I also reiterate that the cost of war and the amount of money continually going to defense contractors like KBR (formally Haliburton), Lockhead and Blackwater has wasted more tax payer money which would have already paid for healthcare. I’m not going to site proof because this stuff is common knowledge to those paying attention and it can be easily researched. My thoughts come from a place of wisdom and insight based on the large amount of information I read, see and hear and from that I express my point of view. Nothing I am saying is made up and I learned in my Communications Research class in college that you can devise a statistical model for any topic you want. Statistics are particular to the agenda you want to set. In school we came up with a theory and then we found the formula to prove it and if it didn’t come out in your favor there where many models to try. Yes research is vital and math is important; however it is one part of the whole picture. I again refer to my Airlines example, they are right statistically to let people dies but are they right morally? I will the clear up my statement about The right to have healthcare, it is a social and moral right not a constitutional right,(although I wouldn’t mind that) I will restate it and say that Healthcare is a principle we must highly value. Healthcare and Education are on the top of my list of principles that we “Should” all value and provide for one another even if some people can’t or won’t pay for it. This is not the same as paying for people’s car or tv or computer or other superficial materialistic things. Personally I would add food and shelter to this list but I am willing to compromise on those because I know there are many people who would resist this as, your words, “Utopia”.

I can not back down from the subject of racism because it is the silent fuel to this fire around the country and no body is allowed to talk about it. You can check out Bill Moyers online at PBS and he has a few documentaries on this hidden issue. Black people are scared to bring it up because white people will get mad, or illegitimate their complaints but it is real and to think it is not a part of this issue, in my strong opinion, would be naive. Also my “proof” I present Jimmy Carter who bravely called it out and unfortunately was brushed off my mainstream society.

My comments are intended for those reading who do value Free Universal Healthcare and I am inviting and urging them to get involved with their representative because it is the only way, Historically, meaningful change has happened. Now I am off to a meditation retreat and will be peacefully away from this subject for a while. Namaste…

There are plenty of unnecessary things that people can make billions of dollars of profit from why does healthcare have to be one of them… I feel that taking the profit motive out of it is just a first step so that there is no longer a vested interest in people’s illnesses.

I’m not exactly sure what your complaint is. I thought your original comment was that there shouldn’t be any profit in providing health care, but here you seem to be concerned with “too much” profit. I’m going to take a shot at this though and you can let me know if I’ve correctly interpreted what you’re saying. Healthcare has to be one of the things that people make a profit in because the people who provide these products and services have to feed and clothe and provide health care to their own families. And they’d like to go out to dinner every once in a while, and go on vacation, and send their kids to good colleges, etc. All the things that you probably wish for for yourself and your family. This is what I mean when I talk about a profit motive and self interest. If there were no profit, no one would do it. If there were no profit in being an obstetrician, there’d be no one to deliver babies, if there were no profit in making an asthma drug, no one would spend the almost $900 million on average that it takes in research and development to bring a new drug to the market. Perhaps they would like to provide those things out of the goodness of their hearts, they just can’t. They have to get paid for their work. And all these people have “a vested interest in people’s illnesses”. They have a vested interest in providing a product or service that makes people well.

Of course there’s nothing stopping anyone from creating a non-profit entity for providing medical services and indeed there are many in existence. We have non-profit groups like Planned Parenthood and non-profit hospitals and providers such as the Mayo Clinic. Although they are called non-profit, this does not mean they don’t make a profit. The profit is simply called a “surplus” and it doesn’t get distributed to owners or shareholders, but is instead retained to provide additional services. In most cases they must still charge for their services and often those fees are in line with what is charged by for-profit entities. They pay their staff well and are still beholden to the “bottom line” or they would be out of business. Their business model is not all that different than for-profit businesses and except for cases of charity care or services provided from voluntary private donations, their services are far from free. And again, there’s nothing stopping people from creating more of these and putting the for-profit providers out of business.

Insurance companies are middlemen that do nothing to increase the effectiveness of the final product.

I think our insurance system is highly dysfunctional and there are many changes that I’d support. I’m not going to get into all of that here, because that’s what I’m covering in my next post. Let’s talk about this after I make that post.

We seem to feel strongly about that in education, military service, police force and fire fighters and none of these people are slaves working for free.

This is my point. They don’t work for free. Many are paid handsomely for their services. The fact that we don’t pay them out of our pockets doesn’t mean it doesn’t cost us anything and these are not non-profit entities, they are government paid for entities, paid for with our tax dollars. For each of these, however, we have a different rationale for why we do that. In the case of police, they provide for the general protection and act as a deterrent. And since they are given the “police power” and can use force against the citizenry, it would be virtually impossible to provide this as a fee-for-service. As for fire fighters, it would be theoretically possible to provide this as a private service, but the problems involved in providing this service in that manner make it unlikely to occur. As far as teachers are concerned, this is one area where some amount of privatization or at least the introduction of competition would probably do a lot of good.

Most of these people go into these careers because they view it as a public service.

