"the negative side callously contended that America is a country founded on individualism and that "those people" -- the millions without health care -- simply need to exercise more responsibility in taking care of their bodies."

The ignorance and arrogance behind that statement truly saddens me.

I've heard this kind of thing in one form or another many times - always from conservatives, usually from people who consider themselves to be moral, or worse, morally superior. Sounds to me a lot like the Pharisee praying in the temple - "Thank you, Lord, that I am not like this publican here" (To paraphrase: like one of "those people").

It's good to remember that the one group of people whose attitudes and behavior Jesus clearly despised was those very Pharisees - the religious conservatives of that day. My personal experience with modern "Christian" conservatives tells me this - if Jesus appeared today as he did then, walking the streets and teaching the equivalent for our modern times of what he taught then, today's religious conservatives, like their counterparts 2000 yrs ago, would find his message just as offensive, and would find a way to silence him, again. In far too many churches and bible colleges across this country, they are doing exactly that.

May God always be in our hearts. The human mind is obviously completely incapable of accommodating Him.

Posted by: Mike | June 24, 2008 7:10 PM

first, i have to say I LOVE THAT MOVIE! just saw it for the first time last week.

further, i would love to call attention to a thoroughly insightful comment made in response to my satirical treatment of this same topic several weeks ago. it comes from Al Mytty, a former healthcare executive. i would love to invite Al to help organize the conversation that he proposes. perhaps sojo would be interested in hosting it (said the man who has no power to initiate such a thing :-):

"Health care is a real mess. I know becaue I've spent most orf my career as an executive in health care. I'm interested in talking with people who are not 'single payer' or. 'free market,' but want to solve the problem.

"What we often forget is that the primary goal of the 'health care system' is...health. From that vantage point, the next goal is doing all we can as individuals and a society to promote good health. It falls under the 'promote the general welfare' language of the Declaration of Independence.

"Moving down the food chain...next to health, comes health care, which is intended primarily to restore health, cure disease, ease our suffering or learn to live with our disease.

"Then finally, there is health care insurance which was originally, and still should be, designed to protect us from the high costs of health care and be a way to provide financial access to health care. Insurance deals with the financing of health care and health care is there only to restore or maintain health. These are separate and distinct functions—at least under a system that pays providers for illness on a fee-for-service basis.

"We often forget that the greatest improvements in American health and improved health status in countries that enjoy such a blessing, result from clean water, sanitation, functioning sewers, breathable air, and immunizations. Those are public health functions and we should all gladly pay our taxes to support public health and prevention. We also ignore the facts that much disease is either preventable or at least influenced by lifestyle. Lifestyle is behind 71% of cancers, 70% of strokes, 82% of heart disease and 91% of diabetes. That does not mean we blame the patient, but it should mean that whatever we do should encourage wellness, personal responsibility and a shared responsibility for disease and illness that cannot be prevented.

"Our system has plenty of money to pay for the care of every child born with congenital heart disease and to provide good wheelchairs and other equipment for quadriplegics. We also have all the money we’d need to ensure immunizations are available, premature babies are given every chance at life, emergency services are available, transplants are paid for, etc.

"But we're kidding ourselves to think that we should all pay for poor lifestyle choices and that the "health care system"--whichreally does not exist--should somehow shield people from the costs of all care.

"I'm not sure what all the answers are but I do know that:

