Friday, July 31, 2009

Is Health Care a Right?

I first heard that question in the 2008 presidential debates.

I'd never really thought about it in those terms, and I wasn't quite sure how to answer. Since then, we've seen that question in many forms and forums, and, though the left usually declares health care a right (with caveats to be discussed below), the conservative answer has been mixed -- some say it is a privilege, and some say it is a responsibility.

My initial response to the question was to say that it was a right, but then I balked because, as Dr. "Dalrymple" put it, "If there is a right to health care, someone has the duty to provide it."

But if it is a privilege or something else, then no one has a claim to any care at all -- a notion we rejected as a society long ago.

I believe health care is a right.

If we have a right to life -- as our founding documents have said and as we have derived from scripture -- then we should have a right to what is necessary to maintain that life.

But that does not mean someone has the duty to provide it.

To understand why, consider another right, that of free speech. Our right to free speech does not mean that anyone is obliged to publish your book or put you on tv or even to give you a laptop and a blogger account.

A right to free speech means government can't lawfully silence you, prevent you from spreading your ideas.

A right to health care does not mean that anyone is obliged to pay for your medical care. It means government cannot deny you care because you're black or gay or a member of the wrong political party (think USSR). What about "because you're poor?" Denying you care because of your socioeconomic status is not the same as not providing something for free.

We all have a moral obligation to love our neighbors, and sometimes that means helping the sick or the hungry. We can, as a society, decide that we want to handle that corporately, e.g., to create government programs to do it, but that is not because health care is a right, nor does it make health care a right.

That liberal caveat:
Liberals will generally say health care is a right, but they don't mean it, at least not in the way they claim.

As shown in the countries with nationalized health care (e.g., Great Britain) and in the bills currently floating around Congress, they don't believe health care is a right. They believe health care is a privilege you are granted as long as you aren't too old, too sick, or in need of expensive medicine. If you are, then government is, to them, well within its rights to cut off your health care and help you suffer or die quietly -- which ever way you want to think about it.

Thursday, July 30, 2009

Headlines 7/30/09

=Alleged U.S.-Based 'Jihad' Plot Could Indicate Alarming Shift in Strategy
Oh, yeah, there's still a war on. Anyone else tired of the healthcare reform debate?

=You're (Probably) a Federal Criminal
Perhaps if some members of Congress get arrested for this stuff they'll see the light.

=Obama still cashing in on Bush's failings
Obama's default mode: campaign against Bush

=But, since the debate is still going on:
5 freedoms you'd lose in health care reform
When CNN's running this, you know the Democrats are having trouble.

Tuesday, July 28, 2009

Headlines 7/28/09

4Conyers Sees No Point in Members Reading 1,000-Page Health Care Bill--Unless They Have 2 Lawyers to Interpret It for Them
That tells us a whole lot about our modern political system.

4Obamacare: It's Even Worse Than You Think
The Democrats want to spend $1.5 trillion over a decade, impose an $800 billion tax increase in the midst of the worst recession in a generation, increase federal borrowing by $239 billion..., impose costly mandates on employers that will discourage hiring as unemployment nears 10 percent, force individuals to buy one-size-fits-all government defined insurance, and insert the government in countless new ways between doctors and patients. All of that would occur whether or not the plan includes a "public option."
And that's before we get to the hidden costs.

4'Death sentence' of 1,300 cancer patients denied life-saving drugs because of NHS postcode lottery
But I'm sure that's not "rationing."

"The elderly will go from being the group with the most access to free medical care to the one with the least access."

Monday, July 27, 2009

More Healthcare Links

4Have you signed the "Free Our Health Care Now" petition?

=US Gov to Tell the Elderly About Starvation & Dehydration Options?
The message is clear: government can save money by encouraging old people to die a little sooner than they otherwise would. Instead of being regarded with reverence, and cherished, human life is subject in this view to a utilitarian cost-benefit calculus and can be sacrificed to serve fiscal policy and the sacred imperative of trimming a budget.
Can you imagine? "Excuse me, but would you mind dying now?"

=Health Reform’s Hidden Victims
Namely, the old and the young.

"The president assures us that he will cut health-care spending... by adding $1 trillion to health-care spending."

=Can the US President save the patient?
This British author says the US voter is the problem: "In the UK, people accept that just because a procedure is available somewhere doesn't mean you can have it."

