Health care: a right and responsibility? (Erin)

Erin, if you can explain how insurance works I believe you'll answer your own question about why insurance must be mandated. If you can't it won't matter.

As one with a keen interest in the sociology of religion, I wonder what impact this will have on religious groups in the United States, who under the pretense of not being "unequally yoked with unbelievers", do not presently participate in health insurance programs. I am specifically thinking of the traditional Anabaptist communities (Amish, Mennonite, Brethren, etc.)

These groups came here from Europe for religious liberty. If that religious liberty is threatened by a governmental entity, there will probably be another exodus of these people, perhaps to South America. There has already been some migration there in the past few decades.

-Matthew

What is the Vatican's teaching on access to health care? What is the guidance of the U.S. Council of Bishops?

I'm not Catholic. I'm just curious what the Vatican and the U.S. Bishops have to say on this issue. Your post just seemed to be missing a religious element, which is present in most of your other posts. Have you reflected at all on what the Church teaches about health care?

Compendium of Social Doctrine

166. The demands of the common good are dependent on the social conditions of each historical period and are strictly connected to respect for and the integral promotion of the person and his fundamental rights[349]. These demands concern above all the commitment to peace, the organization of the State's powers, a sound juridical system, the protection of the environment, and the provision of essential services to all, some of which are at the same time human rights: food, housing, work, education and access to culture, transportation, basic health care, the freedom of communication and expression, and the protection of religious freedom[350]. Nor must one forget the contribution that every nation is required in duty to make towards a true worldwide cooperation for the common good of the whole of humanity and for future generations also[351].

182. The principle of the universal destination of goods requires that the poor, the marginalized and in all cases those whose living conditions interfere with their proper growth should be the focus of particular concern. To this end, the preferential option for the poor should be reaffirmed in all its force[384]. “This is an option, or a special form of primacy in the exercise of Christian charity, to which the whole tradition of the Church bears witness. It affects the life of each Christian inasmuch as he or she seeks to imitate the life of Christ, but it applies equally to our social responsibilities and hence to our manner of living, and to the logical decisions to be made concerning the ownership and use of goods. Today, furthermore, given the worldwide dimension which the social question has assumed, this love of preference for the poor, and the decisions which it inspires in us, cannot but embrace the immense multitudes of the hungry, the needy, the homeless, those without health care and, above all, those without hope of a better future”[385].

No, it isn't a mandate that the government has to run everything, but it certainly requires social consideration of the problem. And yes, health care is a right.

11. But first We must speak of man's rights. Man has the right to live. He has the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services. In consequence, he has the right to be looked after in the event of illhealth; disability stemming from his work; widowhood; old age; enforced unemployment; or whenever through no fault of his own he is deprived of the means of livelihood. (8)

Pacem in Terris

But mandating that people be obligated to purchase health insurance, private or government-provided, or face penalties for the failure to do so may not change the landscape of health care as much as we'd like to think it will.

Here's what's really going on.

First, we need contributions from everyone to make this thing work, whether they think they are likely to need health care or not. Some of those uninsured people are impecunious people in their 20's who do not think they will need medical care in the near future, and most of them are right. But "insurance" only works as a risk-spreading device when people at low risk as well as people at high risk are included in the pool.

The sensible and usual way to get the entire society to contribute to some perceived general good (take for example, water treatment and sewage processing) is to take money from everyone for this purpose, even from people who, say, live in the middle of nowhere, get their water from a spring and use an outhouse. We call this levy a "tax."

Remember that word, it's important.

Now the proper term for a mandatory government levy is in fact "tax." Let us hypothesize a situation, one which now seems quite likely, where everyone or almost everyone is required to purchase health insurance. This requirement does not differ from a "tax" in any meaningful way. It is a financial payment required by the government, and there will be, as Erin points out, "penalties" for not complying.

But they're not going to call it a "tax," at least not yet, because that word has acquired a poisonous sound to Americans, and can be ruinous to political careers.

This post of Erin's, interesting as it is, does not address the real problem here. I am quite familiar with the (very different) health care systems of Scotland and the Netherlands. In Scotland there is open socialized medicine, and the levies are called "taxes." The Netherlands have a mandatory universal insurance scheme; I'm not sure whether they call these payments taxes or something else.

