Healthcare...should it be a for profit venture?

Healthcare should not be a For-Profit Venture

“Am I my brother’s keeper?” is the question that Cain asked before he was cast out for killing his brother Abel over a petty argument. I hear an argument very much akin to this question in the debate of Healthcare Reform today when it is suggested that the government be involved in providing healthcare for American citizens. Currently, America has the most expensive healthcare system in the world, and does not offer a level of quality that would justify the expense. Among six countries studied for various aspects of their healthcare system, America was last or next to last in all categories, and was the only country that did not have access to universal healthcare. From this information, one could infer that healthcare, and the care of your fellow man, should not be a for-profit industry, instead falling under the purview of the government as a basic civil right.

If opponents of nationalized healthcare of all types are to be believed, then the government does not belong in healthcare, or other areas, as that would inhibit the basic freedoms that an individual holds. This is a valid argument, to an extent, but it has become more a question of which situation will cause more damage to the average person. With premiums for health insurance rising, and the number of things that a policy will cover decreasing, (not to mention the qualifiers put on which prescriptions are covered, what one has to do to qualify for a particular prescription, as well as the price of medicine going through the roof), I feel that it is more difficult for the average person to
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continue to pay some of these costs, and my personal finances along with many others that I know will evince this belief. I truly believe that the government should be involved in how an individual lives their day to day life as little as possible, but there are also certain responsibilities the government is set forth to provide to allow citizens to live the fullest life possible. It is high time healthcare becomes one of these issues.

One of the most common arguments I hear against nationalizing healthcare is that to do so would increase taxes, and that many feel it would be unfair to have to pay into a program that would provide medical care to others. This is very much like the situation referred to in the opening paragraph with Cain and Abel. Were this argument to be analyzed, it would boil down to one individual considering himself or herself to be more important than anyone else, and showing no thought to anyone but his or herself. This
goes against the grain of any moral and/or ethical teaching that I have ever seen. Without going into too much detail and opening an entirely separate topic of discussion, if one were to use the Bible as a guideline for creating their personal ethical code, then looking at the Parables of Jesus in particular there are multiple instances when Jesus points out that it is better to help others than to help one’s self. Throughout the Bible, there are stories that imply that the good of the masses is more important than any individual.


To take the debate further, under the Declaration of Independence, three inalienable rights are listed as inherent to the human condition: “Life, Liberty and the
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Pursuit of Happiness”. To continue in the same situation as exists today in healthcare takes away the ability to “pursue happiness” when an individual is unable to pay for treatment. I work with a lady who has a 12-year-old with a severely debilitating disease and constantly has to see specialists at UVA Hospital. Over the course of this child’s life, her parents have incurred close to $1 million in debt, AFTER insurance payments, forcing them to file bankruptcy and lose their house and any other assets they may have owned and they are still incurring bills that they find difficult to pay today because of the sheer amount of money required to care for her. They are unable to receive any Federal Aid whatsoever; because their yearly income falls above whatever line has been determined as the cutoff point for Medicaid benefits. Unable to do anything about these bills, they are subject to judgments, garnishments, and various other forms of debt collection until their daughter turns 18, at which point she will qualify for Medicaid. This medical burden requires that they work overtime, and spend all their time simply trying to find ways to stay afloat, and is becoming all too common an occurrence. When an individual’s ability to pursue the happiness referenced above is compromised, then it is time to step in and take action to prevent further injustice.

Until the population as a whole acknowledges that rising costs, and a lack of regulation, are all allowing the healthcare industry to spin out of control then it will become more and more difficult for the average person to receive care. Many want to portray this healthcare dilemma as a financial decision, based upon principles such as capitalism, but I disagree. This is entirely a moral dilemma, and until this is recognized
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and treated as such I’m not sure anything will get better. Government intervention is necessary, though, in order to prevent atrocities such as being turned down for care because a business feels they can make more profit by accepting patient B over patient A due to needing two different types of care. This situation occurs today in care facilities across the country and is saddening, but true nonetheless. When the decision is made to accept one patient over another simply because the care facility can bill more expensive services to that patient’s insurance, then something is wrong. The government was originally put in place to provide services to its citizens, and the private business sector is in place to make a profit, and it’s time that Healthcare is moved from one sector to the other.

