Wednesday, July 15, 2009

Why I, Not We, Must Ration Health Care

The infamous Peter (A-Three-Toed-Sloth-Has-More-Rights-Than-Your-Newborn) Singer has been favored by the New York Times with a lengthy Op-Ed today entitled “Why We Must Ration Health Care.” Would that he had written it in 1965, so that our forefathers could have read it before first turning down this broad road leading to socialized medicine (the destination of which is just coming into sight).

As you read Singer's article, I believe you'll soon note that his argument in favor of health care rationing is flawless. The rabbinic philosophy which he cited in the article, he also soundly refuted. Health care absolutely must be rationed.

What Singer has not addressed is the more pertinent and important question: Not whether health care should be rationed, but WHO should do the rationing?

I believe that I should do the rationing. I should be entitled to all of the health care that I'm willing to fund out of my own pockets. I should be entitled to all of the insurance that I can afford and wish to purchase. Beyond my insurance coverage, I should be entitled to all of the health care for which I am willing to write a (non-bouncing) check. Some people will not be able to afford basic health care for themselves, and I should be entitled to decide whether I would like to help them or not. I should be constrained in my decisions by the compassionate example of Christ, which will compel me to give generously to help the infant born with a defective heart, but will likely not lead me to fund a Viagra prescription for anyone.

I support the HealthSaver formula of combining a High Deductible Health Plan with a Health Savings Account (see more about this option here or here). The best thing about this medical option, in my opinion, is the fact that it puts decisions about the rationing of my health care right where they belong—in my hands. My insurance does what insurance exists to do: It protects me from being destroyed financially by a calamity. My HSA money is money that I use either to save for a rainy day or to spend on medical care today. To decide which I'm going to do, I ration my health care. Before I go to the doctor, I ask myself, "Is this really worth spending my money?" Before I fill a prescription, I ask myself, "Maybe I should wait a day or two and see whether I feel better on my own before I spend money on an antibiotic?" Sometimes I spend the money; sometimes I don't. It depends upon how my own rationing decision works out.

And by the way—about that Health Savings Account—my health insurance has given me $2,829.61 in the last three years, all of which is socked away in a Money Market account and a Bond Fund. Furthermore, I haven't spent a penny out-of-pocket for health care in three years (the "pocket" not including my Health Savings Account, which is extra money I wouldn't have under any other plan). Switching to the HealthSaver 2800 was the best financial decision I've made in a long time.

Many of us will want insurance coverage that provides extensive coverage for major unforeseeable injuries and disorders that could affect us or our families. As those in charge of our own health-care rationing, we negotiate with insurers, shop around for coverage, and decide how much we're willing to pay extra for how much extra coverage.

This is not a perfect system, but neither is it the worst possible outcome. I can't think of a system with better appeal, personally. The only area in which the Big Brother system can tout its superiority over the free market is with regard to providing health care for the deserving poor. But the free market system can address that need as well, when it is populated by the compassionate and generous. And apart from the compassion and generosity of individuals, any system is doomed to failure.

That's one reason why I favor free enterprise so much. It cultivates compassion and generosity. In the free enterprise system, people know that those who have fallen down will not be able to get up unless I help them. I am motivated to show compassion and give generously. But if I have fallen for the lie that it is somebody else's job to help—the government's job—then I have delegated away the tasks of compassion and generosity (as well as administering a death-blow to gratitude on the part of the recipient) and can comfortably look the other way. "The government has programs for that."

Certainly I am more comfortable with making my own decisions about health-care rationing than I am with putting those decisions into the hands of the Federal Government or (may God protect us all!) into the hands of Peter Singer. There will be little compassion and generosity in either case. But between the two of them, at least Singer is being honest. Socialized medicine will always involve bureaucratic rationing of health care. We need to read Singer's article and think long and hard before our government steals away from us the ability to make our most critical and private decisions for ourselves.

In summary, I provide three reasons why I, not we, must ration health care:

  1. Because rationing is ultimately a moral question, and we cannot trust utilitarians like Peter Singer nor the Federal Government to make such moral decisions. If they advise that a severely disabled fetus should be aborted, what rationing decision will they make about extending treatment to such a child if the mother rejects their opinion on moral grounds and bring the baby to term?
  2. Because the tendency of people toward selfishness—toward over-valuing one's own life—has not been demonstrated historically to pose nearly the problem that has been inflicted upon humanity by the tendency of governments to under-value the lives of people. Strange as it may seem, people often courageously put aside their own needs and value their own comfort below the needs of others. Ask the disabled veteran. Ask the good mother. Ask the first-responders of September 11. Government? Put the needs of others ahead of its own needs? I'll let my good readers cite all of the examples of that phenomenon that they find in history.
  3. Because the shift of rationing away from the individual and toward the insurance company and the government has contributed greatly to the increase of health care costs that threatens us today so much.

