OPINION – To solve the health care fiasco in the United States, we have to understand actual health care markets and spending; we need to establish foundational principles from which to build health care policies; and, we need to strip health care debates of politics.
Short of paying cash or trading chickens for service, the private health care insurance market has served its customers relatively well. Insurance providers offer medical plans and consumers choose from those plans or not at all. As with all insurance, medical coverage is based on risk. If you live a healthy lifestyle and do not seem to suffer from a history of illness, you would pay lower premiums for your coverage. The opposite is true if you have chosen unhealthy behaviors and activities or if you have a history of some illness. This is the way insurance works and it will not work any other way.
What we have now, whether from Republicans or Democrats, is not health insurance. The private insurance market will cover anyone who can afford it but not with pre-existing conditions. Covering pre-existing conditions is not insurance; it is welfare. It is assurance but not insurance. Failure to admit that reality is causing all sorts of policy problems.
We also should keep in mind the realities about health care consumers. Just one percent of the population accounts for 20 percent of all personal health care spending in America. The top 5 percent of the population accounts for half of all spending, and the top 10 percent accounts for 65 percent of all spending. Half of America accounts for only 3 percent of all health care spending. So think of that: The top 10 percent of the population accounts for 65 percent of all health care spending in America. Our focus should be on that top 10 percent responsible for most of the spending – and only politics keep us from that focus.
We must strip all health care discussions of politics. In other words, all solutions must be free of partisan politics. We cannot decide for or against any policy just because the other party or our opponent first thinks of it. We have to set aside such pettiness.
We also have to come to some sort of societal agreement over the very nature of health care. For instance, is health care a right – like a human right? If a human right, medical care becomes an egalitarian ideal and every effort must be made to apply that right for everyone. In other words, medical care must be universal and its application covered under any circumstance. But if it is not a human right, what is it?
Conservatives, like me, see health insurance as a commodity, not a human right. We see medical care the same way we see food, shelter and clothing. That said, we do recognize our moral obligation to those in need. If someone needs medical care, we provide it.
If health care is a human right, the answer is universal, single-payer, coverage – we would socialize coverage, meaning we would place the cost of everyone on the backs of everyone. At that point our only concern would be to make sure that everyone, even the poor, contributed to the most efficient system possible.
But, if not a human right, then we are tasked with the moral obligation to care for our neighbors. Charity care is the most efficient and wisest use of societal resources to provide care for those in need. But the reality is that not everyone is moral or even feels the need to help their neighbors in need – from volunteer providers to volunteer financial donors – and when we do not step up voluntarily, we can hardly argue when advocates seek government to step in. In other words, we can hardly argue when failure to volunteer turns into compulsory means. That’s the way it works. There are no vacuums in these affairs. Needs will be met one way or another.
So, if you are a conservative, our health care public policy looks like this: First, ensure a free marketplace for medical coverage; second, emphasize charity care to provide for our neighbors in need; third, define the proper scope of an effective public safety net when charity fails or falls short of meeting needs; and fourth, the hardest part, meet all needs because, for one thing, it is our moral obligation and, for another thing, if we don’t, politics will enter the picture and we will end up with what we see going on now in Congress – failure on all counts.
Paul Mero is an opinion columnist for St. George News. The opinions stated in this article are his own and may not be representative of St. George News.
Email: [email protected]
Twitter: @STGnews
Thank you Mr Mero for a very well written piece that I agree with fully.
There you have it, another example of why conservatives are lacking in humanity. You sound off for moral obligation and in same breath deny basic human needs to those who are less fortunate. Paul, there’s a poor person in need of life saving surgery for about $100,000. You claim to be charitable so we expect you to pony up and save a life.
Thank goodness it’s only your opinion, and a poor example of humanity. Puke
There you have it, another example of why liberals lack the ability to think through an issue.
The problem is that liberals lump every aspect of “health care” under “basic human needs” (by which you mean basic human right, which health care isn’t; it’s a combination of products and services, many of which are new in the last 20 years; how can you have a basic human right that 6,000 years of human haven’t had access to, including the richest and most royal among them?). I can see giving people compassionate care and doing our best to ease their suffering, but does that include bleeding edge treatments that are $100,000 per treatment? Does that include the latest medicine that is still $6,000 a pill (but in 10 years will be $2 a pill)? Does that include abortion? Does that include all-you-can-eat viagra and cialis? Does that include every treatment and every pill for every malady or inconvenience? Where do you draw the line?
The problem is you have conservatives (some, anyway) on one side saying nothing should be offered unless you pay for all of it yourself, and you have liberals on the other side saying every conceivable treatment should be covered for everyone for free.