• When everyone—insurers, hospitals, physicians, consultants, labs, non-profit health organizations, drug companies—everyone but the patient—profits from higher costs and more use of services, it is virtually impossible to control costs.
• We should de-couple health insurance from employment. Having a job should not be so tightly linked to health care coverage.
• Health care is hugely subsidized by U.S. taxpayers. Medicare, Medicaid, tax deductible medical expenses, business deductions for health care, government research, tax subsidized contributions to charities, etc.
Taxpayers should demand that we first guarantee public and preventive services for all people. Second, taxpayers should demand an end to the unnecessary duplication of taxpayer subsidized hospital services in almost every metropolitan community in our country. Third, taxpayers should demand that a universal electronic medical record be created so that every American has a comprehensive, transportable and secure record that covers all services. Fourth, taxpayers should demand that all American health care providers and insurers agree to a common language and format for bills, insurance forms, “Explanations” of Benefits that don’t explain, etc. so that patients easily understand what they owe. Fifth, taxpayers should demand that the payments for services become consistent across the country so that providers are indeed accountable and so that clear comparisons can be made. Sixth, taxpayers should demand that quality and cost comparisons that are being developed and promulgated by health care providers and insurers are consistent, and understood by patients. At present the move toward “transparency” will lead to a decade or two of confusion. Seventh, taxpayers should demand that pharmaceuticals, medical equipment, and medical and surgical procedures have sound, evidenced-based, cost-benefit support for them before the patient or an insurer should pay for the service.
• Neighborhoods and retail areas should all be linked with sidewalks or greenways so that people can walk, jog, bicycle, Segway, ride scooters, or otherwise transport themselves around so they get outside and maybe get some exercise.
• Schools should be required to promote physical fitness.

"Lastly, I’d say that generally the less health care you receive the better off you are. I think the only way to manage the demand for services and to thus control costs is to increase cost-sharing for the patient. And only through higher cost sharing will we be able to make insurance affordable and attractive. However, without increased cost sharing, insurance premiums cannot do anything but increase and that will lead to more uninsured, which will lead to higher premiums and lead to more uninsured…and the beat goes on."

Posted by: Al Mytty | June 4, 2008 12:19 AM

Posted by: melvin bray | June 24, 2008 8:32 PM

The longer this debate goes on more of us are starting to learn and realize,

"Them R Us"

Even those people who thought that they had paid for some kind of Health Care are wondering.

Posted by: Ms. Cynthia | June 25, 2008 6:40 AM

I don't understand, take away the problems you may have with the way the article is written, take away the long words, take away the them and us. 9 million children without healthcare, why? Whose responsibilty, there are people in need, someone said if Jesus was walking about now... If Jesus was walking about now, He'd probably want to ask, why aren't my people responding to this need and just making up excuses wondering if they will have to foot the bill.

Posted by: john heasley | June 25, 2008 7:20 AM

Take it from someone who has lived in countries with public health - the criticisms about high costs and long waiting times you hear from places like the Heritage Foundation are exaggerations. Every system has problems, and public health, for all of its faults, guarantees equal health access to everyone.

At the end of the day I think sentiment has very little to do with the issue. It is raw statistics. Try going up to Canada or the UK and telling them that their healthcare system (which is under attack from conservative government types and private business) is going to be cancelled and you'll have a riot.

At the end of the day voters will decide - so here's hoping that American citizens finally vote to bring our health system in line with the rest of the Industrailized world!

Posted by: splinterlog | June 25, 2008 9:44 AM

'Look at the UK and Canada people' what are you talking about, the system with its faults works great, thankyou. Yes you can have private care, that is the choice, but when I or 'anyone else' needs care, they will get it, regardless of race, wealth or immigration status, I cannot believe people are still trying to justify a system where those in need, go without, get a grip.

Posted by: john heasley | June 25, 2008 10:40 AM

Posted by: Another nonymous | June 25, 2008 12:20 PM

I have learned much - and even changed my attitude on some issues. I have learned that if I as a conservative take a step or two toward the center on an issue, most including Wallis will not make a move toward center from their place on the line. I see that we need to have a policy for several issues when it comes to assisting people - Wallis and Co just want more Gov't programs. Wallis has yet to bring the Rep. canidates for Pres. together for a debate on the issues...oh that correct - little late but then again I believe that Wallis planned it that way.

I have learned a lot and as iron sharpens iron...this site has assisted in galvanizing me into a more committed conservative than any Rep. could. I was hoping to find people willing to engage and talk about the issues in a meaningful way. The greatest answer here on this site for all the problems that we have in the world and in some cases their personal lives is...(drum roll please)...it is George Bush's fault.