In both places, however, and this seems to me to be the real question here, these countries pay (whatever you wish to call these payments), total, about half per person of what we pay for health care in this country right now. That's before any prospective reforms. And by all measures, you pick the measure, they do at least as well on outcomes as we do, and usually better.

So the question in my mind is not, should everyone be "forced" to contribute to this social good, or what shall we call these payments. (My answers would be, respectively, "Yes," and "Taxes.") The question is, if we're already spending twice what Europe spends for inferior results, why will spending even more be a good thing?

I think this bill is unlikely to pass in its current form. The atmospherics in congress are similar to those in 1993 when congress was trying to pass Clinton's BTU energy tax and Hillary care. Both of these measures failed, yet the democrats from moderate districts got clobbered by the republicans in 1994.

Obama is a lot like Clinton. He ran as a moderate and has governed as far left since getting in office. That along with the agenda of Pelosi and Reid makes many moderate democrats uncomfortable, remembering what happened to a previous generation of congressional democrats in 1994.

Also, the economy is not turning around. I do not expect any turn around before the end of the year. This will most certainly kill the climate economy termination bill in the Senate.

I recommend any of you living in congressional districts with democratic congressmen to write (not email) your congressperson reminding them of what happened in 1994, urging them to stop the far-left railroad express. We need to help amplify the atmospherics of 1993-1994.

Am I the only one that thinks healthcare insurance should be run by non-profits?

Umm, Observer, mandated government levies we usually call "taxes" are paid to the GOVERNMENT, not to private corporations. A government-mandated payment from a private citizen to a private corporation is--well, I'm not quite sure WHAT to call it. Graft?

Erin,

My last comment on this thread is still locked (it had links to the Bishops response on health care). Can you please unlock?

Thanks,

-Matthew

"Yeah, that would be a real shame if single payer government health care damaged stockholder profits and deprived corporate administrators of their million dollar salaries...."

Well, ObamaCare will bankrupt the nation further, limit available care, and introduce that "obligation to die" that necessarily follows the "right to die".

Well, ObamaCare will bankrupt the nation further, limit available care, and introduce that "obligation to die" that necessarily follows the "right to die".

Um, no it won't.

Right now insurance companies decide if you can have that kidney, if you really need a MRI, and whether that cancer treatment for your child is really worth the cost. I know they have my best interest at heart and would never put profit over medical necessity.

Until economic crash, which happened under your boy George Bush happened, medical costs were the #1 reason for bankruptcy in the country. Now it's only #2, so as always Americans are one missed paycheck or firing from being economically wiped out.

But that is surely preferable to the evilllll socialized medicine that the rest of the civilized world seems to deal with.

Get sick, lose your home. It's the American way.

Why the quotes? If you're making $250,000 a year you are wealthy. More so than the other 95% of the rest of the country.

An extra $3,000 a year. Maon. Wail. Oh it's soooo unfair. Why don't those lazy baggers get off their behinds and get a second job.

As a political matter, I think the comparison to HillaryCare in 1993 fails for one big reason: in the intervening years virtually everyone has had one or more bad experiences with private insurance companies. The stories are legion. Harry and Louise simply will not resonate with enough of the population to make a difference in the outcome.

Frankly, I find these arguments against the rights of people to have access to life-saving care (preventative or reactionary) unchristian and ungodly. I hate to ask this question, but just on whose side do you think Christ would be? The cancer patient waiting to begin radiation before the disease spreads to his bones or with the bigwigs at Humana denying him care?

It's obvious. Of course. It's even obvious to the people who advocate against it, which is what produces the ridiculous and strained "arguments" you can read on this blog.

Oh no, they say, the "free market" will take care of the sick and the unfortunate, ignoring the undeniable fact that the "free market" has never in all its long history done anything of the sort in any field whatever. I'm very much afraid that boils down to "I've got mine too bad for you."

"Frankly, I find these arguments against the rights of people to have access to life-saving care (preventative or reactionary) unchristian and ungodly. I hate to ask this question, but just on whose side do you think Christ would be? The cancer patient waiting to begin radiation before the disease spreads to his bones or with the bigwigs at Humana denying him care?"

Look, I don't think anyone has a "right" to health care. However, as a Christian I believe that we have an moral obligation to care for people. Those are two distinctly different ideas.

