Wednesday, May 13, 2009

should I rob you to keep Grandma alive?

From syndicated columnist Ellen Goodman in the C-J...

I was not surprised by the President's story. Health care reform is not just a matter of spreadsheets and patient charts. It's a repository of the personal narratives we carry around in our family hard drives.

This time, the story he told was about end-of-life costs and caring. It was about Madelyn Dunham, the grandmother who had died just a day too soon to see him become President. You see, the woman called Toot was terminally ill with cancer when she fell, broke her hip and then agreed to a hip replacement. The surgery was "successful" but two weeks later, as the President said, "You know, things fell apart."

Obama told a New York Times reporter that he would have paid for the operation himself if necessary, but then he asked aloud whether society should be expected to pay for such treatment of any other terminally ill parent or grandparent. Was this a "sustainable model"? asked the presidential grandson, adding, "So that's where I think you just get into some very difficult moral issues."

I appreciate Obama's courage in asking this difficult question. That said, I'm troubled that his public policy proposals-- for more govt involvement in health care-- would sadly require confronting this question much more often.

When someone has private insurance, payments are covered through the private, voluntary arrangement you have with another entity.

But when someone has "public" insurance, their benefits come at the expense of another-- through taxes.

End-of-life issues are interesting and difficult enough, without bringing coercive payments into it. In other words, we should "support life". But what if we're supporting life by forcibly taking money from others?

Or to put it in a more crass manner: Should I rob you to keep Grandma alive?

10 Comments:

At May 13, 2009 at 3:37 PM , Blogger Greg said...

It is very hard to argue that one is "supporting life" while confiscating life sustaining resources from others through taxation.

It is another example of "that which is not seen" argued by Frederick Bastiat. Every coercive transaction has two effects, the one which is seen (and usually applauded) and the one unseen. The "seen" is the one everyone applauds, but what are the consequences?

 
At May 13, 2009 at 3:39 PM , Blogger Eric Schansberg said...

Preach it, brother!
Bastiat? Nice!

 
At May 13, 2009 at 4:29 PM , Blogger Greg said...

Here is a reference for Bastiat's What is Seen and What is Not Seen, certainly worth reading. Excellent, in fact.

The Law has also been very influential, and worth reading.

 
At May 13, 2009 at 6:08 PM , Blogger PianoMom said...

We do have a problem with healthcare in this country.

How about a COBRA-type, universally AVAILABLE health insurance plan, by private contract, for people who have no employer provided health insurance coverage (for whatever reason)?

Should we "cap" healthcare costs somehow?
Medicare/Medicaid = Unsustainable.

Healthcare is a complex issue based on the very high cost and the life/death aspect.

Certainly, people should not live/die based on their ability to pay.

 
At May 14, 2009 at 3:48 AM , Blogger Greg said...

Hi PianoMom - great and challenging questions!

I don't see how healthcare is really any different than any other "need" - food, shelter, employment, etc. Individuals need them all, or they may die. If healthcare "should" be regulated and partitioned out, then by the same logic these all "should", as well as air and water.

It is the free market (and God's blessing) which provides for these needs. We need to let the market do its work.

Caps are really just limitations on freedom. What if I want to pay more than $xxxxx for medical care in order to get better care - would I be allowed to? What if a doctor finds a real and permanent cure for cancer, but it will cost $40 million per person to do it - does that then create a right for everyone to get that treatment? Does a cap prevent that doctor from offering his cure?

I think the solution is twofold:

1) Free markets, which increase general prosperity, availability of services, and lower prices.

2) Christian (or other) charity, which will help those in need.

Only freedom will bring us closer to a solution for these problems.

 
At May 15, 2009 at 4:25 PM , Blogger PianoMom said...

Hi Greg,
I see what you are saying, but here's what I think.

The extremely high costs and the absolute necessity of healthcare do make it difficult. If I lose my job, I can move in with relatives and eat Ramen noodles to make it. However, if I get diagnosed with breast cancer and need surgery and chemotherapy and have no insurance, I'm in deep dirt.

It also seems the effect of third party involvement on healthcare costs should be considered. Has the ready availability of insurance funds caused costs to inflate? Insurance companies "cap" costs all the time. Are we operating within a true free market in the current system?

If we're going to keep the third party system as it exits, shouldn't we make sure that everyone at least has the opportunity to buy it? Eliminate Medicare and Medicaid and require people who want healthcare to purchase insurance (or get help from their church to buy for it).

What do you think about the fact that people are required to buy auto insurance in order to drive?

 
At May 16, 2009 at 6:11 PM , Blogger Greg said...

Hi PianoMom - First the easy one, I don't believe drivers should be required to have auto insurance. Not having insurance is a non-crime.

Regarding healthcare, you asked if we are operating in a free market - well the answer is obviously not. Consider the effects of insurance regulations, the FDA, doctor certification, etc. There is not a whole lot that is "free" in the healthcare market.

My solution remains the same - freedom and private charity, rather than coercion.

 
At May 16, 2009 at 9:26 PM , Blogger PianoMom said...

So are you saying we should reform the third party system, or drop it altogether.

I think I understand the Libertarian philosophy on this, but am unclear as to how this translates into real world answers. As someone investigating Libertarian thought, it honestly seems that at times, although it sounds good on paper, it does not to provide reasonable solutions. On some issues, I agree wholeheartedly; other positions just don't seem to make as much sense.

Are you saying we should all drop our health insurance and allow the "free market" to take care of things? Sounds good and I agree in principle, but for the reasons I stated in my last email, it's not that simple with healthcare. Are you willing to drop health insurance for your family?
Basically, without the insurance system, rich people (or those who qualify for giant loans) will live and poor people will die.

I am a Bible-believing Christian - doing "tithes and offerings" and I believe in giving to support the needs of others. I seriously doubt, however, that with unfortunately only around 10%(?) of Christians actually tithing, the church is capable of meeting these needs on a broader scale.

 
At May 16, 2009 at 10:28 PM , Blogger PianoMom said...

Hi Greg,
Ok, I just did a little more research (talked to Eric!) and I think we're more in agreement than I thought.

Insurance, as an involved entity, is not the problem. These are the issues:

#1 - We are overinsured. In order to work properly, it should be employed only to cover catastrophic needs. In being used for every little office visit and drug copay, it has acted as a subsidy to drive up costs.

#2 - Government subsidies through direct payment/pre-tax premiums need to be eliminated. Free market forces, in the form of health savings/flex accounts make participants more aware of, and accountable for their choices.

#3 - In a new system, ideally, all individuals would have the opportunity to purchase catastrophic health insurance. The free market would in fact correct the "now-subsidized, then-uninsured" inflated costs. Medicare and Medicaid, as they currently exist, would be eliminated.

Hope this covered a very complicated topic, "simply" enough.

I am happy that I can once again consider becoming Libertarian!!
Appreciate the discussion, Greg.

 
At May 17, 2009 at 9:46 AM , Blogger Greg said...

Hi PainoMom - I am as well a Christian. Glad to have "met" you and to have had this discussion online.

Keep exploring, there is much that I once believed which I no longer do. I was once a part of what is called the "Christian Right", but am now far from that political philosophy, and now call myself a Christian libertarian.

If you want to learn more about libertarianism from a Christian viewpoint, a list of resources which might help are found on my blog in the Comprehensive list of Christian libertarian blogs. Note that I do not endorse the religious or political views of all of those on the list, but it is a great resource to start exploring.

I am going to quit checking in here to comment. If you wish to discuss any more, feel free to comment on my blog somewhere, or email me at the email address in my profile.

 

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