Yes - I have learned a lot and the bottom line is that Wallis is one of the most polarizing personalities in the Christian world today. Compared to Wallis - Fawell is a light weight.

Blessings -
.

Posted by: Moderatelad | June 25, 2008 12:38 PM

BTW, I see that Wolverine's post has once again been removed. For the record, he was suggesting that the original post presents a caricature of the opposition to universal health care, showing an unwillingness on the author's part to try to understand his opponents' position. Fair enough, but my question to Wolverine stands.

Posted by: Another nonymous | June 25, 2008 2:44 PM

I'll be happy to answer your question, but there's no guarantee it'll stay up for long. I appreciate your taking the time to describe what I was saying. I'll just add that I'd be willing to bet dollars to moldy donuts that if you went through the debate transcript you'd find the pro side use the same two words ("those people") together, or something roughly equivalent.

What I've learned?

I've learned that the debate can be frustrating but it's worth having.

I've learned that a lot of Christian conservatives haven't really thought things through either.

I've learned that there are decent, honest people on both sides of the political line.

I've learned that there's a powerful humanitarian impulse behind supporters of amnesty for illegal immigrants. Agree with them or not, one cannot underestimate the importance of that impulse.

I've learned that it is easy to confuse partisanship with principle.

I've learned that there is a place for a thoughful Christian left.

I've learned other things, but those are the ones that come to mind first.

Wolverine

Posted by: Wolverine | June 25, 2008 3:26 PM

"Sound to me like the Pharisee praying in temple,'Thank you, LORD that I am not like the publican here.' (to paraphrase some of 'those people'."

My Brother-in-Law is one of "those people." A self employed father of five with no health care plan. He goes to Mexico for the family dental work, buys holistic medicines and home remedies and has not seen a doctor for over ten years. Yet he doesn't want national health care because he is afraid of the government.

Some people just don't get and never will. Health care is a right of humanity. None should be denied. In the Middle Ages, the church provided medical care for the masses while the rich took care of themselves. What we have today is less practical than that and is less effective as well.

Those people are no less worthy of medical attention than the illegals. The men and women that worked for Wall-Mart are denied health care as well as the thousands of other part-time workers in the job field. If the average working business man cant afford to provide the workers with medical care, then who is going to step up to the plate?

Why don't the Mega-rich provide aid for the working masses if they don't want the government to do it? After all, that is what Francis of Assisi did, he took his (and his Father's) wealth and started up hospitals and clinics and still found time to feed and cloth the "those people."

Posted by: Paul Shiras | June 25, 2008 8:13 PM

Meanwhile, in countries that have actually entered the 21st century...

Posted by: canucklehead | June 25, 2008 11:03 PM

If you do not have health coverage on your job, you are in a bad position. Healthcare providers are more concerned about what coverage you have rather than what you ailment is. Even with coverage, the co-pays are too high, and they go up constantly. Many people use the Emergency Rooms as their healthcare providers, they get a bill for the service and never pay it. It should not work that way. We all should be able to go to a Doctor, be taken care of, and be able to get our medicine he prescribes. Medicare, Medicaid, and the Children's Health Program are looked down upon. Many Doctors will not accept Medicaid, or they will say they have their quota of Medicaid. This is not fair and whatever needs to be done should be done. Too many people in America are sick because they do not have insurance, money, or means to go to a doctor and pharmacy. Yes, our government has a responsibility to its citizens to help provide a better healthcare system.

Posted by: L. B. Watts | June 26, 2008 11:06 PM

I agree with much already stated, so I will try to propose something that addresses the needs for efficiency, justice and choice.

PROBLEM STATEMENT
1. Our health care system is a mess because it provides poor inefficient service to the poor.

2. Our health care system is a mess because of its highly distorted incentive structures greatly inflate the cost of truly delivering the help needed to get well and stay healthy.

3. In our fallen world, insurance companies, lawyers, drug companies, health providers and patients (rich, poor or in the middle) all contribute to the mess by being instruments of overcharging, overtreating, undertreating, generating too much paperwork or wastefully using available resources.