Max, my man,

Look, I don't think anyone has a "right" to health care. However, as a Christian I believe that we have an moral obligation to care for people. Those are two distinctly different ideas.

So....if no one steps up to this moral obligation you speak of (as is only too likely, I'm afraid, given the behavior of self-identified "Christians", to say nothing of the rest of the population), what then?

Those bad immoral people will burn in hell forever, later some time? What comfort will that be to the untreated cancer patient and his or her family?

I am not looking for a handout, but I am looking for fairness in the marketplace. If the market cannot provide that, or in this situation, will not provide it, then I have no problem with the government stepping in.

I truly cannot figure out why others aren't, how people say without irony that the system we have is working. Do you people never get sick, never try to find a doctor covered by your HMO? Have you never had to sit on hold for hours because you just want to get a referral?

The delusional folks who think our current "system" is working (a smaller group every day, things going as they are) are those people who have (a) lots and lots of money, and (b) employer-provided health insurance, and (c) a very good set of blinders.

I personally am provided with lots and lots of money plus very good health insurance which my firm pays through the nose for. What I seem to be lacking is (c), the conviction that because I'm perfectly OK the world is perfectly OK, no problem.

The people you talk about, the people who think everything right now in the health care field is just peachy-dandy, tend to be of the "I've got mine too bad for you" persuasion. And, they haven't gotten sick lately.

Sorry about the Captcha thing. That's from long long ago, Please delete, it's off topic.

here's the real post...

The first problem here is "INSURANCE". Insurance is not health care. Health care is a broad term that includes everything from your annuals required for a job, for instance, to that LASIK surgery so you don't have to wear glasses to drive. Sadly, most people have failed to recognize this.

Imagine if you obtained your vehicle by buying car insurance. So, you buy a policy to provide you with "basic transportation that has at least 5 seats, moderate collision risk, and average fuel economy". So, what vehicle would you get? Well, the least costly one that fit the description. You'd likely find yourself driving a rusty, clapped out Hyundai.

Now, what if the government ran the car insurance. Exactly the same problem. It's still all about spending the least possible on you for the money coming in.

Massachussetts required everyone to buy health insurance. Well, it was boon for insurance, but it hurt hospitals and doctors... and poor people. You took cash away from them that could have been used to pay for basic services. And the insurance didn't pay for basic services, so bills went unpaid and people didn't use basic care to prevent catastrophic problems.

I can't imagine why intelligent adults would continue to advocate buying health care from an insurance company. But, you do. You walk in and buy "10 dollar office co-pays and 10 dollar medications and an annual limit of $5000 out of pocket for blah,blah, and blah".

Who you should have been dealing with is the PROVIDER. Blue Cross isn't the provider. Just like Geico doesn't sell cars, Blue Cross and Aetna don't provide medical services.

Buying services or products from an insurer is the absolute worst possible way of purchasing them. The insurer is motivated to provide you the least, and the provider is motivated to charge the most they can possibly get.

Now, you buy car insurance, right? Why? To protect YOU from catastrophic loss. Back into that Nissan GTR with your Yukon and there's likely to be a bill in the tens of thousands of dollars. Not a real problem, though, because you pay 40 to 200 dollars a month for insurance to cover you in case of catastrophic loss.

Every economist with even half a brain understands that consumers provide incentive to be efficient when there are competing products and services. This is why YOU should be visting your doctor and asking... What will it cost me to have you do my annual checkup? And then the next doctor down the road, as well. If one costs half of the other, which will YOU choose?

Which will an INSURER choose for you?

Which will the GOVERNMENT choose for you?

Oh, so you say "What happens if I get cancer?" Well, what happens when you have an accident in your car? You mean, that's the proper role of INSURANCE? Well, yeah!

And, of course, we're going to have the "What about the poor?" splattered all over in response to this. Well, what about them? Do you, by virtue of poverty, have no obligation to provide for yourself? Iv'e been "poor". I've been in the situation of having 3 kids and living at 70& of the poverty level for income. Guess what? I had to pay those doctors. Sometimes it took years and caused much pain and suffering and stress. Guess what? I got wiser. We learned to set aside a budget for medical stuff. And yeah, we did that even when it cut into our twice a month eating out, and our leisure travel. We even did without cable. And we had to shop at used clothing stores.

