It may seem that something like health care is well out of bounds of a Christian apologetics ministry but it is not true. The divorce made between faith and politics, often made by Christians themselves, is usually wrong headed. That is not to say that I advocate a ‘theocracy.’ It is to say that there is a clear connection between beliefs and actions, and ideologies and consequences. The current health care debate illustrates this very well in that a person’s preferred solution often depends on one’s overall ideology.
Not all ideologies are created equal. Some result in increased freedom for all. Others result in slavery. Sometimes the ideology leads people to embrace slavery as being less harmful than the cost of freedom. Sometimes, people get hurt. And that’s generally bad, and something that I as a Christian apologist should like to try to prevent if I can.
Many folks seem to concede that turning over the management of our health to the Government is giving up some of our personal freedoms, ie, a form of slavery… but the need is great and so the ‘solution’ justifiable. When you object to this ‘soft tyranny‘ the retort is: “Oh yea? What is your solution?”
This always strikes me as in the “When did you stop beating your wife” category. I can almost see the Nazis standing over the trenches, ready to slaughter another hundred Jews; one bystander protests and the Nazis retort, “Oh yea? What is your solution?” Uh, well… This is not to say that all those pushing for American Socialism have in mind National Socialism. I’m just trying to illustrate the principle.
So what follows are my ideas for a ‘solution.’
First of all, I trust the government to provide for my interests like I trust a loan shark to give me a good deal. More people have died at the hands of government then just about anything else you can think of. Take a look.
As you shall see shortly, that does not mean that I am advocating that we leave the Health Care Insurance Corporations in charge of our health, guided as they are by the profit motive. (Still, the profit motive is better than the Government’s ‘sincere motives’ in my book).
The chief problem in the health care situation in this country is not health care insurance coverage. It is health care costs, period.
Naturally, how many of us can afford to pay for a surgery that runs into the tens of thousands of dollars? Not many; hence, insurance. But if that same surgery cost only $1,000? Or less? Now we’re getting somewhere.
All this talk of bringing health care costs down in order to afford insurance for all of us- including that mythical ’47 million uninsured’- is rubbish. It won’t happen. For those like my own family, which pays hundreds of dollars every month out of pocket plus whatever the employers matches, there is no way on God’s green earth that we are going to ‘cut back’ on the health services we feel we need. I mean, we’re paying, literally, tens of thousands of dollars a year for it and we want our money’s worth.
And for those who get ‘free’ health care, now, or in the future, there is no appreciation for the cost of things, so services are used without regard for their value.
So whether one pays for their health insurance or does not, ‘costs’ will still be incurred. That is why it is inevitable that there will be rationing boards (there actually already is one) no matter what they say. There will have to be some outside group poking around our affairs, deciding whether or not it is ‘cost effective’ and wondering if it is worth spending on you, at any rate. You imagine to yourself that they really have your best interests in mind as they consider the rest of society, too, but the odds are very good that they are actually operating from an entirely different value system.
How do we bring costs down? Do we have any tried and true mechanisms? Hmmm… what about the free market?
Back in 1998 I bought this computer for $2,000. It was a Comcrap with like 16 mb of memory in it and 2 gb of hard drive space. Today, I probably couldn’t pay someone to take it. The quality of computers continued to go up and the costs have continually come down. Today, you can get a pretty decent computer- awesome in fact, if you compare it to a 1998 one- for $300.
Sure, a lot of medical technology is pricey, especially if it is new. But the funny thing is, if no one will buy it, then the price is lowered until someone will. Competitive pressures push for better technology and lower costs. We see it every where else in our society. Why then do we tolerate $500 bottles of aspirin?
We’re caught in a vicious circle, that’s why. A long time ago, someone thought that providing insurance plans was a good idea. Over time, however, the medical establishment has learned that the ones that put food on the table are the health insurance companies, not the patients. A huge chasm exists between the ‘buyer’ and the ‘seller’ and this chasm is filled by corporations- health insurance companies- that strive to ensure the doctors and hospitals get their due compensation… and make a profit at the same time.
To me, the solution is obvious: it’s time to dump the whole notion of health care insurance, not double down on it and think the government can do it better. Let’s put the consumers directly in relationship with the medical establishment. Let the consumers be their own ‘rationing’ board and watch prices fall as hospitals, still eager to be profitable, aim to please.
I think there could still be some room for some kinds of health insurance. We have home and auto insurance, for example, and it is generally affordable, right? And why? Because it generally kicks in only with the unexpected catastrophe. If we had auto insurance that paid for all of our gasoline, repairs, etc, you can bet that prices would soon inflate. After all, you’re paying your $250 a month for your car insurance… why do you care how much a gallon of gas costs… you want your money’s worth… so on and so forth.
But catastrophic health insurance makes a reasonable amount of sense. Just like you buy car insurance in case of a catastrophe, you’d buy this health insurance for a health ‘catastrophe,’ like for example, a cancer diagnosis. Amazingly, though, in a system like this, even these costs would come down. Auto insurance costs would come down because the health costs being covered would be coming down and the costs associated with treating cancer (to continue with the example) would also be coming down.
Now, you will surely object: dumping the whole insurance thing is sure to represent a massive overhaul with lots of crazy unforseen consequences. No doubt. But I fail to see how that is substantively different than what is being proposed. What is being proposed is a massive overhaul and will have lots of crazy, unforseen consequences. But what would be substantively different is that the doubling down on the current system is merely to continue with a system that was unsustainable to begin with, whereas relying once again on free market principles (like it was before 1900 or so), is a return to sanity.
I know someone else out there is thinking, “Well, but we’ve tried capitalism…” but that’s just nonsense. In general, capitalism was shown the door back in the 1930s and its been pushed ever so surely out that door, little by little, ever since. I don’t personally believe we live in a genuinely free market society but some important components still linger, showing great promise (would you like to buy my 16mb/2gb Comcrap computer? It will cost you just $1,000! 50% off of retail!). Free market principles certainly haven’t applied in the health care system. To the extent they have, it amounts basically to the ‘profit motives’ of the health insurance companies that currently serve as intermediaries.
Consider. Imagine that a hospital needs to make $1,000 in order to stay in business. Now imagine that a health care insurance company needs $500 to stay in business. There are ten people enrolled in the insurance program. In this paradigm, the hospital receives almost all of its income from the insurance companies. The consumers/patients pay for their medical care, but they do so through the insurance company. That means, instead of each consumer needing to pay $100 (10 times $100 = $1,000 to stay in business) they have to each pay $150… to keep both the hospital and the insurance company in business.
Imagine if the hundreds of billions of dollars earned every year by health insurance companies were suddenly in the pockets of the consumers themselves to make medical and financial decisions with. Now that’s a stimulus package! And one with kick, because suddenly the medical establishment will be fighting for these dollars. The profit motive is still there, but it is in its proper place, and ultimately everyone wins.
Everyone except for the health care insurance companies and the Government, of course.
Trust me, I don’t have it out for for-profit corporations or anything, but in this case the problem is not that they are for-profit but that they exist at all for what they do. They are essentially government agencies with a profit motive. But if the same thing were to be done not-for-profit, the problems would still be there and in fact would almost certainly be worse.
The solution is simple: get rid of the intermediates. The sooner the better. It will hurt, but after the broken bone has been set, healing will ensue.
In a later post, I shall explore how the Christian Church can help as costs come down.