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Comment by Joseph L. Rogers on August 14, 2009 at 7:19pm
Christatos...you impress me, yet again. You are intelligent, and knowledgeable beyond what I ever hope to achieve. A Natural Monopoly is something I am going to have to research, and tie into my arguments forthwith. Thank you. Thank you very much.
Comment by Christatos Aristad on August 13, 2009 at 9:43pm
Speaking in the strictest sense, all available data on the subject clearly indicates that Healthcare is what is known in the money game as a natural monopoly, meaning that unlike other businesses, competition, rather than improving the quality of the services it provides, actually reduces the quality of the services it provides. Research into natural monopolies is extensive, and one thing is clear, that they are best provided by governments.

Issues of slavery and freedom don't even enter into the equation. One can not be enslaved by a democratic government, and illusions to the contrary are childish. There are not many forms of slavery, just one parading around in different clothes, and Americans of the modern era have never even vaguely felt the taste of it.

The question of health and well fare is one of utility, and utility comes down to what works and what doesn't, no more, no less. The problem isn't that there will be people leeching off of the system and we will all have to pay for the lazy, but that in all systems built around an interconnected society, we always will, and at least if we do so upfront, we can limit our liability, humanize our system, and prevent undue wear and tear on the sinews of our society by the truly needy.
Comment by Øystein on August 9, 2009 at 5:07am
True, the oil has been a big advantage for the Norwegian economy, but that is not the sole reason for our welfare.
If you look to Sweden, they have one of the best health care systems in the world, with only small fees like Norway. Sweden is not a large exporter of oil.

Creating a universal health care system that anyone can afford is a much bigger challenge in a country like the USA than in Norway, but I can see no solution that would be more fair.
Your assets, income or the quality of your health insurance does not always match with your contribution to society.
Comment by Patrick on August 8, 2009 at 10:36pm
Øystein only provides half the picture. He doesn't mention how Norway can afford to pay for it.
1) Norway has a population a little more than 1/2 the population of New York City (4.5 million v. 8.3 million).
2) The government of Norway controls the oil and natural gas industry of the country (30% of their economy). They are the 3rd largest gas exporter in the world and the 7th largest oil exporter.

I imagine that if NYC had that much oil, they could afford to pay for the health care of all their residents too.
Comment by Joseph L. Rogers on August 8, 2009 at 6:53pm
THAT'S what I'm talkin' bout! You see that! THAT'S WHAT I'M SHOUTING!

*throw in various obscenities as your imagination provides*

:)
Comment by Øystein on August 8, 2009 at 8:59am
Let me give my two cents coming from a "socialist" country. (Norway)
Health care is not free, but very cheap. A visit to a GP is about 28$, a specialist 42$ and most other exams, like x-ray is somewhere in between. Plus you never have to pay more than 285$ a year. (Some drugs are included in this number, others are not. Transport is included if necessary) The rest of the costs is funded through tax-payers.

As for the quality I have very few complaints and it's not like the government owns the whole system. There are hospitals owned by the state and private hospitals. The private ones often have financial agreements with the regional health authorities.
You can chose which hospital you want to be diagnosed and treated at among the government owned and the the private with agreements. My GP works within a private company.

There is some waiting time for certain sorts of surgery. This is the main reason some people have private health insurance. They can get treated at a private clinic and thus shorten the line.

As for the emergency rooms, the last time I was at one I waited only 10 - 15 minutes before someone assessed my injury.

If it's payed for with taxes, then you may end up paying for someone that gets sick more often than you, but the same could happen with insurance.

I do however see some benefits of for-profit health care. If the system is incomplete, then profit could be a good incentive to build new clinics and hospitals as long as it's somewhat regulated to insure that the patients are not harmed by people trying to cut corners.
Patients should also have a choice not to use government hospitals if they do not wish to. There is no reason why health care could not be both public and private.