For all of these reasons, and more, let us avoid Peter Singer's solution and ration our own health care.

29 comments:

Luke said...

Bart,

Not only does free enterprise allow for me to be the one to help another up, it also allows me the freedom to walk away from the one who only wants a hand out. Scripture is clear that if a man doesn't work, he doesn't eat. Scripture is also clear that children born out of wedlock is not a norm to be accepted.

I am glad to see you addressing this issue. It would seem that many are of the opinion that "politics and religion" don't mix. Scripture addresses that as well. When the righteous rule, the people are happy. May God grant us righteous rulers.

Luke

Wayne Smith said...

Government-run Health Plan

U.S. Congressman Sam Johnson believes that members of Congress who vote for a public, government-run health plan should be the first to enroll
By media release
Jul 16, 2009
Backs legislation to hold Members accountable

Today U.S. Congressman Sam Johnson (3rd Dist.-Texas) insisted that Members of Congress who vote for a government-run health plan for the American public should be the first to enroll. A pending health reform proposal has a special carve out for Members of Congress exempting them from mandatory participation in the public health care plan if it becomes law.

“Members of Congress should stop asking the American people to make sacrifices they are not willing to make themselves,” said Johnson.

This morning Johnson took to the floor of the U.S. House of Representatives to tout his support of legislation that calls on Members of Congress who vote in favor of a government-run health plan to enroll in that plan. Johnson’s remarks on the floor follow below.

Johnson supports improving access to health insurance for all Americans but fears that the House Democrat plan will put bureaucrats between patients and doctors and ration care like in Canada and Europe. In addition, with an estimated price tag topping $1 trillion, and reports that the costly health plan still leaves 17 million Americans without health insurance, Johnson feels there are better, less expensive ways to make health insurance more affordable, accessible and available. Johnson believes that the problem isn’t that Americans currently don’t spend enough on health care; it’s that money is being spent inefficiently.

Johnson represents portions of Dallas and Collin counties.

Remarks by Congressman Sam Johnson:

“As we debate the best way to reform our health care system and ensure that all Americans have access to quality health care, some in Congress insist that a government-run public option must be included.” Yet in one proposal, Members of Congress are curiously exempt from participation in the public plan.

“For those who are convinced that government run health care won’t sacrifice quality and won’t lead to rationing, I back a resolution saying that if a Member of Congress votes to support the government-run option, then the Member must be automatically enrolled in it.

“If Members of Congress are convinced that the government-run option will deliver the same quality of care as their Congressional health plans, then they should be the first in line to enroll.

“Members of Congress should stop asking the American people to make sacrifices they are not willing to make themselves.”

© Copyright 2002-2006 by North Texas e-News, llc

Wayne

Mark said...

Bart, Peter's article does in fact advocate giving people the option to avoid rationing through private insurance or out-of-pocket payments. He's just arguing for a parallel universal public insurance that ensures everyone has a good (but rationed) level of care, irrespective of their ability to pay.

Ben said...

Bart -

Sorry to communicate with you via your blog (this has nothing to do with your post), but go to Marv Knox' editorial in the Baptist Standard.

Ben Macklin

Joe Blackmon said...

Why would ANYONE want to read anything in the Baptist Standard? I mean, you pretty well know before you get there that it's just liberal drivel written by mainstream christians.

Alex said...

I'm sorry, but if there's one thing I hate it's hypocritical believers.

How, Joe Blackman, can you list among your favorite books some by the rationalist humanist Asimov and come on here pontificating about not reading a slightly different shade of Christian in a Baptist news site?

You, sir, need to think and pray before you type.

Anonymous said...

One thing I would like to see reformed in our health care system today is true transparency in provider charges.

HRAs and HSAs are or can be great - the problem with most providers is that even they dont know what it costs to come see them. They have one set of costs for Medicare, one for BCBS , one for United Health Care and on and on and on - but woe to you if you go in and are not covered by a health plan - then you pay "retail"

Medicare charges are so low that providers go broke accepting their payment, and then shift those costs on to those with health insurance raising the cost on us all.

If congress passes a national "alternative" and uses medicare or a percentage of medicare pricing (which they will have to do for the new system to not be bankrupt in 2 month - not to mention 2 years) they will drive every insurance or self funded plan bankrupt. The cost shifting will be so bad that it makes todays look mild. And then will come in the rationing of health care.

What kid will be able to go to med school and afford to pay off their loans.

Wow, didnt mean to rant, at least not so much.

One answer - transparent pricing, have the docs list on their walls what each and every procedure costs (kind of like auto repair shops) - if a patient pays cash, give them a discount, if the doc is required to file the insurance - charge for the privilege. This would cut admin costs, let patients shop around, and bring true competition to the market place.