Oh, the suffering and agony.

But if you want to help poor people... don't force them to buy "INSURANCE". Help them buy medical services. Duhh.

Use the market forces that exist to lower REAL costs. Put competition to work at that. And then, use your head when it comes to helping those who actually need it.

But learn, for pity's sakes, people. Learn. If you haven't changed your mind yet about "insurance", then by all means re-read this. And continue to do so until you do change your mind. We don't need to compound the problems that government created by linking insurance to employment, and by doing so, causing us to buy health care products and services from an insurer instead of the provider.

Nationalizing or creating a single payer merely results in changing the title on the desk of the person who rations payment for services. You need that to be YOU, and then you need protection from catastrophic loss, like cancer or chronic conditions, etc.

And in between times... to be a WISE CONSUMER, rather than a sheep.

Oh, and nobody has a RIGHT to health care. Nobody. You have a right to consume only 2 things... air and sunshine. Everything else has to be paid for either by work, effort, or money.

Sorry, that's the truth. Claiming you have a right to the services of a doctor is just telling the doctor he's your slave. Let's see how long he stays a doctor after you tell him that for the rest of hhis life, he must work for free for everyone who asks, becuase they have a right to what he does.

The same is true of farmers, builders, loggers, even the guys that make TP. You have NO right to anything someone must provide for you. Get over the silly notions promoted by juvenile thinking. Be adults and accept responsibiilty for your own life.

Observer, I leave this fact for widespread consumption:

Trivia used to generate political rhetoric will not result in rational conclusions. You're wrong about a whole lot of things.

PNWCC--I can see the need to draw the line between "health care" and insurance, however I think your argument breaks down because while our car insurance does not determine the kind of vehicle we are able to pay for, our health care system is controlled by the insurance companies, so it is a reverse of the relationships in insuring motor vehicles.

You pay higher health care costs if you do not have insurance because the health care system does not have to deal with the individual consumers. If you don't believe me, go try to get an aspirin in an ER. It's going to be a helluva lot more expensive unless Anthem negotiated with the hospital a payment for that aspirin. So our access to health care as individuals is now determined by the health insurance we have or don't have. And they have figured out that they don't have to pay for that aspirin if THEY decide we don't need it. So they tell you, sorry, make do. The market forces are not lowering costs because they don't have to. And if you don't have the benefit of an insurance company, you pay even more for basic care. And if you can't pay, the costs are then passed on, but not to the insured, but to the uninsured, because again, the insurance companies will only pay what they will pay.

Now, to the morality of being poor. This is not about being a deadbeat. I wish, for the sake of all that is good and holy, people would stop conflating the two. I have always worked. But I have sometimes been poor. And I have sometimes been uninsured. And when I was uninsured, I was injured--a dislocated shoulder. I never got it treated because I couldn't afford to. I knew how to put it back, so I put it back. 15 years later, it's arthritic. In another 15 years, I will probably be unable to use it. Had I had access to AFFORDABLE HEALTH CARE, with or without insurance, I would be healthier now.

Does that make sense? By the government mandating health insurance, they are forcing people into HEALTH CARE ACCESS because our system is largely only accessible to the INSURED.

"Frankly, I find these arguments against the rights of people to have access to life-saving care (preventative or reactionary) unchristian and ungodly. I hate to ask this question, but just on whose side do you think Christ would be? The cancer patient waiting to begin radiation before the disease spreads to his bones or with the bigwigs at Humana denying him care?"

I'm sure that Christ would be on the side of the patient, given your scenario. However, your scenario presents a false A or B choice. There is a third entity involved in this process: Those in government who seek to use a centrally-planned health care system to either wield incredible power over the will of the people or who seek to use such a system to guarantee votes for their particular candidate or party into perpetuity, just as the AARP and Democratic groups use the words "reform" and "Social Security" to frighten senior citizens into voting for candidates with whom they might otherwise disagree on nearly every count.

JB: That is exactly what is going on w/health care on the GOP side. Have you not been paying attention? Oh no, eeeeeevil government health care, socialism, communism, DEVIL. And it is also no different than what the GOP does to people like me with regards to abortion--argue for something you're not going to change/can't do anything about to get us all conflicted.

