Saturday, September 5, 2009

The Compassion Argument

A liberal friend of mine had this to say on his Facebook page:
No one should die, or lived diminished lives because they can't afford health care. No one should be a victim of the insurance companies. No one should go broke because they get sick. No one should be unable to change jobs because of a "pre......-existing condition". If you agree, please post this as your status for the rest of the day.
Let me be clear, my friend is a decent human being, a great artist, a good husband and all around good guy to hang out with. But I disagree with his premises.

I struggle with answering an argument from someone who is compassionate, because I think of myself as compassionate as well. But sometimes the truly compassionate answer is not obvious, so here is my answer.

First, we will never be able to afford all of the health care that would prolong everyone's lives; instead of bankrupting an individual, we would bankrupt the country, because some treatments are more expensive than we can afford for all who would demand them. I like thought experiments, so try this. Suppose some biologists conceived of a way to deliver a cure for cancer through a very expensive process. Perhaps involving cloning bits of an individuals DNA onto a virus that would deliver a death blow to just the cancerous cells. To develop their cure they seek out venture capitalists to fund their work. In the pre-Obamacare world they get the funding because they will be able to patent their invention and reap tens of billions in rewards for billions invested, if all goes well. That last statement is important, because it is in fact more likely that their efforts will fail. In the post-Obamacare world these same venture capitalists realize that under the strict price control structure that has been put into place, that even if all goes well, they will not be able to reap the tens of billions in profit from their discovery, they will only be able to break even or show some small profit. In this brave new world the invention goes begging and is never bears fruit. However, the cost of health care has been contained, because there is no demand for the new invention. Which situation is indeed the more compassionate one, reduced costs and no innovation or continuous new inventions with inequality of treatment?

Now with respect to the evils of the current system, unable to get coverage, and unable to change jobs, there are free market proposals that are not being considered by the President nor the Democrats in Congress. Here is what John H. Cochrane had to say in a WSJ Article titled "What to Do About Pre-Existing Conditions":

First, if you get sick and then lose your job or get divorced, you lose your health insurance. With a pre-existing condition, new insurance will be ruinously expensive, if you can get it at all. This, the central defect of American health insurance, explains why most Americans are happy with their current coverage yet also support reform.

Second, health care costs too much. Yes, we get better treatment, but the cost-cutting revolution that has swept through manufacturing, retail, telecommunications and airlines has not touched health care.

The problems are real, but the proposed remedy—even more government intervention—is counterproductive. A market-based, deregulation-focused reform is possible, and it will work.

And further:

A truly effective insurance policy would combine coverage for this year's expenses with the right to buy insurance in the future at a set price. Today, employer-based group coverage provides the former but, crucially, not the latter. A "guaranteed renewable" individual insurance contract is the simplest way to deliver both.
So my friend, I oppose Obamacare, not because I lack compassion, but because I do in fact want to see better conditions for others. But none of the plans being considered by the Congress actually make our situation any better. In fact, we will lose the benefits we already have in a mistaken effort to "level the playing field."

Let there be no doubt, as we have seen in Oregon and Massachusetts, treatment will be denied by the government. That this is somehow better than the current system, where at least charity or private funding are an option eludes me.

To see the full range of my opinion on this issue click the tag Obamacare.

1 comment:

  1. Brian-I wish I could actually take credit as the author of the sentiments, but in fact I saw them posted on several facebook accounts that day, and liked the very basic, simplistic tenure of them.

    Reading your post, I can also see your point of view,particularly as one who has lived in the UK, and witnessed the gradual diminishing returns of the National Health service since Mad Maggie's reign, although one should not confuse the UK system with the one being proposed here, as they are radically different.

    I will be the first to admit that my knowledge of the American political system is what cricket is to baseball, but I have observed and oft wonder as an outsider here-and I say that as someone who cannot vote, but still pays taxes-how many people here in the US, merely oppose a view out of deference from the opposition. My feeling is that all too often, I see a differing view point-and I label the charge at both parties-out of some need to affirm an allegiance by shaking a fist and being some form of devils advocate. I also wonder if such a self same view would be as forthcoming, if the shoe were on the other foot.
    And when trying to push a point,I find the imbalance of statistics procured from both sides is dizzying to me. It occurs that either party must be using very different ingredients when they bake their pie charts.

    It's fascinating.

    This probably seems terribly naive and simplistic, but I feel that it would be more divisive in a debate (rather than the slanging match it has degenerated to) such as this,if that we recognize that at the most fundamental level,we all agree with those sentiments-that general health care should not be at the behest of the have-not's, and that if the policy of further government intervention is not the answer-then what is?

    Mr Cochranes article is a good start, but too broad a stroke, and akin to putting a band aid on a septic limb,or 45.7 million limbs to be exact, because ultimately it still excludes that 15.3% of the American population without health insurance-or a staggering 8.5 million children. My feeling is as Bill Moyers said-"we should be treating health as a condition, not a commodity." And until people look at the core issue-that is of caring for those without, there will be no resolve.

    The virtue of the Good Samaritan is baseless otherwise.