I read this article on CQPolitics.com that deals with some of the issues of handling health care costs, and also suggests to me that my feeling may be right that the types of savings claimed by the candidates as part of their health care programs may be much more complicated to attain than they would have us believe.
There’s a fundamental qualitative difference between saying that someone has the right to life, liberty, and the pursuit of happiness, and saying that someone has the right to free health care. While there are costs for life, liberty, and the pursuit of happiness, once won, they impact very broadly. In the case of medical care, someone has to produce the care, in fact, many someones. There are physicians who spend huge amounts on their training and go into massive amounts of debt for the privilege of treating us. Drug companies do make profits, but they also must expend a great deal of time and energy on research and development. Those who produce medical equipment again have huge investments. Then we turn around and say that everyone has a right to their services.
Now those who have been around this blog for some time may want to remind me that I have called for universal health care, and this post sounds like I’m arguing against it. But I hope you’ll also recall that I have mentioned the contradiction. The problem is simply this: We’re not going to deny people treatment at the emergency room door. What happens as a result? We do cover those least able to pay but in one of the most expensive and least effective ways possible.
Since we’re going to spend money here–and as a Christian I believe I should do what I can to see that these people are cared for–the question is how are we going to do so more effectively. The article I cited at the beginning lists a number of excellent points. I’m not going to try to reiterate them or argue with them. I confess that I am finding the details confusing, and I don’t think I’m that easily confused.
Here’s the direction my thinking is going. I think we need to define basic medical care that will be universal, and provide the necessary subsidies for that care, possibly through a type of credit on taxes. Then we need to leave the more advanced and experimental care ideas in private hands to be developed over time. As a technique becomes ready for the mainstream, we could change the boundaries of basic medical care.
I believe Nurse Practitioners are one way into the future. I often wonder how people from non-medical families do it. I can call my wife, sister, mother, all RNs, or my brother the cardiologist, and say, “Here are my symptoms, do I need to go see the doctor?” Generally the answer is no. A little sensible care at home and I’m up and running again. Just consider this: Friday was probably the most miserable day I’ve ever experienced in terms of illness, and today I’m sitting here typing, no visit to the doctor involved.
People are concerned with lawsuits, but that is something that could be managed legally as well. Preventative care would be important and could be pursued through more accessible primary care.
But health care plans that simply deal with distributing care won’t provide a long term answer. We need to keep in mind how good health care is produced, and what any new plan will do to that production. Medical practitioners are not merely distributors of an existing good, like water. They are producers, and if we want them to produce we’ll need to deal fairly with them as well.