I didn't present a false A or B choice. That is the choice we have right now. And using your logic, there is a FOURTH party involved here: Big Insurance/Big Pharma/Big Hospital working really hard to keep charging a lot of money for very little care. So what are we going to do? Throw our hands up? I guess you, PWNCC and Max (cute, by the way) already have, 'cuz you got yours. Congratufreakinlations.

"Well, ObamaCare will bankrupt the nation further, limit available care, and introduce that "obligation to die" that necessarily follows the "right to die"."

What then is the alternative? If we look for models that already provide top level care and hold down costs, we see programs with lots of government involvement. There is no functional, cost-effective, first world model that is a free-market model. The Republicans may be able to defeat this, but then we are left with run-away costs.

Insurance. Oy. Insurance is a big part of the problem, but try to come up with a plan that does not involve insurance. When requested by our local Congressman (Republican) to write up an outline for a plan for health care reform, I could find no way around the insurance conundrum. How do you make sure people in their 20's can pay for that trauma care or a sick newborn? The costs of modern medicine are too high to cope with without insurance.

Morality- I do not find it difficult to see that some people see health care as an issue of morals. We already provide emergency care without concerns re; ability to pay. I believe you can make a quite valid case that it is the morally correct thing to provide reasonable health care to all. Face lifts? No. Life saving care for mothers in labor. Yes. Now, we just need to figure out where we want to be in between those two extremes. Following is a link to an article for a system that works well at half our cost. People should know that much of what they hear about other systems is false.

http://www.npr.org/templates/story/story.php?storyId=92419273

Steve

Trivia used to generate political rhetoric will not result in rational conclusions. You're wrong about a whole lot of things.

Translation into English: "I don't exactly have any statistics or reasonable arguments to undermine your position, or anything else reasonable to say, really, but I do think on the basis of nothing much that 'you're wrong about a whole lot of things.'"

Erin,
You state that of course you believe that everyone should have healthcare-- but then you are opposed to taking any practical steps to achieve that goal. This rather reminds me of people who claim they are against abortion, but then refuse to support any measures, even small ones, to limit it. You can't have it both ways.
As for mandates, anytime you live in community with other people there will be non-negotiable demands made on you, and sometimes this forces you to spend money. I doubt you oppose public nudity laws, though these force people to buy clothing .And I would likewise surprised in you opposed sanitation laws, even though plumbing costs a lot, as do the taxes needed to fund sewers, garbage collection and the like.

Erin,

You state that of course you believe that everyone should have healthcare-- but then you are opposed to taking any practical steps to achieve that goal.

Thanks, Jon.

The "right" has now come to the point where they are (rightly, no pun intended) ashamed to admit, in public, that they think that leaving a substantial proportion of the population to die of preventable or treatable illnesses is perfectly OK. (So long, of course, as they and their families do not find themselves in that group.)

What I'm not hearing, and what I would like to hear from this faction is some alternative ideas to the ones so far proposed. Because of course no human system is perfect, and if these folks have some ideas to make a health care system work even better than those in Europe, well, we're all ears over here.

I don't know what Erin's husband does for a living. She does seem to be very...comfortable. You who have been reading here for a while know what I maen. I am assuming that Erin feels, accurately or otherwise, that her own family is safe from the black hole of no-coverage-no-care which is swallowing up so many American families. (Congrats, by the way Erin, on your Christianity. I'm-safe-who-cares-about-everyone-else?)

It is perhaps interesting that we don't hear Rod Dreher, the blog owner here, weigh in on this side of the debate. I gather that Rod has several small children, one with special needs, and I know that he is working in an industry and a situation which makes it likely that he might be laid off. He knows that COBRA only goes so far; he knows what his chances are of individually purchasing adequate insurance for his family at anything like a reasonable cost. So he is - wisely - silent when the I've-got-mine-too-bad-for-you contingent posts.

Mr. Dreher's situation is precarious, and he knows it.

My situation is not. Don't you-all worry your little heads about me. I'll get adequate and better health care no matter what happens.

But adequate-care-for-the-rich-only? It's unjust, and unwise. You conservatives who don't like the solutions so far proposed, come up with something of your own that will do the job, cover everyone at reasonable cost, we're all ears.

Believe me. The situation is quite fluid right now. If you have The Idea, now's the time.