HRAs and HSAs will be hugely successful under this scenario, medical inflation will be reduced etc. Until there is true transparency in pricing I would not have an HSA or HRA.

One other thing - one of the biggest scams in health care is/are PBMs (pharmacy benefit managers) - look on the back of your insurance card for the name of yours PCS, scriptcare walgreens etc- these clowns by scripts in huge bulk, get paid "rebates" or in the real world they are called kickbacks and then pass some or none of it to the actual health plans or end users (you and me) This is one of the things that make prescription drug costs so high. Get this stuff out of the system through transparency and we just might get control of health care costs in this country

Jim Champion

Tim G said...

Bart,
Great example of Stewardship lived out in your daily life!

Nice job!

Bennett Willis said...

The wisdom of the prosperous and relatively healthy. Your plan sounds like a way to reduce the population of the poor ethnic minorities. (A statement more or less taken from a previous blog on this site.)

"If they advise that a severely disabled fetus should be aborted, what rationing decision will they make about extending treatment to such a child if the mother rejects their opinion on moral grounds and bring the baby to term?" OK, now that she has made this decision, who is going to pay for the care? How are you going to ration this? Few medical policies will not top out relatively quickly under this sort of burden. Then it becomes spread over all of us either through taxes or medical bills.

There are no free lunches. When ever someone receives anything (other than a miracle) it shows up somewhere on someones bill.

Bennett Willis

Bart Barber said...

Well, Bennett, here is what I wrote:

"But the free market system can address that need as well, when it is populated by the compassionate and generous. And apart from the compassion and generosity of individuals, any system is doomed to failure."

Thanks for demonstrating the unbounded capacity of people to spout stereotypes rather than read and interact thoughtfully.

Bennett Willis said...

But what about you? I really don't get the impression that you are among that group of free market people that you talk about here. Are you willing to pay your share or are you just going to take care of your own--until you can't do it any more and then call on "the generous free market" to complete the job.

Have you looked at what sort of disaster it would take to put you in this situation? It is a lot smaller one than you might think.

Bennett Willis

Bart Barber said...

Bennett, you judgmental soul, how have you come to such intimate knowledge of what I have or haven't given to help people in need medically?

Was it by speaking to the man with cancer whom I and some family members supported financially until he died, and his wife afterwards? Was it in conversation with the people in Kenya overcome by water-borne pathogens for whom we funded multiple wells? Was it with the man whose wife has a terminal debilitating illness whom I assisted financially?

Or have you spoken with none of these people—indeed, done no research at all—and once again are spewing vile stereotypes here out of the hardness of your heart? Are you leaping to conclusions because you are so deceived as to believe that tax-and-spend liberalism is the only "generosity" that exists in the world?

If you want to see an absence of compassion and generosity, go to an inner-city slum. Go to an Indian Reservation. See how government entitlement programs rob people of dignity and shackle them to multi-generational squalor and dependence without hope. Go to an Indian hospital. Go to a VA hospital. Who among those who can go elsewhere lobbies to get into those places? Who but their worst enemy would condemn people to such a fate? Who but the ignorant would clamor for the expansion of such carefully-cloaked brutality in our nation?

Bennett Willis said...

You said, "But the free market system can address that need as well, when it is populated by the compassionate and generous. And apart from the compassion and generosity of individuals, any system is doomed to failure." Give me some help. Who are the organizations and individuals in the free market with the interest and capability of taking care of serious medical issues and costs? I may need to visit with some of them one of these days.

In case you have not noticed, the free market dumps you onto the government as soon as you reach 65—if you have the quarters in the SS system. They also expect you to sign up for part A even if you don’t have the quarters. [By the way, if any reader is over 65 and has not signed up for part A of SS, you should do so as soon as you can get an appointment even if you don’t have SS work quarters and have other insurance. If there should be something that part A is supposed to cover and you are not signed up, you will find that you are personally responsible for the bill.] In my personal case, I "outsmarted them" and kept working in a new job where I have group insurance. My industry retirement insurance has become a distant third in my insurance pyramid. Where is the free market that you talk about? Where would the free market be for the seriously impaired child (and eventually adult) that you spoke of in your blog?

In my previous job, I did the United Way collecting for my department for several years. When I started this "volunteer work," I had the attitude that I was helping someone else. Then I reviewed my family. My wife had spent several months in polio rehab thanks to March of Dimes. Her family would have been bankrupted if they had funded the activity. Most of my family members had, at one time or other, received help from a United Way aided agency. Maybe they are the free market you are talking about. But if you have a really serious problem eventually you will get help from the government--or just die on your own. No one else is willing and able to take care of the problem.
(continued in next comment)

Bennett Willis said...

