Real Issue in Healthcare Debate

[Dave Roberts]

The more I listen to the rhetoric in the healthcare debate, the more one issue seems to rise to the top. That issue is: "Is healthcare a right or is it a privilege for those who can afford it?" This has been an American debate, never rising strongly to the surface since the enacting of the Hill-Burton Act. The website JDSupra summarizes it this way: "In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization. In return, they agreed to provide a reasonable volume of services to persons unable to pay and to make their services available to all persons residing in the facility’s area. The program stopped providing funds in 1997, but about 200 health care facilities nationwide are still obligated to provide free or reduced-cost care." That financing law following World War II and in the face of record numbers of births and also hospital usage required (for the first time) certain levels of care for all Americans.

A second place where the debate was carried was with the creation of Medicare in the mid-1960's that insured some level of care for senior adults who would pay into the system throughout their working lives in order to insure that healthcare would be available to them after age 65 when the prices of medical insurance skyrocketed for most people because they were subject to age-degenerative conditions.

The third place where this debate hit center stage was with the Affordable Care Act in 2009. The ACA was another set of compromises in the effort to move toward more universal insurance and the recognition of a right to healthcare. The mandate for insurance was upheld by the courts because of the accepted principle of many states requiring car insurance and liability insurance for businesses. It moved a step closer to recognizing a universal right to healthcare. The effort to repeal is basically one that wants to eliminate the mandate because it makes healthcare a right and not a privilege of what one can afford or what charity care can be received. All the partisan politicking going on seems to do its best to evade the basic question that the USA must debate and face: "When a person gets sick, does he or she have a right to healthcare?"

By the way, did you ever notice how many times that Jesus or the apostles got into trouble for providing healing? Were they getting in the way of that day's healthcare system? What is the Christian principle for the decisions regarding healthcare?

[William Thornton]

Jesus didn't heal everyone and folks died as a result, so I don't think there's much of a point there.

At least with Medicare gummit has extracted some payment from folks for future health expenses. If health care is a right then where is the connection between forcing individuals and institutions to provide services and forcing recipients to pay?

Health care as a right will eventually be the principle we try and follow, unworkable and complex as that might be and with clearly intended along with unintended consequences.

Health care is already a right, given that anyone can show up at an ER and receive some level of health care.

"When a person gets sick, does he or she have a right to healthcare?" One might ask, "When a person gets sick, does he or she have a right to demand the services of others, at no cost?" "When a person eats sugar nonstop and weighs 600 pounds and has all kinds of diabetic problems or when a person smokes constantly and has COPD or lung cancer or other related sicknesses or when some boy decides he is a girl and has some authority to diagnose a disease or syndrome and demands a sex change operation does government have the right to put a gun to my head and force me to pay for it?" Yes to the latter.

I have no idea where health care is going other than it will be a mess.

[Dave Roberts]

[Rvaughn]

[Haruo]

The United States (compared with the rest of the industrialized world and some of the semi-industrialized world) has been stuck on stupid on this issue since before I was born. I hope Krauthammer is right on this, and that seven years from now we will have a single-payer system like the one in Canada, or the one in Australia that Trump recently praised. But the various Obamacare replacements the GOP has been trying out in Congress will make things (temporarily, but for how long I know not) worse. I'm proud of Washington State. Although we have four GOP congressmembers (out of nine total), we only gave ONE vote to the thing that just passed the House.

I agree with Robert that one thing (among several, I think) that is not always clear in this matter is how Christian principles relate to secular government. But tons of other countries, religious to greater or lesser degrees, Christian in their religiosity to greater or lesser degrees, have single-payer health insurance systems that have functioned pretty darn well for decades with far less cost either to the poor or to the average citizen. And their drugmakers, by and large, haven't gone broke either.

[Jim]

[Haruo]

Jim, what about (among others: "among them are") "Life, Liberty, and the Pursuit of Happiness"??

[Haruo]

[Rvaughn]

[Haruo]

[Jim]

[KeithE]

[Jim]

My wife and I are on Medicare, for which I paid for many years but must carry both supplemental insurance in addition to costly Medicare B as well as costly RX insurance. The cost amounts to about the entire amount of my wife’s pension. Just my supplemental insurance premium (not including drug coverage) has increased by 13% since June 2016. All of my wife’s coverage has increased as well (haven’t bothered to calculate for this post since it doesn’t actually matter, holding us automatically hostage no matter what happens). This is simply an example of what Obamacare has done for very old people, not to mention that it has driven insurance companies out of the market. In Iowa, there is now no insurer, for instance, and buying coverage across state lines is not allowed. If the employer mandate had been enforced in 2014 by Obama, as required by ACA law, the whole enterprise would have already flamed out, thus leaving nothing today. The tax-word is anathema to legislators but it needs to be understood that there’s no free lunch. The national healthcare program should be a version of Medicare for all if insurance (with the right to make choices) is to remain the main player. This is the same as individual accounts but with the law guaranteeing it (raising Medicare wage-deductions) though regulating it, as well. No one need get rich on anyone’s health-problem. The alternative is too awful to imagine. Just check out the VA mess.

