I haven’t written much about politics lately for various reasons: too busy with other projects, a general feeling that anything I’d say on the subject would fall into the same category as a country music songwriter penning an ode to drinkin’, dancin’ and honky-tonkin’. The subject’s already been covered. Nevertheless, thought I’d toss in my thoughts on healthcare.
Last month, in my Examiner column I posed this question: what would Jesus do about healthcare reform? In it I outlined my belief that Christ’s directives are a command to take care of each other’s needs as much as we can, and to adopt His full view of health being not only a matter of physical well-being but also spiritual wholeness through believing in Him. Not that taking care of the body is unimportant; it is His temple, created in His image. However, if your soul is diseased whether you’re physically well is the least of your problems.
With the above in mind, back to the current debate. Summarized, it goes thusly:
“We need universal healthcare!”
“We can’t afford it and we don’t want the government running it!”
“Okay, we’ll make those evil insurance companies pay for it.”
Which is where matters currently stand.
The problems with the originally proposed government-run healthcare are numerous. At its core is the belief is healthcare is a fundamental right of the people, and as such ought to be provided for by the government using the monies supplied by the people via taxes for funding. This belief is vehemently objected to by several groups:
– Strict constitutionalists, who find no such right stated or implied in the Constitution.
– Libertarians, whose base philosophy is that the government should have minimal participation in the people’s lives.
– On the pragmatic side, those none too keen on high taxes who point out the tremendous cost of such a proposal would necessitate either a dramatic tax increase or an equally dramatic rise in the national debt which is already at a record high.
– Finally, along libertarian lines of thought comes the expressed opinion that given the government’s demonstrated ineptitude to manage social programs, with Social Security and Medicare both stumbling toward bankruptcy, the last thing anyone needs is another Washington-run program, particularly one with such dramatic personal impact on everyone.
There is also more than a bit of the class warfare issue at play. The notion that taxpayers, especially those carrying the cost of their health insurance, should pay for those who either can’t or won’t pay for their healthcare is understandably anathema to many. Even the most generous of individuals prefers selecting who they gift. The government forcibly taking over this role does not sit well. On the flip side, you have those who believe that “the man” is holding them down, therefore “the man” should pay for such things as, say, healthcare.
There is also the matter of what care will and will not be provided by a government-run system. This is where the debate becomes even more heated. Opponents to the proposal are of the firm opinion that government-provided healthcare means government-run and managed healthcare, a system under which those overseeing the program and not physicians would have the final say on who gets how much care and the nature of said care. Proponents of government-run healthcare insist this is nonsense and the various proposals floating around Washington are nothing more than efforts to provide coverage for those currently unable to afford it. None of the current privately offered plans or the companies providing same would be affected. Opponents say this is nonsense, as should it be offered the public option will via defection to same inevitably destroy the current health insurance providers. And so it goes. There is little if any middle ground in this debate.
Naturally, I propose one.
Although health insurance provider bashing is quite the popular hobby, as it provides a convenient villain against which government can portray itself as the protector of people, it is both misguided and futile. No, “they” are not evil. Neither do “they” have an unlimited supply of cash with which all can be fully covered. Thinking along these lines is the same faulty reasoning that led to today’s economic miseries, brought on when years of forcing banks and financial lending institutions to offer home loans to those incapable of paying for them inevitably led to the housing market collapse following shortly thereafter by the collapse of banks and financial institutions, crushed into bankruptcy by the weight of defaulted loans and corresponding ownership of property which could not be resold at even a fraction of its price just six months prior.
Back to the proposed solution. It’s built on the government treating health insurance in the same manner it treats property casualty insurance (auto, home, etc). Which is a field I have at least some familiarity.
A property casualty insurance provider has two primary fallbacks for when disaster strikes: reinsurance and government provided coverage for extreme catastrophes. Reinsurance is sold by assorted private companies. In essence it’s insurance for an insurance provider. The provider pays the reinsurer X amount in return for a guarantee that should a major disaster strike involving multiple major claims, the reinsurer will cover a large percentage of the losses. Government provided, or more accurately funded, coverage is for major risks no private company could hope to afford — for example, hurricane coverage in Florida. In this case the government either provides the coverage or acts as a reinsurer for providers.
Now, one of the fundamental differences between health insurance and property casualty insurance is that the former is far, far more likely to be called on than the latter. You can buy an auto insurance policy at sixteen and have never used it by the time you’re sixty-six by never being in an accident. Not going to the doctor ever? Not nearly as likely.
Also, consider this. Few targets in this society are easier to lob live ammo against than corporate profits. Never mind that without said profits the companies would cease to exist, thus rendering their employees — in many cases that’s you and me, folks — unemployed. In the case of an insurance provider, it is necessary for the company to be sufficiently profitable to the point where if every single policyholder filed a claim tomorrow for the maximum amount of their coverage the company could pay every single claim without going under.
Now, take this to healthcare. Would it not be far better for the government, rather than assorted members trying to score brownie points with their constituents by playing the blame big business game, actually work with same for the benefit of all? Sure, it’s not nearly as much fun as grabbing your share of soundbytes. But how about actually leading for once instead of striking a pose?
Here’s how.
Make the government’s sole involvement in healthcare being a reinsurer. The health insurance providers pay X amount a year. In return, the government covers the cost of catastrophic care when the bills any given individual incurs exceeds the limits on their healthcare.
Also, go with the suggestion that every individual be required to buy health insurance. No exceptions, no excuses. If you want to set up government assistance for the disadvantaged, fine. Humanitarian concern cannot be neglected. However, write into any such agreement the mandate that the individual be required to pay back the assistance when able to do so. The era of handing out endless checks because you’re poor must be abandoned forever. Personal responsibility must become the action item.
Tighten regulatory control of health insurance providers, not to the point of forcing them out of business but rather insuring fair business practices. After all, if the government is the reinsurer, the “we can’t afford to cover this person or that health problem” immediately flies out the window.
Finally, could both sides cut the crap? Seriously. Start acting like adults. Stop striking poses. If you can’t, then STFU and step aside. Work out a common sense solution such as what is proposed here.
And start being honest. Things cost money. Stop borrowing us into unpayable debt to China. Stop pretending we can simply print money and everything’s good. Stop pretending the rich and/or corporations could pay for it all if they wanted to. They can’t. So can the rhetoric and get real with the math.
That’s pretty much all I have to say on the subject.