(continuation of previous comment)

My wife suddenly lost the ability to walk about 5 years ago. After about 2 weeks in the local hospital she was ruled “stable” (but undiagnosed) and we had to move to a long term care facility—a free market example of rationing. After about a week there she went to St. Luke’s (Houston medical center) for 40 days in ICU (inverse rationing, I suppose), then back to the long term care facility. She was now on a ventilator, a feeding tube and largely paralyzed from roughly the shoulders down (but we knew why). After a couple of months in the long term care facility she was judged stable and sent home—more rationing. At the time there were only 2 nursing homes in the state that would take a resident using a ventilator—one in Beaumont and one in Austin. So I suppose that bringing her home was rationing on my part. I provided her care (with some rehab and visiting nurse help) for the next 5 weeks including the ventilator, feeding, and wound care (an infection from a chemo port removal). Then she died. About a year later the long term care hospital called. My free market insurance had decided that her medical bills were supposed to be paid by Medicare—and there was $300K left. We were not signed up for Part B. The fact that they had paid for several months was not relevant. Their suggestion was that we posthumously enroll her in Part B. SS looked at me as if I was crazy when I showed up for that. Eventually we figured out that she was not eligible for Medicare B since she did not have enough work quarters under the SS system and the insurance picked up the bill.

We thought that we had it all planned out but once disaster hit my choices quickly became “spend a lot of money” (eventually covered by insurance) or ration the care and bring her home to die to start with. I had adequate insurance but it did have a limit and I suspect that we were getting up there toward that limit.

Unless you can provide more information about how the free market is supposed to address serious health care costs (for all of us and with empathy), I will (judgmentally, of course) continue to regard your “solution” to the medical issues as the simplistic wisdom of the prosperous and relatively healthy. Please be sure to address the issue of the “hypothetical” (but all too real in actuality) child mentioned above. Give us all some scenarios and how they are supposed to work out. You have enough experience with long term, really sick people to be able to do this. How does it play out in your experience and how is your rationing going to "fix" that?

Bennett Willis

Bart Barber said...

Bennett,

Yes, those institutions are all part of the free market. Who has the resources to pull it off? The simple economic fact is that the government has no resources that the free market does not provide. It creates no product, provides no marketable service, and adds no value to the system. It exists parasitically only.

Now, we need it to exist. I'm thankful for its parasitic existence. We could hardly defend ourselves or enforce our laws without a government.

But what it cannot do—what is entirely beyond its power—is to create a dollar. It can print a bill, but only by further diluting the value of the other notes out there. The value behind the bill is created by people laboring in the private sector.

If the free market does not have the resources to address health problems in the private sector, then neither does it have the resources to address health problems in the government sector.

BTW, the child in the situation above is not hypothetical. It is the daughter of a friend of mine with whom I grew up. She had an enormous tumor in utero. The medical community put enormous pressure upon this couple to abort. She would die shortly after birth if they did not, they said. She could never live a normal life, they said.

She was born. The tumor was removed. It wasn't nearly as bad as they had guessed. She's a teenager today. I could put her in a lineup of teenaged girls and you could never pick her out.

Would that couple have had the courage to persist through to the birth if they had been told by the government that their baby could not have any medical coverage if they chose to bring her to term? I don't know. As things were, they had private insurance and therefore had some protection to embolden them to do the right thing.

...continued....

Bart Barber said...

...continue....

Here's the root of the question:

Heaven forbid, my child gets sick. Dreadfully sick. Treatment is available, but I do not have the money to obtain treatment. People in my community do have the money to pay for the treatment of my child.

Now, given that scenario, which is the right thing for me to do:

1. I could beg. I could launch a charity movement and beg for people in my community to help to pay for the treatment.

2. I could take what little money I have and hire someone to go door to door in my community with a gun and threaten people and force them to pay for my child's treatment.

Government health care is option #2. Don't believe me? Don't pay your taxes and see who eventually shows up at your door.

I'm arguing for option #1. And I'm arguing that each of us, if we are believing sorts of folks, ought to give when someone resorts to option #1 as their last option.

I'm arguing for option #1 not because it is the most efficient or certain solution—I'd have more confident in getting the money with the gun. I'm arguing for it because it is the right way to go about it, and the gun is the wrong way to go about it.

Bart Barber said...

BTW, the prosperous and relatively healthy, if they are wise, will spend a little of that prosperity to purchase insurance as protection against the day when they are less prosperous or less healthy.

And if they do not, whose fault is that?

Bennett Willis said...

Good thing that no one except us is still reading this. :)

We have fundraisers (BBQ or fish fry, etc) in my community all the time. They (on a good day) may produce $10K-15K. Enough for three days of the bill that my wife ran up at the "long term care" facility.

We have special offerings at our church occasionally for this sort of problem. The amount produced might be similar in size if the need is dire--but usually is less.

