Tuesday, September 05, 2006

Health Care's Moral Argument, Part 1

It is absurd to claim we just don’t have enough capitalism in our health care system. We have tried private health insurance for about as long as we have had organized health care in this country. It hasn’t worked and it will never work (if the goal is to provide necessary and quality health care for all who need it). The reason it will never work is because private health insurance’s primary concern is to make a profit – not to see to it that everyone who needs health care gets it. In order to make a profit, they must do two contradictory things: increase the number of premium payers (increase the risk pool) and reduce the number of potential claimants and the amount they can claim (reduce the risk pool and utilization of the premiums) by cherry picking potential additions to the risk pool and limiting the amount of its lifetime use.

One of the unspoken reasons for the governmental policy of not having a very large risk pool (as in 300 million Americans) all of whom, of working age, pay premiums through taxation into risk pool is “Social Darwinism.” From Answers.com:

“Social Darwinism was an application of Charles Darwin's theory of evolution to the field of social relations. Throughout human history, wrote the English philosopher Herbert Spencer, society had operated like a jungle, in which only the strongest and best adapted--the "fittest"--survived…(and) efforts to improve social conditions along the way would be both misguided and futile.”

“Corporate leaders seized on Social Darwinism as "scientific" justification for their actions. Businessmen like Andrew Carnegie argued that unrestrained competition was simply natural selection at work, steadily improving the national economy by weeding out the unfit. Social Darwinism also appealed to those who opposed social legislation.”

Surprisingly, many conservative evangelical Christians are succumbing to this very unchristian ideology. Shame on them. If anything, Christians should be in favor of universal health care. At its foundation, health care is a benevolent and charitable dispensing of care for human beings at their weakest moments and in need of help. See the parable of the Good Samaritan, Luke 10:25-37.

A little background on the story: Jesus was responding to a lawyer who had first asked Jesus what was required of him to inherit eternal life. Jesus responded by rhetorically asking “what does the law say?” The lawyer responded with “love God with all your soul, all your strength and all your mind and love your neighbor as yourself.” Jesus told the lawyer that he had answered correctly; “do this and you will live” Jesus told him. Not to be outdone, the lawyer asked Jesus “who is my neighbor?” Jesus then went on to tell the story of the Good Samaritan. From Wikipedia:

When the lawyer then asks Jesus to tell him who his neighbor is, Jesus responds with a parable about a traveler who was attacked, robbed, stripped, and left for dead by the side of a road. Later, a priest saw the stricken figure and avoided him, presumably in order to maintain ritual purity. Similarly, a Levite saw the man and ignored him as well. Then a Samaritan passed by, and, despite the mutual antipathy between his and the Jewish populations, immediately rendered assistance by giving him first aid and taking him to an inn to recover while promising to cover the expenses.

At the conclusion of the story, Jesus asks the lawyer, of the three passers-by, who was the stricken man's neighbor? When the lawyer responds that it was the man who helped him, Jesus responds with "Go and do the same."

The parable, as told originally, had a significant theme of non-discrimination and interracial harmony…The story [has to be] often recast in a more recognizable modern setting where the [characters] are ones in equivalent social groups known to [interact uncomfortably]. For instance, in [recounting the story] to a conservative middle class audience, the assaulted man could be a middle class businessman, the unhelpful passers-by could be presumably respectable people like a pastor and the substitute for the Samaritan could be some disliked minority such as a homosexual, atheist or biker gang member. Thus cast appropriately, the parable regains its socially explosive message to modern listeners: namely, that an individual of a social group they disapprove of can have a superior moral behavior to individuals of the groups they approve. It also means that not sharing the same faith is no excuse to behave poorly, as there is a universal moral law.

The point being: if anything, contemporary Christians should be in favor of providing medical assistance to all who need it – particularly those who are their fellow citizens. The conservative Christian leaders would probably respond by saying that all assistance should come from donations from their congregants. The reason why this fails is twofold: 1) there are not enough contributing congregants to cover all of the medical costs for everyone in the country; and 2) only getting contributions from Christians fails to understand the universality of the moral law: namely that our neighbor even includes people we may never meet, and that the principles of “love your neighbor” and the golden rule “do unto others” should extend to everyone.


Anonymous said...

I'm not sure the free market or capitalism has been operating in the healthcare system. Insurance has insulated most of us from the true cost of healthcare.

Are you sure it is up to the government to solve these problems? Can mercy/charity be mandated or coerced?

OkieLawyer said...


Thank you for visiting my page and leaving the thought-provoking comment.

"I'm not sure the free market or capitalism has been operating in the healthcare system. Insurance has insulated most of us from the true cost of healthcare."

I guess I am curious how you are defining "free market" and "capitalism." It is my argument that private health insurance has increased the cost of health care.

Let me explain:

When you pay premiums every month to a private health insurance agency, does 100% of that money go to health care providers? No. Insurers would probably argue that they provide a service to root out fraud and negotiate lower prices because of the large risk pool "economy of scale."

However, some 25% to 35% of insurance premiums go to administrative overhead, advertising, salaries, bonuses and other business costs. If the federal government did it, you could save billions of dollars. For instance, the government would have to do very little advertising; government executives would not get $145 million/year in compensation (as one recent HMO exec did); it would be able to negotiate even lower prices because it would have a risk pool and economy of scale of 300 million Americans and it would be able to work in tandem with the Justice Department to root out fraud (more government lawyers would need to be hired to handle the increased workload -- but they could just be shifted from other parts of the economy).

Did you know that the estimated administrative overhead cost of Medicare is around 3%?

"Are you sure it is up to the government to solve these problems? Can mercy/charity be mandated or coerced?"

I don't think we have any other choice. The U.S. is the only industrialized country that does not have some type of guaranteed universal health insurance. We pay more than any other country and we get worse results.

Not to mention that medical costs are the number one cause of bankruptcy. In my sense of Justice, no one should suffer insolvency because an accident or illness.

While you make a good point that "government cannot legislate morality" on one level, all laws and legislation have moral and ethical choices at their foundations as well as economic ones.