Saturday, September 8, 2012

Healthcare Dreams

I have to admit, for years I've been quite the quixotic dreamer, thinking that if we could only get government out of the way the glorious market would intervene and cure all ills.  Unfortunately, while I do believe this could have been the case, the reality is that its never going to happen.  As long as human beings are able to combine in self-interested mobs to assert themselves over other human beings, they will. And that really is the definition of government, isn't it?   

As originally formed, our government was supposed to be different--it was specifically designed to limit the natural inclination of governments to overreach.  Unfortunately, by finely parsing the words, not the intent of the Constitution, the Supreme Court unshackled the mob that is Congress and the result is what we have now--self-interested factions continuously banding together band to force their beliefs or economic interests on others.  Think of unions or corporate special interest groups.  That being the case, what's a dreamer to do?  Besides drink, I mean. 

This year's Presidential election clearly illustrates the problem. On one side you have a sitting President who wants to expand government into just about every facet of our lives.  On the other you have a candidate that wants to do the same thing--only from a different perspective. We are left to choose between two sides of the same coin.  Why, after decades, is Roe v. Wade even an issue?  Why do Democrats insist that those whose religious beliefs oppose contraception and abortion must fund them with their tax dollars?  Why does the Republicans' right-wing insist that everyone must follow its religious beliefs? Wasnt freedom from religious persecution the primary reason the Pilgrims came here in the first place?  Both parties act like abortion is the most vital issue facing the country when, in reality, those of us in the middle think its just a huge distraction.  

With our aging baby boomers, healthcare should be front and center to the debate.  And yet the best the Democrats and Republicans can come up with is shifting the deck chairs on the insurance Titanic. I'll let you in on something--when everyone is insured its not really insurance anymore.  The underlying premise of insurance--risk of something occurring--is pretty much eliminated when coverage is universal because the larger the pool the easier it is to predict occurrences.  This should mean lower costs to customers, but it just results in higher profits for insurance companies under both parties' current proposals--for insurors, Obamacare and the Republican alternatives are simply "heads I win, tails you lose".  [Hedge funds seem to agree, having poured billions of dollars into the stocks of insurers following the Supreme Courts decision on Obamacare.]

We don't have insurance that covers police, fire or education, the three rails of public service. If healthcare is truly the fourth rail--and its healthcare, not insurance that's the issue--then we need to suck it up and nationalize the whole system. And if that means death panels and delays so be it.  At least everyone would have access to a basic level of care and if they chose to spend more on better treatment and less on something else that would be their choice (and if they didn't or couldn't that would just be too bad, which is how it works in every other country that already has national healthcare).  As it is, we've become slaves to our insurance companies (and to our employers who usually pay the bill), who are more than happy to take our premiums but come up with every excuse to deny or reduce benefits when we submit a claim. Handing these criminals more of our money in the name of universal health insurance is a travesty. And yet that's the best both parties can propose?

If our government is going to be involved in healthcare, and it clearly will be, then the answer to America's healthcare situation is painfully simple--if we want everyone to have access to healthcare then it needs to be a public good, i.e., healthcare should be nationalized. The public has been misled by the insurance industry into believing that government control would lower its level of care.  That may be true in some instances, but what we get right now isn't exactly wonderful.  Has your insurance company ever disallowed a claim you were previously told would be permitted, sticking you with the bill?  Have you ever gone to a doctor who won't even take your insurance?  Get hurt in Canada and--even if you're an American--the cost for emergency care will be a fraction of what it is here, in large part because there is no insurance bureaucracy to navigate.

For once, this is a political issue that defies religious boundaries.  Is there a religion that wouldn't want everyone to have access to some basic level of care--at least for its members)?  That being the case, maybe government control is actually warranted in the case of healthcare.  Clearly, there has to be limits, especially with an aging population.  But creating an incomprehensible (I've got degrees in finance, accounting and law and I have no clue how Obamacare or the Republican alternatives are supposed to work) system that has the primary result of putting more money in the pockets of insurance companies, whose main priority has never been to provide the best healthcare, strikes me as the wrong way to go. I guess I'm still a dreamer.  

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