Friday, July 17, 2009

Are all men created equal?

All men are created equal. These five words do better at summarizing what America is about than any other five words you could string together. I believe that all men are created equal, and I’m glad that Jefferson had the wisdom to put these words in the Declaration of Independence. There is nothing more American than believing this to be true.

The US House recently put together a bill for universal health care in order to cover the 45 million or so people who don’t have health insurance. The CBO estimates a $1.5 trillion price tag, and the House has decided to pay for it in part by taxing the “wealthiest” Americans, which is basically any couple making over $280,000 a year. This new tax will be in addition to the higher taxes that Obama has promised for the “wealthy” to pay for his spending, and in addition to the tax hikes that will be passed in the next few years once Congress realizes the need to control federal deficit spending. I’m nowhere near that limit, but if I work hard and keep a full schedule I just may eclipse that mark and become one of the “wealthy”, although I hardly feel that way.

So this is what our government plans to do. They want to take money from me in order to give healthcare to someone who doesn’t have it. Basically, I will be paying for someone to have healthcare.

I you believe like I do, that all men are created equal, then you should have a serious problem with the above notion. Because those who support this plan tend to believe that healthcare is a right, not a responsibility. Therefore, since it is a right, every human being must be granted healthcare. But in order to do that, the money must be taken from me and given to another. In other words, I owe my fellow Americans healthcare simply because I make (or could possibly make) a certain amount of money. In other words, I am indebted to them.

This creates a problematic situation. If I am indebted to another person to the point of owing them healthcare, then what exactly have I done to incur that debt? And what has this person done to become my creditor? What is it about the two of us that makes us different to the point that I owe this person a portion of my earnings so that he/she can have healthcare or any other entitlement? I think it would be interesting to know how the supporters of this bill would answer such a simple question.

You can’t say that the debt was incurred by the mere existence of the non-healthcare person. Just being born does not entitle one person to healthcare, or retirement savings, or food stamps, or free education. Those things cost money and that money has to be paid by someone else. If you believe that all men are created equal then you will have a tough time reconciling that belief with the notion the merely existing entitles you to these things paid for by the fruits of someone else’s labor. My mere existence does not incur a debt to another person. In order to incur debt there must be an exchange of some sort of commodity or service. And that person’s mere existence does not entitle them to these things that I mentioned because they have done nothing to earn them. If you disagree, then you will have difficulty defending your beliefs in light of the truth that all men are created equal.

To claim that healthcare is a right amounts to a gross misrepresentation of what a right really is. A right is something that all human beings have regardless of race, color, ethnicity, religion, etc. We are born with rights. We are endowed by our Creator with them. They can’t be taken away or altered. They come with being human. Freedom of speech is a right. Voting is a right. Freedom of religion, peaceful assembly, to keep and bear arms. These things are rights. To place healthcare on that level is to say that all humans have a right to the labor of a healthcare professional, they have a right to my trade, my time; which creates a major discrepancy because if the government says that one person has a right to my labor, paid for by my money, then that in itself infringes upon my rights as a human being. I have done nothing to incur such a debt, yet I am being told that I owe this person healthcare.

The simple fact is that one person’s rights extend only so far, in that the rights of one man cannot infringe upon the rights of another. Healthcare is my trade. My commodity is time. That is how I make a living. To say that one person is born entitled to my trade, my time, is to say that his rights supersede my rights, that our mutual existence creates a debt between me and him even though nothing has been done to incur such a debt, which violates the notion that all men are created equal.

Which brings up a second question: If I pay for someone else’s healthcare and have done nothing to incur such a debt, then isn’t that person in some way indebted to me? And if I’m paying for healthcare, shouldn’t I have the right to demand responsible, healthy behavior from those who benefit from my tax money?

So if someone smokes, abuses drugs, is morbidly obese, eats too much salt or fast food, refuses to comply with doctor’s orders, engages in risky sexual activity, or participates in dangerous extracurricular activity, shouldn’t the government revoke their healthcare privileges in order to protect the taxpayer’s money? I think it would be a reasonable thing to do, which unfortunately brings the healthcare debate into a whole new realm regarding individual liberty and freedom of choice.

The point is that all of us are created equal. We may be born into different circumstances, but we all have freedom and opportunity. Taking full advantage of that opportunity and succeeding in life does not incur a debt to those who haven’t, because they were born with the same opportunities. And there is great danger in a system where one group of people provides for another group of people because that establishes power of one group over another, something the Founders never intended. This is why I oppose entitlements. It’s not because I lack compassion, it’s because I cherish liberty. If you depend on the government for food, education, daycare, retirement, healthcare, medication, or anything else…then you are NOT free! Your vote has been bought, and your liberty has been surrendered for the comfort that these entitlements bring. They have been provided for you so the providers can further ensure their reelection to office, and further ensure their power over you. That is not what America is about.

