09 September 2009

11 Talking Points About Health Care

Health care reform is complex. Blog posts are simple. Hence, I might have a compatibility issue as I tackle this topic. I have to admit that at times I find the debate amusing: it is almost as if we have fourth graders debating (silly?) string theory or mortals debating eternal life. Which is to say the health care debate represents life at its most absurdly normal: people writing and talking about issues we don't really understand. And how could I pretend to resist such a temptation?

Here’s a list of points you may want to throw out at a dinner party – like incendiary conversational devices. This is not an attempt to solve all the health care problems nor offer a comprehensive plan (just one more way in which blogging is better than being president):

1. A country that offers health care that makes people more vibrant, relieves pain and delays death is more moral than one that does not. As the richest country in the world, the question of offering universal health care is not a matter of affordability. It is a matter of morality.

2. It seems essential to define which kind of health care coverage we're saying is a right that everyone deserves and which is a luxury that only the rich or those committed to spending all their money on health care deserve. Our health care is like an 18 wheeler - big, complex, and able to handle the oddest conditions thrown at it. Everyone deserves transportation, but maybe we should guarantee a Vespa and not a Peterbilt truck. You can't legislate everyone into the lifestyle of the rich.

3. What kind of administrative costs and price insensitivity would we have if we used our auto insurance for every auto-related expense, from filling up to changing spark plugs, and not just for serious accidents? Would you care whether gas was $2.44 a gallon or $4.42 a gallon if you had a $5 co-pay in either instance? Maybe it is time to insure everyone from catastrophic costs and nobody from regular costs? This might drive more competition into health care. [This is essentially the interesting point made by David Goldhill in the September issue of the Atlantic.]

4. It is ridiculous to talk about funding health care while we're still subsidizing detriments to health. Can you say corn syrup? As long as we're talking about subsidies, how about making fresh fruits and healthy foods as easy to find and as affordable as are candy bars and unhealthy foods? What about offering blackberries and raspberries in prime condition in as many places as skittles?

5. You cannot steer a parked car. We've been debating health care reform for decades and passing legislation at this point is not "rushing into reform." We need to start with a plan and modify as we go. We're never going to get legislation that everyone likes nor a program that works really well from the start. One reason to accept compromised health care is to get moving towards better health care.

6. A huge portion of health care costs are incurred in the final months of life. Maybe we should promote religion in this country. If people were religious and hoped for heaven, they would be less intent on taking every measure to extend life by another week or day. [Wouldn't you think?] Either that or we could refuse to spend money on anything but pain medication in the two weeks before a person died. [I will just say that explaining the technology behind the technique of determining this date deserves its own post.]

7. If we have a health care system and we have illegal aliens here, they will have access to it. In the same way that if we have a system of roads and highways and illegal aliens are here, they will have access to it. This is not a fact that lies or outrage will change. Get over it.

8. For every $100 we spend on beating back disease, we should spend $10 on promoting health.

9. Any discussion of health care that ignores the importance of mental health ignores a leading cause of death and dis-ease. (Suicide is the cause of more violent deaths than war and homicide combined.)

10. As we become more advanced, we'll likely spend more on health care - from longer lives to whiter teeth. We can't automatically assume that spending a greater percentage of GDP on health care is a bad thing. Would our society really be better if we spent additional dollars on more clothes or entertainment rather than more health?

11. Universal health care can actually help make the economy more dynamic. Employees who did not have to stay with one employer in order to keep their health insurance would have more freedom to make employment changes and take entrepreneurial risks.


Unknown said...

Great post! My biggest quibble is with #5 - we already have compromised health care as you call it, why can't we fix that first by implementing 2-4 for example before expanding in a dangerous way? The spending of the past administration was dangerous and they got it wrong. This spending could be worse, however, as it is also dangerous, they may also get it wrong, but it also will not end once passed (unlike a war which always lingers longer than expected but also usually has an end). In fact, government spending is almost always done wrong so should be done carefully (even though it almost never is).

Lifehiker said...

Ron, this post is you on top of your game! I hope you don't mind if I print it and pass it around.