Then there is the problem of the medical bill. I am under no illusion that my insurance company really paid $5K/day but I also know that I could talk the bill down to their rate even if I were willing to write a check right then(rather than making the hospital wait a year or so).

While the total community (as represented by the government) has money (or in your terminology, can be forced to give up money as taxes) to help with the problem, each of our individual communities is not large enough (or generous enough) to make an impact on the problems that occasionally come up. Your group might never have a reason to donate for one of yours--but they have to because my group can't cover it if we have a really bad problem. Thus we will be taxed. This is my experience and I strongly suspect that it is your experience too. Some may have relief from the community, but most just fall through the cracks.

I recognize the problem and regret that the government is going to help us with the solution--but I see nothing in what you have said that indicates a realistic approach especially since so many of us are relatively low paid and under insured.

Those of us who are prosperous and relatively healthy (which includes me) should take care of ourselves. And you and I are doing this relatively well unless we have a really significant problem. However there are lots of people who are neither prosperous nor healthy. When they have problems they don't do so well.

We are instructed again and again to take care of the poor, the widow, the orphan. We don't do this very well. We seem to have better things to do with our time and money. So we are going to get some help. Enjoy.

Bennett Willis

Luke said...

"Good thing that no one except us is still reading this."

Actually, that isn't true. I've been watching to see if anyone would respond with socialist drivel and I was not disappointed. So along those lines, I'll share just a little of what I've been thinking.

Jesus was NOT a socialist. To the one who had one talent and was not profitable, he had that talent taken from him and instead, given to the wealthy prosperous individual. That is the complete OPPOSITE of socialism. It is called being a good steward of what was entrusted to you, whether great or small.

Good debate there Bart!

Anonymous said...

I'm still reading . . . yes, it is a good debate.


Becky Illingworth

Bennett Willis said...

Luke,
I offer you the same challenge that Bart has so graciously refused to respond to with any useful specifics: How are you going to take care of the health care needs of the poor, widows, and orphans (and mentally ill, etc)? Or perhaps since you are a pastor: How are you leading in taking care of the needs...? Do we have any obligations in that direction and how should we fulfill these if you think they exist? [By the way, I think that obligations exist. This is one of the resons that my church is my largest investment. I feel that our pastors have neglected the teaching and modeling of the practical/applied aspects of the gospel to the point that it does not do that part of the job like it should.]

I am a productive member of society. Tank cars still haul out to customers the result of my intellectual effort and sweat and now future operators of those chemical plants benefit from my experiences. One thing that I saw again and again in my industrial years was that if you did not run things "correctly" that someone would help you--and you might not like that help. The medical industry has not been run right and now it is going to get help that it does not like. And the religion industry has some responsibility in that because we have not done our job either.

You emphasize that Jesus was not a socialist and go on to take a literal slant on the parable (it is all about the money). However do you remember that some of the early Christians moved well past that? They sold what they had and shared it with the rest. This is a model that we (both you and I) have rejected in a big way but it exists.

Bennett Willis

Luke said...

Bennett,

Our church operates under a few principles.
1. I Timothy 5:16
2. II Thessalonians 3:10
3. Galatians 6:10

And exactly what is a health care need? I would LOVE to have RK or laser correction on my eyes but I cannot afford it. It IS NOT anyone else's obligation to see that I get it nor do I EXPECT it. Abortion flat out is a sin and to call that a health care need is nonsense. Visiting a dentist 2x's a year...I don't even do that and NO I do not have dental insurance but neither do I EXPECT anyone else to pay for it either. Neither does being either an American or a Christian ENTITLE me to any of that. I do have a health plan but it is a very basic plan and it is what I can afford.

The church that I pastor at times has helped others with their health care needs. But you must understand, those needs were genuine and were not because some woman decided that her life would be to generate as many babies as she could from as many daddies as she dared who would stay home and watch Oprah. The Church I pastor does not reward such behavior.

We contribute through taxes to a system that helps individuals get basic needs and even there, we understand that the system is abused by those who really could be more responsible for themselves, they just choose the lazy/easy road.

This whole point about health care, as Bart has so astutely pointed out to you is that the Government is in NO WAY able or capable to make decisions about who gets health care when and for what. What the proposed health care system will do is drive the choice of an INDIVIDUAL deciding what he/she will or can afford to have done into the choice of some government bureaucrat who will make that choice for them. Those of us, like myself, who have very little health care insurance, do not want our choice(what little we have) taken away from us and instead, made for us by someone who is simply concerned with crunching numbers. In fact, I serve God to the best of my inability(smirk--theological debate) and trust God to supply my every need. If I am indeed faithful, I have no doubt that HE will provide what I truly need.