Of course, in the UK, people believe they should bow to certain people. Is their stratified society the reason why such random inequality is acceptable?

Friday, July 24, 2009

Healthcare Headlines 7/24/09

=GovernmentCare’s Assault on Seniors
The Congressional majority wants to pay for its $1 trillion to $1.6 trillion health bills with new taxes and a $500 billion cut to Medicare. ... The assault against seniors began with the stimulus package in February. Slipped into the bill was substantial funding for comparative effectiveness research, which is generally code for limiting care based on the patient’s age.
In Britain, this has been accomplished by NICE rules that will spend about $50,000 per quality-adjusted life year.

The quality adjusted year is, in brief, how many good, productive years you have left in you. If you're older or if you're otherwise ill (e.g., MS or parapalegic) your remaining years, however few they may be, are discounted with respect to a healthier person. If you're old and sick, you're going to have trouble getting them to treat you curatively.

=Health Care Hellfire
Which insurance policy "sets out annual dollar limitations on coverage of those benefits?" Obama's.

=Democrats Block GOP Health Care Mailing
They apparently don't want you to see this chart illustrating the bureaucratic nightmare the Democrats are trying to create to govern our healthcare.

Reforming Without Understanding

After the president's press conference on healthcare reform, David Freddoso observed:
"With his example of the red and blue pills, and another about whether a child's hypothetical tonsils should be removed, President Obama unwittingly presents the real problem with his plan for reform. Here is a well-meaning government official who so fails to grasp the problem in health care that he can present such absurd oversimplifications and suggest that this sort of thing is the real problem .... If medical doctors with a decade of schooling cannot distinguish between good cures and ineffective ones that must be discontinued, then by gosh, we're lucky that the good folks from the government can."
I'm reminded of a conversation I had some months ago after a friend read a piece of mine on healthcare reform.

She works in the insurance industry. She knew all kinds of things I didn't know, cleared up some misunderstandings, and clarified some things that were fuzzy.

And revealed what she didn't know about the hospital side of things, which I tried to clear up for her.

Since then I've heard some of my earlier misconceptions echoed by my coworkers, even doctors.

This has helped me realize that I only get to see one piece of the problem up close, and everyone else is in the same boat.

Well, everyone except the folks who are up to their elbows in healthcare reform bills. They're lawyers; they don't get to see any of this up close.

But the human condition is such that they don't realize how little they know. We're all like that. But politicians, from my observation, seem to be a little worse. They hold their hearings and ask questions of experts, but those questions all too often seem to be designed to show how smart they are, not to learn from the expert.

So I wonder just how much our elected representatives (and their staffers who actually write most of the bills) really understand what they're tinkering with. And I wonder if they realize the dangerous game that they're playing.

But maybe they do. That's why they've made sure they won't be part of whatever system they give us.

Thursday, July 23, 2009

Headlines 7/23/09

4Obama Challenges GOP Critics on Health Care
Says, "We can't afford the politics of delay and defeat when it comes to health care. ...There are too many lives and livelihoods at stake."

Actually that sounds like a good reason to go slow.

4How the NHS is letting my father die - by a top hospital consultant
One detail not spelled out in the article: In Britain's system, if you pay for any of your care, you pay for all of it. So she can't buy him the drug without reimbursing NHS for all of his care.

"But that's not in any proposed system here!" Yeah, but these things evolve. The only certainty is that goverment control over our lives will only grow under a single payer system.

4Postcode lottery 'denies free care to 3 in 4 elderly'
That's right, "lottery."

Wednesday, July 22, 2009

Headlines 7/22/09

=Poll: Canadians like their health care despite grumbles
Inside: "They aren't scientific random samples.... Rather, they resemble large focus groups...."

Meaning: This was a non-story, but we wanted people to read the headline.

=How to Make Health-Care Reform Bipartisan
Bobby Jindal's ideas. Worth reading.

=Like a Switch
"Notice how there was no “antiwar” movement during the ’90s... And now, ... there is no “antiwar” movement or daily casualty count in all the newspapers. It’s like the “antiwar” movement can be turned off and on like a switch, depending on which party is in the White House."

It's neat how that works.

=Coolest July 21 recorded in Nashville as cool wave continues in Tenn.
Al Gore blames global warming.

Tuesday, July 21, 2009

Healthcare Reform: Meeting in the Middle

Can we reform the American healthcare system to provide necessary care to everyone without destroying what is good about our system? I think we can.