[Dave Roberts]

I have learned across the years that there are many different kinds of healthcare in this country. There are clinics that do not seek to make a profit as well as hospitals that are non-profit in status, often those started by churches or other public service groups. Most have preserved a certain level of charity care as part of their founders' hopes for them.

A second type of hospital or clinic is that related to the public good by a chartering agency or government group. These are often non-profit while others support medical research and may be attached to a medical school. Again, they do a certain amount of charity care, and some of them receive indigent patients from the area of the governing body or sponsoring agency.

The third type of hospital is the for-profit model, often with groups that buy up other hospitals that they believe can be operated for the benefit of the corporate shareholders. Most doctors' offices and pharmacies also operate on this model. The market charges what the trade will bear knowing that reimbursements from insurance and government programs will often be at lower rates, but they are allowed then to write this off as a loss to grant even greater profit margins to the companies. Insurance companies all operate to make money themselves, not just to provide for the public good. These are often a problem determining how care is given. I have been told that my insurance, in past treatments, would not pay for me to be an inpatient following a procedure, but that it would allow for me to be held for observation for 23 hours. It is not my doctor who is treating me determining what is proper or needed but an insurance clerk or medical officer who has never once looked at me. The system deprives doctors of the right to determine proper patient treatment.

[KeithE]

[JE Pettibone]

Ed: Leave the Vets program alone. Just see that current rules and regs are enforced, including staffing models. .

[Sandy]

There are ideas and thoughts I see floated around in the Christian community that I find to be counter to the philosophical perspective of applied Christian living, particularly among those who claim they believe in the absolute authority, inerrancy and infallibility of scripture. I think much of that is simply a lack of information. Locked up inside the fantasy world of Christian and conservative "news" sources that are all commentary and very light on fact, the information they have is simply false. It's taken eight years of hearing from the real people who are most affected by this to get enough information out there to create the realization that if this goes away, they are back to square one, which is basically trying to scrape together the rudimentary health care they had, at exorbitant, profiteering prices, to try to treat symptoms and in some cases, stay alive.

The intricate, Biblical arguments for the pro-life position takes a philosophical stance on the sanctity of human life. Any Christian based pro-life organization most likely has a website that lays these principles out with a good assortment of Bible citations in support. If you simply accept the philosophical statements, you don't even have to insert any other language to make the same, strong argument that health care is an equally Biblical sanctity of human life issue. The part that deals with pregnancy and the unborn isn't really even half the argument if human life is valuable enough from conception to be protected. When does it lose its value, in this regard? Asking the government to protect the life of the unborn is the exact same philosophical ball park as asking the government to provide universal health care. It's antithetical to the pro-life position to legislate to protect the unborn, but not to legislate to protect a life, once born, from circumstances which either allow pain and suffering to become free market economic commodities to be exploited in a supply and demand system, or to allow quality of life to be regulated by a dollar amount.

In our "separation of church and state" culture, the government should not be expected to operate under religious principles, though the collective conscience of the nation certainly has the right to influence its actions. The government's acknowledgement that health care is a basic human right isn't establishment of religion. But the fact that a majority of conservative, Evangelical Christians are opposed to any government attempt to make health care affordable, and take it out of the realm of being nothing more than an economic commodity to be exchanged for as much money as "the market will bear" is an indication that they are exclusive and selective when it comes to applying the principles they use to insist on the rights of the unborn. Their view of health care rights also stands in contrast to those "godless, liberal" Europeans, and the secular Canadians, who long ago recognized that health care in the free market means that only the wealthy have access to it, and have developed high quality, well funded, nationalized health care systems with costs that run about half or less than what we have available in the US. Most American Christians, and virtually all of the self-proclaimed leaders, are fascinated by wealth, and are so bent on chasing after it to fund the capacious palaces and edifices they build to house congregations that use them for an hour once a week, that you can't expect them to hold a moral view in the face of an opportunity to make a buck off of someone's misfortune.

[KeithE]

[Haruo]

[Jim]