For me bankruptcy because of medical reasons is hard to imagine. This should be totally unnecessary a country like the USA.
Comment by Will Aygarn on August 8, 2009 at 8:16am
I think many people have a distorted idea of "rights".
The idea that one is entitled to the fruits of another man's nature is as old as history and slavery exists in various forms to this day.
Governments routinely treat their citizens/subjects like property.

I believe that the individual has the right to all the medicine and medical care that he can obtain without force or fraud, but this would leave out every government medical scheme I have seen so far.
Comment by Joseph L. Rogers on August 8, 2009 at 6:43am
First off, O Authority on Biblical matters...it was not the Samaritan lying there on the road with his ass kicked. It was the Samaritan who found him, and took him for care. That's why it's called the Good Samaritan.

Second, and I will delve into this further later in the day, I have to go to work now, but I am not necessarily arguing for Nationalization. I just want to see something different, because right now, the system is screwed. However, the government is put in place as a logistical agency, as I've stated before...perhaps SOME oversight of a system may help. I have another essay I'll post once this one has been thoroughly fleshed out.
Comment by Adam van den Hoven on August 8, 2009 at 3:06am
There are so many inaccuracies in this article that its hard to know where to begin.

First of all, I'd like to know which study is being cited, and which countries are being checked because its certainly not Canada. Let me tell you what its like here in BC (healthcare is a provincial matter).

The author mentions, for example reductions in prescription coverage. In Canada, the public healthcare system doesn't cover the cost of prescriptions at all (I think drugs taken in hospital are covered and special cases like for some disabled people). Further, there are a lot of basic healthcare things that aren't covered. For example, vision and dental are not covered.

Then there is the waiting. If you go to the Emergency Room, you will wait several hours from the time you're registered, until a triage nurse can prioritize you, then you can expect to wait several more hours for treatment(depending on how severe your condition and who else is in the room). In some jurisdictions, like Ottawa (the capital of Canada) the average (yes average, not maximum) ER wait time can be 20 hours or more (see: http://www.cbc.ca/health/story/2008/05/21/ot-er-waits-080521.html?ref=rss the CBC is government run, statist, left wing news group, btw).

In my own case, I have a family history of a rather uncommon genetic syndrome. Normally its not a problem, but it does mean that certain procedures can't be done on you. There are also some significant effects that can occur which knowing you have the condition will allow you to deal with it more effectively. There is a simple blood test that can detect this in some cases. We know my brother has the syndrome, if he takes the test and it comes out positive, the test will be definitive in our case. We've been waiting the better part of a year for the specialist to schedule the blood test.

I personally know several people who are waiting for surgery who have had their surgery delayed or cancelled for months and have to continue living in pain and reduced mobility. Many people spend 6-18 months living in pain and sometime bed ridden, waiting for "elective" surgery. Elective is any surgery that can be scheduled as opposed to emergency surgery that has to happen NOW.

The dirty little secret is that many of us have secondary health care through private (for profit) insurance providers which provides for things like vision and dental, drug coverage, private rooms during hospital stays, preventative and alternative health care. That costs several hundred dollars a month (my last job it was something like $250 - 300/month). Plus I have to pay $50+ per month on top of my taxes in health care premiums.

Second, the author asserts that the desire to not pay exorbitant taxes so others can reap the benefits of your work, "goes against the grain of any moral and/or ethical teaching that I have ever seen". He even misuses the story of Cain and Abel to make his point (there is not the space here to discuss proper exegetical methods). Its a bold assertion and a logical fallacy.

The argument falsely equates paying taxes with doing good. Lets take Christian moral teaching, since its the one I'm familiar with and the author invoked the Christian world view with his reference to Jesus' teachings.

Probably the best example of moral teaching in scripture is the story of the good Samaritan. You know the one, a Samaritan man is waylaid by robbers in the wilderness. Along come some a Priest and a Pharisee, both of whom ignore him and hurry on their way (don't want to run into those same robbers). Eventually along comes a man who takes the Samaritan to an Inn where he does what he can for the man. He pays the inn keeper a significant amount of his own money for the care of this man he didn't know.

Notice that he went and did this for the man. Not the government. The liberal lie is that by getting someone else (i.e. the State) to do "good" things on your behalf, you're doing good. In the Protestant Christian traditions, this is impossible.