Thursday, July 09, 2009

Healthcare, the argument for and against

Continuing the health care debate, I ran across this column by Steven Findlay in USA Today. I chose this column to rebut because Findlay does a good job at summarizing the pro-reform crowd who are convinced that our medical system is deeply flawed and must be completely overhauled. I encourage you to read Findlay’s words, and then read my response to his talking points below. Findlay is just one example of many who clearly don’t understand the facts of this debate and are therefore either ignorant of the issue or are deliberately trying to deceive the public into supporting something that will ultimately be harmful. You can decide that for yourself. Here are some of Findlay’s main points:

Gov’t insurance wouldn’t have a competitive advantage over the private industry. “it wouldn't be that difficult to design a public option that abides by the same rules as private insurers and has no competitive advantage”. The argument is that a gov’t system would eventually squeeze out the private sector and before long we would all find ourselves insured by the government, thus putting our health in the hands of bureaucrats. What would start out as a “government option” would eventually become the only option. Findlay says this is a bogus argument, that no such scenario would happen and anyone who beats that drum is just fear-mongering. Bull.

How Findlay can say that a gov’t program would have no competitive advantage over the private sector is beyond me. A “public option” would have a huge competitive advantage in federal subsidies. The bottomless pockets of the US taxpayer would ensure that a public option could undercut the market and eventually drive away any competitors. Private companies don’t have access to this type of subsidy. So this fear is very real. A public option could most definitely become the only option, just as it is in Canada and England.

Quality and access won’t suffer. “Cookbook and rationed care? This fear stems from concerns that the government aims to dictate what doctors do and cut costs by limiting access to care. These notions are wrong. Rather, what Obama and both Democratic and Republican leaders want to do is aggressively measure the quality of care that doctors and hospitals deliver and change the way those providers get paid so quality of care — rather than quantity — is rewarded.” It’s simple math. Today’s doctors manage a group of patients while walking a fine line between quantity and quality. However, we get paid by volume, the more patients we see the more payment we get. That allows for good access since most doctors can comfortably see 3-4 patients an hour and still deliver quality care. But what if this were changed so that ONLY quality was rewarded? Well, suddenly doctors wouldn’t be as concerned about volume. Spending 30-45 minutes with a patient would lead to better payments, meanwhile access vanishes. A doctor that usually sees 3-4 patients an hour is now seeing one or two. In other words, appointments will be hard to come by. Quality and Quantity in medicine are inversely related. That is a hardened fact. Increase one at the other’s expense. Today, we walk that line rather well, but changing the rules puts access at risk. And when you consider that 45 million people will suddenly flood the primary care system in a public option and it’s easy to see just how difficult it will be to get in and see your doctor.

“The medical industry must be challenged to cuts costs;” Findlay says that medicine is too expensive and much of this comes from unnecessary tests and procedures. He wants a leaner, more efficient medical community, with doctors who only order tests that are necessary. I agree with this, but changing the current system of compensation isn’t the way to go about it. Findlay and those like him seem to think that we order unnecessary tests because it is financially beneficial to do so. That’s untrue. If I order a CT scan, I don’t see a dime of that money. However, ordering such a scan, even though the likelihood of finding an abnormality is slim, could potentially protect me from a lawsuit a few years down the road. This is called defensive medicine. I know that this patient doesn’t need a CT scan. But I also know that in a courtroom, a hired physician can armchair-quarterback in front of a jury and claim that I should have ordered that scan and potentially saved the patient some pain and suffering. It’s very, very easy to armchair-quarterback in medicine. So I order the scan, and this ultimately costs the system, which is wrong.

In order to stop things like this, then it’s the legal system that should be reformed. When doctors stop fearing the lawsuit, then they are more apt to avoid the unnecessary tests. Findlay makes absolutely no reference to the legal community in his article.

An earlier post of mine referred to some key points about improving health care in America. 2 of those things involve reforming the payers, so that we don’t have to hire people to fight with insurance and medicare in order to get our payments, and we don’t have to deal with declining reimbursement for our services. I also mentioned tort reform and more focus on preventive medicine. If these things aren’t addressed, then the system will not improve. Findlay didn’t hit a single one of these points. He simply has no idea, and neither does Washington.