The thing that people seem to be missing is Erin's basic point. Health care, especially life-saving health care, is extremely desirable and worth paying a lot of money for, but that does not make it a "right." A right is something you can enforce, protect, and even assert AGAINST SOMEONE ELSE. Who is that someone else, the doctors who provide it? your neighbors? or unidentified "rich people" who should pay surcharges on their wealth? Why should they pay it just because you need it? You should earn it, just like you earn your food and your clothing, without which, of course, you will also die. No one has a right to force someone else to treat them or to force someone to pay for their treatment. The fact that you can get a democracy to enact laws to do so, doesn't make those laws right, it simply constitutes oppression. Why is it that when there is a problem, people resort to government force so quickly? Why not encourage people to create charitable societies, charity hospitals, mutual assurance associations? Because it's simply easier in the short term to force some nameless "rich person" to fund your misfortune. That is despicable opportunism and should be condemned. The reason "government" permits it is that they enjoy having yet more power to control others' lives as if they are the saviors and not the "rich people" they rip off to fund their pseudo-charity. Please let us grow up and take care of ourselves, our friends and family, and our neighbors, but do not abide forcing someone you don't know to do it for you because you are too lazy or uncaring to do it yourself!

Dear RSG,
I expected the ad hominem attack you posted, devoid of argument refuting my points. Thank you for being predictable. Both my parents are dead, my mom after extended alzheimers, so no inheritance coming this way, thanks, and my appendix is in a jar somewhere, so I know the outlines of death's door. But that is completely beside the point. The only one with an absolute right to someone else's labor is a slave owner, a concept I believe we abandoned at great human cost some time ago. Now as to ideas, please open your eyes; first of all to the concept that there is no health care "mess." That tired canard is trotted out to justify all government intervention usually most quickly when government intervention goes afoul. Google "Republican health care plan" and read to your heart's content as to other ideas. As to the government solution, go to Mark Levin's web page and review the materials from July 1 discussing the real health care crisis in the model government-run British health care system.
But now to your real point, that Jesus instructs that we force others to pay for someone's health care. Please show me chapter and verse or that. This argument is trotted out to shame Christians into supporting government's expansion of its coercive force, but Jesus told us as individuals to help the poor, not force others, especially unbelievers, to do the same! What a terrible witness, using the coercive power of government to enforce your beliefs. Sounds like conquistador talk to me!

Dear RSG, Everyone else has moved off this post so it's just you and me and we can be honest. You don't really believe the stuff you post. You certainly are not a Christian. You probably once were, which is why you pulled the Beliefnet beat. You might even be a PK, but it's more likely you just grew up in a conservative christian house and became disillusioned with what you saw as the "hypocrisy" of your church. Been there, done that. Your desire to help others, however, has led you to another calling, working for people who really want to change the world for the better. They are lying to you. Soros and his tax-evading, pork-grubbing comrades only want to impose their vision of the world on everyone else by gaining more and more political power. They are driven by an intense hatred and contempt for people who disagree with them and who want to let people do their own thing, free of governmental interference. Let me give you one example. If you now believe in the foundation of Roe v. Wade, that a woman has the right to decide, with her doctor, what to do with her body, free from governmental interference, how can you support creating a system where government will make EVERY health care decision for you. Have you read about treatments that they deny or delay because of cost and EFFICIENCY concerns? You should, because someday your life may depend on a healthcare decision and I can assure you, you are going to want to control that decision. You may be fine dying or you may want to fight, but you certainly won't want a government bureaucrat deciding for you based on EFFICIENCY. But let's get to the meat of the matter, here. If you had something else you could believe in, you wouldn't be trusting these folks. I work for government and see how laws, regulations, and policies are made. If anyone is telling you that government is the efficient answer, they are condemnably lying to you. The ultimate driver of government is obtaining and keeping power and it infects EVERYTHING government does. That's why Jesus steadfastly refused to seek political power from his first temptation to Peter's final rebuke. It pollutes everything that is good and decent, namely one soul, nakedly, honestly, sacrificing for the benefit of another in deference to a reward in heaven. God forgave my apostasy and is confirming that his Spirit is the one true guide, not the Church, its doctrines, its programs, or its people. I might be wrong about you, you might be a true socialist, just out to poison others in their attempt to honestly figure out what is right, but if I am right, trust God, not man. I pray for you.