Perhaps they do, but I assure you they wouldn’t do it if they couldn’t make a good living at it. In some cases, such as the military, people who take on this profession do so because the have few other economic options and they see it as an entrée into a middle class lifestyle. The bottom line is that people in these professions are often not doing it solely out of a sense of service although in some cases it may play a role in their career choice.

Some things in life should be looked at from the point of view of public service because it is the right thing to do.

Who gets to decide which things should be “public service” and what is the “right thing to do”?

Whether a person works hard or not shouldn’t dictate whether they deserve to healed, or educated or rescued from a fire or a robbery.

I’ll agree with you to a point in the case of fire or crime. These are things which we traditionally see as emergency services that we agree to make the responsibility of government. Things beyond the emergency, we expect individuals to take care of for themselves; things like insuring your home and valuables to make you whole again after a loss. And we do provide free emergency services to those that truly can’t afford it. I’m thinking of paramedics and stabilizing emergency room care. In the case of education, we should expect parents to pay for the education of their own children if they can afford it. Then our limited tax revenues would go further for the children of those that can’t afford to pay. Realistically though, society can’t provide unlimited medical care to everyone who gets sick or unlimited schooling to everyone who wants to be educated for as long as they wish to remain in school. So we put a limit on that because as a society, we have limited resources. And there has to be some personal responsibility for taking care of yourself and your family and bettering your situation so you can provide these things for yourself.

As far as your question about giving money it doesn’t matter because there are plenty of fraudulent private charities out there that are stealing peoples money there is no inherent dysfunction of government just a broken system at the moment mostly due to corporate interest.

Fraudulent private charities eventually get found out and go out of business. This is also true of charities that just do a lousy job of handling their contributions. The point is that private charities are beholden to those that contribute and if they are not efficient, their donations eventually dry up. Government is under no such constraints. They can keep appropriating funds in the form of taxes and continue programs whether or not they are effective or efficient. I’d submit that this is an inherent dysfunction of government and not just some temporary system that is broken. As for corporate interests co-opting government, I completely agree. Corporate, as well as other, special interests will always try to use the power of government to further their own agendas and gain an advantage. It has always been and will always be the case. The answer is to limit the power of government so the special interests have nothing to co-opt. A perfect example of this is how the health care insurers just came out with ads that are critical of the current health reform proposals. The major news outlets characterized this as the health insurance industry trying to scuttle health reform. Nothing could be further from the truth. The health insurers are upset that the bills don’t go far enough to penalize those that don’t buy the product they are selling. They want the bills to go further with a mandate so they can profit more. I don’t blame them, they are acting in their own self interest and it is perfectly predictable. Instead, I blame the government for including provisions that would force citizens to buy a particular product.

I would give to whichever organization is putting at least 90% of the money towards the cause and STATISTICALLY non-profit organizations do just that.

Again, this is my point. Private organizations do a much better job because they are beholden to their contributors and these people vote with their donations. I would, however, like to see a reference for this particular statistical claim about non-profits. And remember, non-profit doesn’t mean people don’t get paid, just that any surplus must be used for the benefit of the organization, rather than distributed to investors.

To answer your question directly, my dad recently donated to a VA program which is run by the government, so if I had ten thousand dollars I would give them money.

Did you or your dad check to see how efficient they were being with donations and whether there were any private charities that might be more efficient?

For the record I believe Healthcare is a right for all people no matter what their income level is or how well the match up in the eyes of American Social Status.

Health care cannot be a “right” in the same way we have the right to free speech, or to practice a religion without interference by the government, or to be secure in our persons and effects. If it were a right, we would then be entitled to it as a consequence of our birth as free people, but providing it requires that some one else provide us with the fruits of their labor regardless of whether we can compensate them for it or not. This impinges on the rights of others. In essence, we would have to force others to give it to us whether they want to or not. You cannot morally have any right that impinges on the basic rights of others. Therefore, anything that you cannot provide for yourself without taking away anyone else’s rights cannot be a basic right. This is the same reason that we don’t have a right to food. You certainly have the right to buy or barter for food, but you don’t have the right to force someone else to give you theirs.

I believe that as a country we all can pool our money collectively through taxes to assure that every citizen has healthcare, education and safety at the very least. I value those three things more than war and expensive political campaigns and corporate contracts which cost us the most.

Those may be the things you value most, but what about someone who does not value the same things as you. Do you have the right to force them to see it your way?

I also believe in democracy and “65%” of the country wants at the very least a public option and it is not happening because the people with the most money seem to have the strongest voice.

I’m not sure where you are getting your numbers from since you didn’t give us a reference, but the latest Rasmussen Reports poll found that “46% favor the creation of a government-sponsored non-profit health insurance option… Thirty-seven percent (37%) are opposed”. But when they “asked about the creation of a public option if it encouraged companies to drop private health insurance coverage for their workers… support for the public option falls to 29%, and opposition rises to 58%”. I’m not going to debate whose statistics are right since I’m sure you can find some poll that gives different numbers, but I will point out that the support for a public option is not as strong as you suggest. Regardless, taking the public’s temperature on something as complicated and confusing as health care reform is not the best way to create public policy.