This can of worms opens up even further. Since you, Willis, obviously work for a much higher salary than I do with much better benefits than I receive, then why don't you start sending me a monthly check that makes up the difference between our two salaries? Then I can have everything you have and we can be equal.

But no, you want the government to have to FORCE you to do this. When instead, the BIBLICAL model was of men and women MOVED BY GOD to help their fellow man. What Bart and I contend, is that decision is still and should always be left up to those that have been the recipients of such bountiful blessings as to whom and when they shared their blessings. Individual responsibility is the order of the day. And to push this even further, under your attempt at socialized health care, just when will the playing field be considered level and by whom? You are opting that the Government is best up to this challenge...I with Bart contend that this is best left to the INDIVIDUAL. That is why this is America and not Amerika. It is up to the individual to make their way in this country and THAT is what has made this country(from the human perspective) so successful. That is why so many long to come HERE.

No Bennett. I reject your form of cookie cutter socialism and its attempt to thwart the choice being made by the individual. I reject this concerted effort by government individuals to form us into a group of lemmings. You wanna be one, good for you. Canada would love to have you and possibly even the Netherlands. But I prefer the ability to make my own decisions about health care and make my own deals with the hospitals should the bill be more than my insurance covers.

Sorry for such a long rant there Bart, but as Bennett said, maybe no one is reading.;)

PS: I am sure the disciples must have argued about insurance somewhere huh?!

Bennett Willis said...

Luke,
It is interesting that your church operates by selected verses from Paul's writings and not off the "red letter" sayings of the scripture. This gives you a lot more wiggle room on responsibilities for the less fortunate.

1 Timothy 5:16 (New International Version)

16If any woman who is a believer has widows in her family, she should help them and not let the church be burdened with them, so that the church can help those widows who are really in need.

2 Thessalonians 3:10 (New International Version)
10For even when we were with you, we gave you this rule: "If a man will not work, he shall not eat."

Galatians 6:10 (New International Version)
10Therefore, as we have opportunity, let us do good to all people, especially to those who belong to the family of believers.

No one in this discussion has suggested that it is appropriate to pay for abortions. We are talking about things like car wrecks. Falls that leave a person permanently disabled. Problems like my wife had that ran up a huge medical bill over a year (between cancer and the problem that finally took her). As you point out, you gave a rant. You did not propose any solution to the problem or make any positive suggestions that I can propose to my church as actions we should take.

You did not even acknowledge that we have any obligation to help--other than your suggestion that I might want to share with you since I seem to have more. Are you blind? Is your vision restricted to the point that you cannot do the works of The Lord? If so, let's talk about how to get that fixed--otherwise move on.

I think that you need to read the first four books of the NT again--preferably in a "red letter" edition so you know when to pay attention. What did our model for how to live life say about our responsibilities toward others?

Sometimes we have problems put upon us that are beyond our ability to successfully deal with them. We need help and our churches and communities are not providing it--and this means you and Bart. If you don't do it you get help. And Mr. Obama is from the government and he is here to help us fix our problems.

You say "If a man will not work, he shall not eat." I say that there are lots of folks who are working hard and slowly sliding toward the edge. Some of it is bad management--so teach them how to manage. Some of it is bad choices--so teach them how to make better choices. And some of it just happens to them--and we just walk by on the other side of the road.

[Note: My church offers occasional classes in money management and I expect that Bart's does too. I don't know about Luke's. This is both common in many churches and under utilized. We need to involve the community (and maybe schools) more. Dave Ramsey tells it right and a number of others too.]

My interpretation of your suggestion on health care is, "Let them eat Band Aids--that they buy themselves." Don't you feel bad about that?


Bennett Willis

My "word verification" was forks.:)Sometimes I think the computer listens.

Bennett Willis said...

By the way, I really liked Jim Champion's comment--as I often do. He pointed out a number of the really frustrating things that you run into when dealing with the medical-insurance complex (to sort of borrow a phrase from Ike).

My HCP (health care provider) says that he is working just to annoy the insurance companies. Based on what I have occasionally seen on payment delays, he may not be able to figure out how to stop.

I expect to be more annoyed after we get additional government involvement than I am now. But I also expect that some people will get better attention (and get it before they are so ill) than they do now.

None of this should be interpreted as cutting Bart and Luke any slack. :) Poorly thought out and untested/unquestioned "conservative" comments are an insult to the philosophy. They deserve to be challenged. And I keep hoping that something useful might show up if I keep after it.

Bennett Willis

Luke said...

Bennett,

My oh my, what shall I say? You've put me in a quandary because I offered you no solutions. A good look at the book of Ephesians will teach you that Paul taught a basis for activity and then he taught proper activity. It was not uncommon for him to address what we call theology first and practical matters secondly. And yet even when I offered you "red letters" you scorn my use of them because I took them literal. My oh my, what shall I do.

