Those are the connecting dots between nationalized health care and bailing out banks and others on failed mortgages. No straw man there. And health care is not a NATIONALIZED human right. Never has been.
You haven't said this should be part of the national health care proposal. Is that what you're advocating? If so, then I'm not seeing it anywhere else in the national discussion. My feeling is that it would make the whole proposal even more unwieldy and government-top-heavy than it already is (which is monumental). The government can't even monitor Medicare efficiently. It defies logic to expect them to monitor a national health care system efficiently too.
I doubt it, Bob. Tell me how my taxpayer money is paying for them. Is the government subsidizing hospitals, and if so, how?
Again, tell me exactly how my taxpayer dollars fit into this.
And no, Bob, my health insurance isn't jacked up to pay the hospitals for indigents. I don't have any health insurance. I'm one of those people you purport to underwrite, and I'm rejecting it.
Those people who spend their 'extra' money to do things which adversely impact their health should be made to take financial responsibility for their health. That's what I'm doing. That's only fair.
- Thomas Paine
i have a question. why do people in jail and prison get better health care then me. is it because it is the human thing to do? i have done nothing wronge but am i being punished for it. what about the humanly thing done for all? just a few questions since i am not educated enough to debate with ya's .
the picture you see was took before i got sick and beat cancer. i now look like crap
Having insurance for most is a choice. Too many Americans are choosing to be irresponsible and buy things they can't afford. If you can't pay your mortgage, utilties, and food bills, you have no money for anything else. At this point it's time to get another job, more education, cut your own costs by being careful, along with several other options. Everyone needs insurance. Be it health, car, home, or anything else you value. It's not the citizens of this country responsibility to provide you with what you want, but you yourself. What motivation is there for someone who pays their bills and taxes, takes care of things in a responsible manner, denies themselves many luxuries and then has to foot the bill for people who have NO self restraint!!!