Monday, September 7, 2009

Health Care

Previously I have written about being able to see both sides of an issue, but some arguments are so specious that one wonders about the integrity of the arguer. Sarah Palin and others of the far right fringe are sounding off about “death panels” in the current health care proposal; panels that would effectively “kill granny.” The irony is that some of the very same congressmen parroting the phrase actually suggested and supported the same end of life counseling proposal five years ago. On second thought, because these are blatant lies, I do not wonder about the integrity of these people; I do not believe they have any.

Another of the fringe arguments has to do with the proposed committee to study and compare various treatments to determine which work best. What a radical idea – not paying for treatments that don’t work! It’s not about coming between me and my doctor (a function that presently is performed very well by insurance company actuaries and accountants); it’s about letting us know the best approach to curing whatever ails me.

An argument that makes some sense at first glance claims that under the current proposal the benefits would be rationed, because the large number of newly insured people would overwhelm the available practitioners. Econ. 101 teaches that when the demand overwhelms the supply, everybody gets less. This is true, but if you read a little more of the textbook, it also teaches that in time the number of suppliers increases so that the demand is met. If it were not so, people would still be waiting for the Model T Ford they ordered in 1902.

In the case of health care, however, there would undoubtedly be a considerable time of shortages until enough doctors could be educated to meet the demand. But health care is rationed now, not on the basis of supply and demand, but on the basis of the individual’s ability to pay.

Based on the volume of the chorus, the most important argument against the proposed plan is that the government would control health care. Government = bad; private = good. Following that logic we should privatize Social Security and Medicare (a dream of the fringies since the 1930s), police, highway and fire departments, the FDA, the ATF, VA hospitals, the Post Office, the armed forces – the list goes on. I cannot help but wonder whether these people are arguing about what they think is right for the country, or about what they think will bring down the current administration. As a matter of fact, Rush Limbaugh, Senator Jim DeMint and others have admitted the latter.

The right has two arguments which make some sense: 1.) The emphasis on preventive care is overrated. If one out of ten people is saved from serious illness through preventive care, money has been spent needlessly on nine people. I’m not saying it’s wrong, but in spite of what the administration says, it does not seem to be a strategy that will save any money. 2.) But there is one big argument that makes it difficult for me to give an unequivocal yea to any of the proposed plans: they are all so darned expensive.

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