PRELIMINARY PROPOSAL OF SOME SOLUTIONS
Here is my attempt at principles/policies practices for changing the system.

1. All should pay for all healthcare with pre tax dollars. That encourages equality in tax rates, because people are taxed on their income after health expenses. UK spends about 7.5% of GNP on healthcare. We pay around 15% of GNP on healthcare. All should be required to allocate at least 10%? but not more than 30%? of their total compensation for healthcare. All families would be required to buy a healthcare package from private, non-profit, or government sectors that includes a small? amount of preventive care and all medical catastrophes. Lifestyle choices such as smoking, drugs and overweight would impact these rates and would be discussed at an annual medical appointment. If 10% of your income is not enough to cover this basic care, then the government keeps the 10% and becomes your default provider.

2. All should be covered in a more efficient effective way (all are covered through hospital emergency room service, a highly ineffective way to deliver universal coverage), but all should help pay for their care through their earnings. That is the reason for the 10% allocation from earnings(perhaps with a $50,000 per family member cap for the rich???)

3. After catastrophe and preventive coverage is purchased, employees could buy additional insurance but would be encouraged to put their money in a Health Savings Account(HSA).. Currently insurance companies are devouring around 20% of the health dollar. HSAs are a way of reducing health costs by reducing insurance costs. Because overcharging or overtreating is a problem, a minimum of 5% of HSA money would go to the monitor of your choice who would fight overcharging, undertreating, mistreating and overtreating. If money was recovered for overcharging, mistreating or overtreating, a percent of those moneys would go to the agency (possibly an insurance company) for recovering those moneys. What that means needs to be defined, but is already defined to a great extent by government and/or insurance companies. Health providers with bad ratings in any or all of these areas would lose patients. Your HSA monitor could be evaluated based on percentage charged and percentage recovered from overcharging or overtreating. This whole process would be greatly improved by the standardization of medical records and medical bills. The law would mandate a discount (5%?) when provider was paid immediately from an HSA at the time of treatment. That discount might offset monitoring costs. Immediate payment also improves cash flow and decreases paperwork costs for medical providers, but some standardization would make monitoring cheaper.

4. People would be encouraged to use their extra HSA moneys for medical research and to help others in medical need by paying legitimate uncovered bills. That could be a friend or kin or fellow employee or it could go to a Christian or secular NGO that delivers health care to the poor in the US and/or overseas.

5. If your HSA is empty and your insurance does not cover a bill, the bill goes to your employer. He/she pays it out of your wages (pretax), but the amount paid is capped so that health expenses do not exceed 30%?(20 to 30%) of your total compensation for a calendar year.. When the cap is reached, government picks up expenses deemed necessary. Many procedures would be excluded such as optional plastic surgery, sex change operations etc. Initially I would exclude most psychological counseling. The demand for that is too elastic. The expense must relate to basic needed healthcare. Employers who provided a certain level of health insurance might be able to opt out of worker’s comp.

FEEDBACK- PRAISE, DEBUNK OR IMPROVE ON THIS PROPOSAL (What is an alternate better solution?)
Many of the specifics as to how lawyers, drug companies, insurance companies, patients and health providers contribute to overcharging and overtreating are not specifically addressed here, so the specific solutions to all these problems are not always provided, but some of my solutions do address some of these issues.. I know this is half-baked, so I am interested in responses that.
1. Say where my proposal is wrong and why it is wrong.
2. Propose a better solution.
3. Take my proposed solution and flesh it out- that is expand on it or make it more specific. Remember, solutions should contribute to efficiency with justice and choice. Government overregulation can destroy choice by imposing too many requirements- requirements that increase costs but provide little improvement in outcomes. Let the consumer decide with his pocketbook as to whether his insurance includes or excludes sex change operations, chiropractor care, counseling or acupuncture. (i.e. if acupuncture users spend less in total insurance dollars, then acupuncture can easily be a benefit without additional charge.

Posted by: Michael Adeney | June 29, 2008 3:10 AM