I also believe this is an extension of racism. The people who are deemed as not working hard enough or well off enough to afford healthcare or smart enough to work in a company that offers healthcare are predominately minority. This whole issue is looked at through a lens of the haves being hard working white folks from suburbia and the have nots as lazy stupid immigrants or “urban folks” (people don’t like to come out and say black so they conveniently use these euphemisms.)

I’m going to call a major foul here. You are certainly entitled to this opinion, but unless you have some proof to back it up, you don’t get to make it as part of a responsible debate. As I stated in my introductory post, demagoguery is not permitted. Please refrain from these types of Ad Hominem attacks.

I pose a question to you. What if you continue to pay the same amount you are now for your health coverage and that money goes into a government program that offers universal care to all people and their is absolutely no change in the quality of your care would you be against it?

I would support it if it also:
a. was voluntary
b. reduced the costs of health care spending
c. didn’t require a tax increase either now or in the future.
d. didn’t require an increase in the deficit or debt either now or in the future.
e. didn’t require rationing of heath care services.
f. didn’t stifle innovation or advances in medical care or disincentivise high quality people from going into the medical field.
g. required something in return from those that are being subsidized.
h. didn’t subsidize those that can afford to pay for themselves.

No proposal currently being considered comes close to fulfilling even a few of these requirements. I’d also point out that none of them would even accomplish the things that you pose in your question.

I’m not at all advocating any of the things you suggest. I was simply responding to your wish that health care be delivered “non-profit” and pointing out that that is unworkable unless you use force to accomplish it. But please feel free to prove me wrong and lay out a workable, sustainable system that doesn’t use force. Perhaps if everyone in the world woke up tomorrow and decided to live their lives in pursuit of helping others, as a choice, then the world might be a better place. But that’s not going to happen any time soon. And that doesn’t mean it doesn’t or shouldn’t happen as part of a caring and enlightened society.

In the meantime, we have to figure out how best to live together and use our limited resources. We also have to figure out how to best reward those that work harder or contribute more to society. And then we have to figure out how you measure those things and who decides. What I’m saying here on this blog is that the best way to do that is to let people decide for themselves what they value and how much they are willing to pay for it. This is the fairest and most efficient way to allocate limited resources. In addition, such a system encourages all the forces that increase a society’s standard of living. When you have some other entity such as the government or well meaning groups deciding these things, you have to use some form of coercion in order to accomplish the objectives that they have decided are the “right” ones and it’s never the most efficient or fairest way to achieve a better life for everyone.

And regardless of you blanket criticism of the use of statistics to make a point, you haven’t directly acknowledged that insurance company profits are only about 3.4%. If that is correct, then eliminating their profits (or the high pay of their executives) won’t solve the problems you wish to solve. It might make you feel better, but it’s not going help people very much. I wish also to point out that some insurance company practices are improper and need to be prevented, such as retroactively dropping a patient’s insurance when they find some pre-existing condition that wasn’t listed on the application and has no bearing on the claims being submitted. I’ll be talking about these types of problems in the next health care post.

Finally, I want to make sure you understand that I’m not saying we shouldn’t help other people. I’m saying we shouldn’t be forced to do it. Americans, with all their self interest intact, are some of the most generous people in the world. As individuals, we give huge amounts to help victims of disasters like Katrina or those suffering in other parts of the world. And private charity does it better and more efficiently than government ever could. Again, I’ll point to Katrina. So I’ll posit this question to you: If you had ten thousand dollars that you want to give away to help others in need, would you give it to a private charity of your choice or would you give it to the government?

If however, you’re suggesting that every sector of the heath care industry be non-profit, essentially requiring that everyone work for free because other people need their services, I’m not sure how you could accomplish such a thing without reinstating slavery, which we outlawed with the thirteenth amendment in 1865.

I’d also like to point out that it’s the profit motive which brought about all the great advances we’ve had in medicine over the years. If it weren’t for someone wanting to make a profit, there’d likely be no asthma medicine or treatments in the first place. They’d essentially cost nothing, because they wouldn’t exist.

When you’re tempted to look at profits as “evil” it would be wise to remember what the great economist and philosopher Adam Smith said, “It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest”.

But if you ever do find that utopia where people work for free to provide things to others just because they need them, let me know about it so I can go there and sit on the beach while everyone else tends to my need for food, shelter, health care, and education.

On a side note, I find it interesting how some people are so eager to curtail the earnings and profits of others because someone “needs” their services, but they never suggest the same thing for the industry in which they, themselves, make a living.

We are indeed mechanical devices, following the classical “bath tub curve” of reliability. High infancy and end-of-life failure rates, with a generally long, low, flat stretch inbetween. The health care costs at birth and at end of life are fairly well fixed (end of life consumes close to 80% of out total life time cost).

In between, while we buy relatively little health care each year, we do consume. Consequently, improving life style choices are not the panacea to our economic problem. In fact, increasing longevity, as you point out, drive the cost curve upward.

Immortality is expensive. Perhaps our national debate on health care is really about who will have the best shot at it?