Money Management--Easily taught from the Scripture and Dave Ramsey agrees. Do not borrow and do not lend. Do not live beyond your means. And for your "red letter" addition, Take no thought for what ye shall eat or what ye shall drink or wherewith ye shall be clothed. For after all these things do the gentiles seek. Are you not more important than the birds or flowers? And your Father takes care of them. Are you not worth more than them?

I could brag about what our church does to help people but darn those pesky "red letters" again. Do not let your right hand know what your left hand does.

You want a solution proposed. Here's one for you Bennett. Lobby Congress until they pass a law that FORBIDS negligent lawsuits against doctors. Reduce their need for millions of dollars worth of insurance and watch the price of health care drop.

Here's you another solution Bennett. The money you spend on internet service could be used to provide health care for some child down your street. Give up your internet for them Bennett. Just do it.

And we can try to compare what Bennett does with what Luke does but Bennett, that will only lead to pride. Compare yourself to the Lord instead and when you are living up to that standard in regards to health care, then you can begin casting stones towards those who don't. Darn those pesky "red letters" again.

My fundamental philosophy differs from yours Bennett. The way to make meaningful change is not to steal from the rich and give to the poor. Instead, it is to preach the Gospel of Jesus so that their hearts can be changed so that they WILLINGLY want to be of service to their neighbor.

All of this I say Bennett I say as a person who is considered under-insured. My son, in his carelessness, decided to put a bullet through his leg, TWICE in one shot. By the grace of God, the bullet missed the bone, arteries and vessels. Not having coverage for anything of this nature, home health to be exact, I was the one who cleaned my son's wound and dressed it twice a day. I was the one that got to feel his leg twitch with pain as I applied the medication that ate out the bad and left the good. And the whole time, NOT ONCE, did I feel ANYONE owed us anything in regards to financial help. It's all got to do with the heart Bennett. The poor person who demands has the wrong attitude and the wealthy who walks past has the wrong attitude. Last time I checked my "red letters", only Jesus can change the attitude.

In conclusion, let me say this. It would scare you to no end to hear my philosophy about health care. Too many unnecessary surgeries. Too many unnecessary pills. Too much focus on the flesh. It isn't red letter but we are told, "bodily exercise profits little". Prolonging death in some cases is simply that, prolonging the inevitable in an attempt to defeat the inevitable. Unless of course Jesus comes back first but in either case, all who have died in faith and all who are alive in faith will be changed in the moment in the twinkling of an eye. Who gets to make the decision as to when enough is enough? Under the government health care--Obama(aka just take a pill). Under Bart's plan which I support, myself or Bart.

Leave the decision to the individual. And if you cannot afford "necessary" health care, trust the Lord to provide. It really is that simple.

Anonymous said...

Bennett

Thank you for the kind words.

BTW, I am all for a free market health insurance system, we have not had one since the advent of HMOs into the marketplace.

Unfortunatly for me, I have been in this market place (employer and consumer) since the early 80s. When I came in most insurance plans were basic plus major medical. The basic part paid xdollars for care, then you had a deductible (typically $100 which was real money back in those days) and then 80% coverage until you paid $1,000 out of pocket.

We then morphed into a "comprehensive" major medical scheme where we paid deductible and coinsurance - but we began paying providers based on "reasonable and customary' charges. Guess what - what ever providers wanted to charge was deemed "reasonable and customary" Medical inflation took off.

We then came in with fixes - 2nd surgical opinion, utilization review etc - medical care inflation still doubled or more standard inflation.

Then or around the same time HMOs started sweeping the country. Legislation was put into place that plans had to offer at least dual options one of which was an HMO. What a great concept - they did not need to just treat illness, they coached you to stay healthy (sound familiar - hello obamacare) They also introduced the concept of Dr office co pays and Rx copays. What a mistake - people began to think it cost $5 to go to the doc or get an Rx. And they would go back again and again and again.

But they began to negotiate discounts (PPOs also came into being around this time) If you were a member of that HMO or this PPO your plans directed you to a certain provider who discounted his service for that plan. Sounded good until you realized that providers no longer know how much something costs -even in thier own offices.

Now Obamar wants to set up a public option with incredibly rich benefits that only the "rich" are going to have to pay for. That is not insurance, that is welfare - and if it passes it will be horrible. 10 yrs from now it will eat most of the federal budget (ok two yrs from now)

Being inside the industry, I know that there are things that need to be fixed - unfortunately BIG INsurance is in obamars pocket, it will be status quo or worse. Employers and individuals will lose choice both of plans and thier own health care decisons.

My solutions would be to have consumers have more skin in the game, but to balance that with transparency. All providers would charge all consumers the same fees. Unfortunately medicare rates will never be the same as private - the system is already bankrupt - but one of the biggest cost drivers of the private system is cost shifting from medicare to the private sector.