Let's spell out my starting premises:

1) We don't want people to be financially ruined because of an illness.

2) Where possible, Americans will get as much as they can of whatever is free.

3) Competition and the profit motive have made the US healthcare system the best in the world.

4) Providing cradle to the grave full medical coverage of the entire population is impossibly expensive (c.f.: Medicare and Medicaid, Canada, Massachusetts).

5) What the Democrats want (trying to be charitable here): Universal coverage of every conceivable medical procedure for everyone in the country.

6) What the Republicans want (trying to be charitable here): A market based healthcare system that encourages healthcare providers to keep costs low without spending government money.

7) Neither 5 or 6 can happen in the real world.

Let's meet in the middle.

What is important to hard-core liberals is #5, but for most Americans the primary concern is #1. So let's take that and run with it.

1) Preferably through a private company, if necessary via a broadening of a Medicare type system, every American should have catastrophic health insurance. We're talking car accidents, heart attacks, and cancer, not a trip to the doctor to get a rash looked at.

We should expect people to foot the bill for this as much as possible. If an employer provides health insurance that covers this, fine. If not, every American should be able to buy at least a minimum insurance policy with pretax dollars. The premiums for this would be subsidized as needed.

2) This minimum policy should also cover preventative care to help keep catastrophic costs down in the long term. This includes annual physicals, pap smears, mammograms, and pre-natal care.

Failure to keep up with preventative care (e.g., more than two years without a physical) should raise premiums. (Otherwise, as we all know, men won't go to the doctor unless something is about to fall off.)

3) Beyond this minimum policy, everyone should be able to purchase more comprehensive coverage using pretax dollars (unless, of course, their employer provides it). This is the policy that covers rashes, colds, infertility treatments, and viagra. This is totally the responsibility of the insured, except for those on Medicare and Medicaid.

4) All federal laws that limit or prevent buying health insurance across state lines or require certain benefits to be covered by all health insurance (other than what is mentioned in 1 and 2 above) should be revoked.

5) Health Savings Accounts (HSAs) will be used to help people save for premiums and deductables. HSA savings beyond a certain point should be, at the discretion of the owner, transferable to any other legal HSA.

6) The federal government will oversee the creation of a cooperative program for those who have trouble getting insurance (due to their health conditions) for #3.

Your turn:
Think I'm way off base? Please tell us where and how.

Got other ideas? Let us know.

This this is great? Share it. Especially with your Congressmen.

Monday, July 20, 2009

Lowering Healthcare Costs: A Question

When has government involvment ever lowered the cost of anything?

The Hammer

Friday, July 17, 2009

Healthcare Headlines 7/17/09

4Why We Must Ration Health Care
If we grant his premise, that we already ration and it's only a question of who and how, the question becomes, do we want to be an insurance company's customer or a bureaucrat's equation?

4A Video of Rationing Victims

4Massachusetts in Suit Over Cost of Universal Care
Turns out lower reimbursements lead to broke hospitals.

4Massachusetts Takes a Step Back From Health Care for All
Turns out it's prohibitively expensive.

Thursday, July 16, 2009

Nationalized Healthcare and the Elderly

It amazes me that the AARP seems to be on the Obamacare train.

No one argues that any public health system will have to carefully consider where to apply its limited funds. One obvious place to cut back will be care for the elderly. When put into pretty much any equation, those who've already had many decades, who have few years ahead of them at best, and who have many health issues will be seen as a poor investment of healthcare dollars.

Of course, the other big issue is that, even when care is not denied, it will be substandard simply because of wait times, poorly trained physicians, and limited access. The latest horror story out of Britain's healthcare system has people getting arthritis drugs only after it's too late to do them any real good.

If you're old or ever will be, and if you care about anyone who is, I would advise asking your Congressmen to hold out for something else than nationalized healthcare.

Thursday, July 9, 2009

Headlines 7/9/09

4USDA to oversee school snack food
A harbinger of things to come.

4Obama Can't Be Trusted With Numbers
Rove: They've mishandled the stimulus in a variety of ways; why would we let them handle healthcare?

4Do We Need a Second Stimulus?
Since we really haven't had the first one yet...

4House Dems look at taxing the rich for health care
Watch for the definition of "rich" to change -- just like during the election.

4Byrd Blasts ‘Cap and Trade’
Dems vs Dems -- our best bet to keep Obama (and ourselves) out of trouble.
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