Monday, March 22, 2010

Health Care: Getting Our Priorities Straight

A surgical team from Wilford Hall Medical Cent...
I don't know what economists would think of me. I don't believe in government owning the marketplace, which is what I'd call communism. Nor do I necessarily believe in government competing in the marketplace to the detriment of private companies, which I'd consider as a type of socialism. The first limits freedom by definition, the second by implication.

The government as a purveyor of goods and services is like a therapist dating a patient. Maybe he's seen her only for a consult or initial interview and then referred her to someone else, but a contact has occurred and that renders dating an unequal relationship implying unfair advantage. With governmental participation in the marketplace, a similar unequal relationship exists, which may also result in unfair advantage.

But here's the thing, I don't believe in a completely restraint-free marketplace, either. I think child labor laws are a pretty good idea. Workers ought to be able to organize in order to negotiate the terms of their employment. Unregulated use of the environment does not lead to the self-management of resources. Instead, it leads to species extinction and pollution. I'm sorry, but people are people and if We the People don't take steps to monitor our behavior, excesses ensue. This is why our children need to study history.

I've said all this as a preamble to bringing up health care and the legislation passed in Congress last night. My experience has taught me there is something foul afoot in the insurance industry. It is true that the cost of health care has gone up while the ability to pay has not. It is also true that there is an increasing demand as well as increasing need for high-quality health care services. I just don't believe the solution to this dilemma lies solely within the purview of economics.

I think it comes down to ethics. The things we value most are the things we generally find ways to afford. We may have to sacrifice in other areas, but somehow we manage to get the job done. If I have to forgo a new car to buy shoes for my children, I drive the Chevy another hundred thousand miles. Placing a value on the health of our citizenry means we aren't willing to settle for someone going without. And, by extension, it means we are going to take steps to ensure they have equal and affordable access.

In the course of the current debate, both sides have railed back and forth about cost-containment and where will the money come from. I've been waiting for a practical application of "we pledge to one another our lives, our fortunes, and our sacred honor." If those words were good enough in 1776, why aren't they now?

It seems to me the greatest thing we could do as a nation is demonstrate to the entire world our firm intention to take care of each other. Not because we have to, not because we need to, but simply because we believe it's the right thing to do. Once we've settled the question of ethics, the problems of cost and payment become challenges to overcome, rather than obstacles in the way. The place to begin is by getting our priorities straight.
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