Tort reform - but the lawyers fund the dems so that is a non starter

Increase the premium tax, and establish a claims tax on the self funded plans (70% of large ers - 100 ees or more - self fund) and pay no "premium" tax on the claims portion of thier plans. Use those funds fund state pools to provide insurance for the true uninsured or un insurable. Not young folks who dont want to spend the $$, or wealth in the same boat.

My two cents on the matter

Jim Champion

r. grannemann said...

The reason the present government/free-market health care system is in place today is because the totally free-market system of the past didn't provide sufficient care for older, uninsured and needy people (in the opinion of lawmakers). Of course the government does not make the wealth to fund the present system. It extracts it in FICA and other tax. If left to spend money according to their free-market choice, people in general wouldn't save/contribute much for either their own or other people's medical treatment -- they'd rather spend on cars, vacations and larger homes.

The result of the present (government subsidized) system is enough money to try and keep you alive no matter what. If you get an infection (that would in past times have killed you), you are now pumped up with antibiotics to keep you going a little longer. If you lose the ability to swallow, a feeding tube is put down your nose or through an insertion in your stomach. If you have a stroke, drugs and respirators are used to pull you through, often so you can live in a severely incapacitated state. My step-mother lived for six years paralyzed, incontinent, unable to speak with maybe 25% of her brain capacity -- all because she got to the hospital barely in time for them to save her. And Medicare freely forked over hundreds of thousands.

The present system has little cost control in which insurance companies pay (pretty much) whatever the doctors and drug companies ask and extracts the money from you and your employer. I'm not in agreement with Bart's free-market only solution, but the free-market only solution does have this advantage: it would severely reduce medical spending.

Bennett Willis said...

I am pleased. I suppose that I'd be proud but we know what that leads to. I just finished reading two very thoughtful and reasonable comments about the health care system.

If these had preceeded my various rants (Luke, I know I rant too. :)) then I would have never said anything.

My experiences with my late wife have colored my responses. And the problems that my students have filled in several of the holes. [I am constantly amazed at the "anchors" that are dropped on my students--often (but not always) through no fault of their own.]

I am firmly in favor of us taking care of our own as best we can but believe that the system thwarts us. I agree with Luke about surgeries and pills--a few people really run up the tab for no good reason. My HCP and I have me living with a couple of things--minor things. We've fixed a few things that would have killed me by now (or at least restricted my ability to be productive).

I look back at my wife's experience and occasionally wonder if we fought too hard. Studies indicate that Christians tend to prolong things. But people that crash quickly for unclear reasons sometime recover the same way. The problem is that we don't know how it is going to turn out.

In our county there are visiting nurses who will come by for a very reasonable fee to help on things like the leg wound. In my wife's case the insurance covered the visits so I really have no idea exactly what it cost--but I really needed the help and it was not a lot. I would hope that people with this sort of problem would use that service--even people who ask for no help as a matter of practice.

My brother is an MD. He was a huge help during my wife's illness. He helped me keep my head straight about what was going on, what seemed real and what was not relevant. I would pray for a similar person for anyone who is making health care decisions for someone else. You really need to have someone to listen while you go over the day's information and it really helps if they have some experience. But almost anyone will do, even without experience, if they listen carefully and ask a few questions when things seem confused.

We often "drop" friends with medical problems. We do this because we don't know what to say. The person with the problem is dealing with it all the time. Just show up. The sick person will talk about what they want to talk about if you just look interested. I had a relatively novel problem a few years ago. [An acoustic neuroma if anyone needs to talk about one.] The best response I ever got was when I mentioned it to one of the nursing instructors. She said, "Bummer. What are you going to do about it?" And I told her.

From Jim's view of the system, apparently the fee that medicare is willing to pay the primary care physician is not enough for the PCP (primary care physician) to leave home and come down to the ER. Thus the ER physician (who does not know the patient) often orders a lot of tests in response to the legal system. This really runs up the bill. Another unintended consequence of a rule.

If you are ever on a jury for a medical case, please try to look at the case from the point of view of the doctor when you are determining reasonable behavior. Doctors mess up (some more than others) but just because the outcome was not the desired one does not mean they behaved unreasonably.

We did not get into this situation overnight. Unfortunately, we will be stuck with the "improved" system for a long time. Maybe it won't pass and out of fear of it coming back we will do some of the things that Jim suggests--at least in the strip mall clinics. Transparency goes a long way toward helping us cooperate with the system--and it is sorely lacking.

I've enjoyed the discussion and feel that I have made the points I was trying to make. I have learned from the experience. I'm done. Thank you all.

Bennett

Bennett Willis said...

http://news.yahoo.com/s/csm/20090813/cm_csm/ymarino

This is an interesting article on this subject from a secular point of view.

Bennett Willis