The only real, viable solution will reside somewhere in the middle. As a conservative I am 100% opposed to obamacare and even medicaid / medicare in its current form. However, I could support government sponsored wellness checks (to keep you from getting sick) and hospice (to help those who are terminally ill), and probably a lot more depending on how it is administered. But what we have now does nothing to encourage good behavior; quite the opposite. The opioid epidemic is directly related to Medicaid (those on Medicaid are twice as likely to be prescribed opioids and 3 – 6 times more likely to fatally overdose: https://www.statnews.com/2016/11/23/medicaid-opioid-limits/; in Montana they’re 8 time more likely to die: http://www.drugandalcoholdependence.com/article/S0376-8716(15)00282-3/abstract).
So to just make a blanket statement that conservatives lack humanity is ignorant and incorrect. If you want to see liberal policies in all their glory look at inner cities. You have generations of people with government provided income, food, housing, phones, internet, healthcare, etc whose lives are miserable and there is zero being done to lift them out of the situation and massive gravity to keep them there. If they get a job they lose what those benefits, so why would they? And in every case they’ve had decades of straight liberal / Democrat rule. The liberal offers a hand out (gravity down) while the conservative offers a hand up (gravity up), and yet you say we lack humanity? The new plantation offers zero humanity and yet you’re calling for it to be increased and to make it the rule rather than the exception.
Just the mere fact you eluded to a 6000 year existence ends your logic in this debate. You’re wrong and that old tired argument is a failed attempt to promote your delusional pile of crap. Generational poverty is something you need to research. In your logic only people who have money deserve healthcare. Hope you’re not poor stud.
“Covering pre-existing conditions is not insurance; it is welfare. It is assurance but not insurance.”
Wrong. If the premiums for insurance reasonably reflect the costs posed by pre-existing conditions, then it is insurance and not welfare.
There is no such thing as “reasonably” reflecting the costs posed by pre-existing conditions. If an insurance company HAS to accept you when something bad happens, why would you get insurance until something bad happens? You wouldn’t. In fact, this is a major reason obamacare is failing: the healthy want nothing to do with it because the it’s a ripoff (ours costs more than our house payment and covers nothing unless we have something major happen, thanks to massive co-pays and deductibles) and the sick are flocking to it because they have to be accepted. It’s the perfect recipe for bankruptcy which is why in so many places across the country are down to 0 or 1 “choices” for insurance, where they used to have 5 or 10 actual choices, with policies for every need from catastrophic to full cadillac coverage.
I don’t want to be punished for having a rare spine disease it’s debilitating. It can happen to anyone. I did everything right and 1 day it slowly took my livelihood. I don’t want to feel like I have to be punished for this it’s bad enough I have to live with it. For what you take for granted, I struggle just to shower, cook, or clean, I have to take a lot of breaks just to accomplish day to day tasks. I’m college educated and graduated. This is depressing and embarrassing and now I have to wonder if I’m considered a waste or weak human to be picked off.
The answer comes out of left field . Political campaign reform, Get the HC lobbyists out of DC, Tort reform limiting lawyers to <100k max., and get all the middle men out as much as possible . Health care in this country is clearly a business. And what you learn in biz grad school is to maximize shareholder wealth . The current system is rotten from the ground up and even doctors have their hands tied. Good news is this paradigm is eventually going to change in the coming decade as robots start to go mainstream. Right now groups such as doctors without borders are taking care of many indigent Americans as well as people overseas . They need to be subsidized until the paradigm shifts. Till that time we need to put up with the Martin Shkreli syndrome. Health care in this country is a collusive monopoly and unless our government can start legislating changes it will continue to spiral downwards. No other industry or business do prices keep going up 25% 50% 100% a year .
I’m amazed at liberals talking about humanity, love of others and taking care of the most vulnerable.
Sound bites to advance their power base.
How much humanity is there in taxing hard working Americans to pay for those who generationally abuse welfare? Or, how much caring is there in asking religious American to pay for the killing of soon-to-be born infants? Or, where is the love in protestor’s who injure their political adversaries? And, why do liberals have such a poor record of charitable donation?
When it all said and done, isn’t the most benevolent act allowing me the right to fail, accountability, good or bad, for my choices?
United we stand, divided we fall. This issue is not about Liberals and Conservarmtives. What if both your parents died from medical malpractice. The black & white mentality that currently pervades America is the problem. When nobody listens and makes it about their political agenda the discussion ends. One day you can slip in your garage and break your neck. You have been working 30 years, and regardless of your political affiliation eventually if you can’t go back to work, in 10 years your million dollars in tbe bank rus runs out to cover your medical costs. Unbelievable. Does anybody out there really think that politicians will be a able to resolve this? Righteousness becomes pathetic when faced with life and death. The “Let God divide them up” mentality is not the an answer. For the record I am a conservative. We need to get those robots going . Currently there is no solution . Only hope is if Americans can come together and as we all know clearly from, even all the post here as a clear example, that the possibility of that happening is less than 5%. So save your money and buy good work boots. Until we start listening nothing will work. We are the new A.D.D. American culture.