Third, you're assuming that if the Government pays for it, your co-worker would not have had to pay over a million dollars to receive treatment for her daughter. That's probably true, but why do you assume that she would have received the treatment she expected. There are many cases where individuals are turned down for a specific treatment because its 'too expensive'. In some cases they go to the states or else where and pay for the treatment themselves or they have to fight the government for treatment, often in court (at their own expense).

You're not arguing for single payer, government healthcare and more regulation. You're arguing for more personal responsibility and REAL Health Insurance and a change in the business model.

Think about this. What do you think the premiums for accidental death and dismemberment insurance would be for your basic "Evil Knievel" type person would be? HUGE. The odds of having to pay out that policy is huge compared to your average mousy librarian. And that makes sense. We expect to draw on our Health insurance on a regular basis; every time we go to the doctor. Is it any wonder that the premiums are high. Its basic insurance math, the more likely the payout, the higher the premium. Further, you are probably insured for all sorts of things you rarely use. In some cases the government mandates it, in others its simply a way to bump up the price.

Insurance is supposed to be something you never collect on, like fire or auto insurance. What would the cost be if oil changes were included?

So what you need is a normal business relationship with your health care providers (go in for your monthly oil change and checkup), and get insurance for catastrophic events. Then things would probably be a lot better. And perhaps the argument could be made that the government has a role in providing for catastrophic situations, just as it steps in when a natural disaster occurs and normal home insurance just won't cut it.

You're also arguing for Tort reform. The laws in the US are STUPID when it comes to suing people. If you go the doctor with a headache, you're going to get all sorts of stupid, unnecessary tests, not necessarily so you can get fleeced, but so that in that one in a million case where it is something horrible, the doctor has a record of excessive diligence.

Fourth, you make the assumption that the only alternative to "for-profit" is government. You have simply asserted it as a fact, but you have not proven that in any way.

Finally, there is an assumption here. You cite the declaration of independence. The DoI is a document first and foremost which argues that Government (at that time the King but in reality any Government) must stay out of the lives of its citizens, because the right to "life, liberty and the pursuit of happiness" is given by God and the government may not take away what God has given.

Also note that it say the pursuit of happiness, there is no right to receive it. The DoI merely says that governments may not prohibit the pursuit of happiness.

Since we're on the topic of the Declaration of Independence, here are a number of relevant quotes from Thomas Jefferson (from http://etext.virginia.edu/jefferson/quotations/jeffcont.htm)

"Funding I consider as limited, rightfully, to a redemption of the debt within the lives of a majority of the generation contracting it; every generation coming equally, by the laws of the Creator of the world, to the free possession of the earth He made for their subsistence, unincumbered by their predecessors, who, like them, were but tenants for life." --Thomas Jefferson to John Taylor, 1816. ME 15:18

"We believe--or we act as if we believed--that although an individual father cannot alienate the labor of his son, the aggregate body of fathers may alienate the labor of all their sons, of their posterity, in the aggregate, and oblige them to pay for all the enterprises, just or unjust, profitable or ruinous, into which our vices, our passions or our personal interests may lead us. But I trust that this proposition needs only to be looked at by an American to be seen in its true point of view, and that we shall all consider ourselves unauthorized to saddle posterity with our debts, and morally bound to pay them ourselves; and consequently within what may be deemed the period of a generation, or the life of the majority." --Thomas Jefferson to John Wayles Eppes, 1813. ME 13:357

"It is incumbent on every generation to pay its own debts as it goes. A principle which if acted on would save one-half the wars of the world." --Thomas Jefferson to A. L. C. Destutt de Tracy, 1820. FE 10:175

Perhaps most relevantly:

"If we can prevent the government from wasting the labors of the people under the pretense of taking care of them, they must become happy." --Thomas Jefferson to Thomas Cooper, 1802. ME 10:342
Comment by James! on August 6, 2009 at 4:07pm
Sounds like a winner. A government controlled military doesn't seem to be a problem, so why should healthcare be a problem? Add a little tort reform and insurance regulation and it should be a done deal.

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