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By: Erin Lieber
The debate over health care reform in the U.S. is quickly transitioning from concept to reality. Just this past week Nancy Pelosi unveiled the House health care reform bill, weighing in at just under 2,000 pages and just under one TRILLION dollars. Whether or not this marks the progress, it certainly marks a milestone in the health care debate. A very real bill is now on the table – Affordable Health Care for America Act – H.R. 3962. As we think about the changes health care reform may bring and how they will affect us, a fundamental question needs to be addressed: What exactly is health care?
The United States was exposed to our first, albeit loosely based, health insurance policy in 1929 when a group of teachers made a deal with a Texas hospital to pay a fixed price of $6.00 in exchange for 21 days of hospitalization. Since then we have seen many changes in our health care delivery system and the multifarious efforts have certainly become more complex as we survey the health care situation 80 years later. One thing that has not changed is the fundamental debate over where health care belongs, be it with private industry or government. To that end, the debate defining health care as a right or as privilege, has had staying power since the first insurance policy was put into effect. Whether or not health care is a “right” plays a very important role at the core of health care reform, and I encourage you to think about the following: Is health care a right, a privilege, or something else entirely?
Walter E. Williams, the John M. Olin Distinguished Professor of Economics at George Mason University, has this to say about the definition of a right: “the historical definition of a right is something that can simultaneously exist among individuals, without incurring any additional cost or obligation to another, except for that of non-interference. Everybody has a right to speak freely, for my ability to speak or express my opinion imposes no cost or obligation on another, except perhaps the obligation of non-interference”.
Our Declaration of Independence states that “all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the pursuit of Happiness.” If we believe in the Declaration of Independence and the assertions put forward by our founding fathers, can we classify health care as a right? And why is it that we have to decide if health care is a right or a privilege? Maybe we should consider it a product or service like any other that we consume. What about all the people who choose not to be insured; young invincibles, for example, who make the personal choice to go without coverage and significantly inflate our total health care expenditures. And what about the 20% of people in the country, that research suspects could be insured under Medicaid and other government run programs and have not signed up? Does this mean then, that it is not their “right”, to go without coverage. And if health care is a right, whose duty is it to make sure every citizen has access to that right? These are very difficult questions that will vary greatly based on our ideologies and life experiences.
I encourage everyone who reads this to give some thought to whether you feel health care is a right, a privilege, some hybrid of both, or something else completely. As we all try to understand the health care debate, you may find this is a very good place to start.
November 5th, 2009 at 7:20 am
This article made me stop to think about what we’re really looking for – the whole issue is so complex to me that maybe breaking it down in my mind might help. This is making me try to answer her thought provoking comments.
November 5th, 2009 at 8:06 am
This article really stimulates thought about the issue at hand without imposing an opinion. It would be interesting to know whether our government even has answers to these questions…
November 5th, 2009 at 9:40 am
By definition, we don’t pay for rights (think Bill of Rights). I depend on govt to ensure justice (vis-a-vis due process), but don’t believe health insurance is unalienable right. Perhaps if insurance was an amendment our ideology would differ…
November 5th, 2009 at 9:49 am
Although I support healthcare reform (and possible universal plan), I’m not sure it’s a right or a role solely held by our government. Great thought provoking questions.
November 5th, 2009 at 10:30 am
I think that people in general are not aware of what the founding fathers set out to establish as rights. It is however a very difficult topic. While I am insured and believe health insurance is not something that others should not have to pay for you, I do believe that people should have a right to health by not living destructive lifestyles and increasing risks through lifestyle, diet, obesity, etc. Genetic issues are a sep issue and this article is a great way to present this topic to get us thinking. As I write, my beliefs are conflicting with my conscience and how I feel about this. What is certain is that Gov should be out of this process and small Gov is the answer across the board.
November 5th, 2009 at 10:32 am
Here is what the role of my government should be: Instituting and enforcing laws pertaining to civil and property ownership issues so that citizens feel confident in investing and innovating, protecting my country from foreign aggression and staying out of my way. Access to health care is NOT a right as promised by the Bill of Rights, or guaranteed in the constitution. This is a private issue that a free market system would correct if the government would simply stay out of the way.
November 5th, 2009 at 12:02 pm
I think the government should not be a health care provider. Rather, I think that they should take the money used to adminster this “public option” and put it in the hands of the young, smart and daring. Similar to the software and technology industries. Further, if the government still feels the need to “intervene” on our behalf. Make these grant awards conditional. Make the grant open source. If your work, based upon the grant is that much of a game changer, then your project should be available to the whole, so that there is no monopoly on any new medical technology, or agree to sign the patent for your discover to the government for a yearly stipend.
This allows the government a hand, this may encourage innovation, and it potentially drives the price of exorbitant new drugs down as “big pharma” is not trying to recoup the investment. Let people succeed but let the country benefit
November 5th, 2009 at 7:21 pm
The government is not in a position to serve as a healthcare provider. The complexity of such a task seems beyond their scope. Healthcare as right is a bit much, no different then housing or food…not free, but there are programs which aid those in need.
November 6th, 2009 at 1:28 am
Health is in my opinion is not so much a right or a privilege but a responsibility of the individual .As part of this you may need to access various goods and services. The “health” debates in most countries are in fact arguments over who pays if the individual has not taken responsibility for their health. This particularly applies to chronic diseases which are lifestyle related(Diabetes 2 obesity osteoarthritis hypertension etc)
If the costs associated with drugs and other “treatments” for these conditions were removed the system would have more than adequate capacity to cater to trauma and other acute illness which is not the result of years of failing to be responsible for ones health
November 6th, 2009 at 10:10 pm
1. Access to healthcare is available to all, from saftey net clinics, to subsidized clinics to Emergency Departments. Like all goods and services healthcare comes at a price. Why some people believe it should be free is strange to me … I have access to groceries and yet I don’t expect the store to give it to me for free nor do I want to government to tell me what milk I am allowed, so why is healthcare any different?
2. Regardless of what politicians say there will be rationing of services with “universal healthcare”. In order to provide insurance to all there will be cuts in other programs. The elderly and frail will be hardest hit with major cuts in MediCare. Want more proof? Check out the V.A. or just look at how the H1N1 flu vaccine has been handled (long lines, shortage of supply and no end to the demand). Whenever a beauracracy is formed to regulate services their will be less convenience and choice available to the consumer.
3. If we want true healthcare reform we must look at where the failures in our current system are and deal with them on an individual basis. As my grandmothe said don’t throw the baby out with the bath water. There are many many great aspects of our current system. At this point we are trying to swallow a side of beef in one bite. If we could take the emotion out and deal with each area logically and rationally then perhaps we could make some real reforms that EVERYONE could live with.
5 steps to meaningful healthcare reform:
Step 1: Eliminate the interstate ban on the sale of health insurance. Let the free market create competition and allow Americans to find the plan that best fits their needs. If the government allowed individuals to create their own pool with other individuals the result would be truly portable health coverage not dependent on their employer. The pools should be eligible for the same tax breaks that businesses do for providing health insurance.
Step 2: Prohibit insurance from paying greater than 80% of actual cost: patients need to have some skin in the game and will dramatically control costs when they are so motivated (actual experience). If the doctor discounts for the patient, the insurance company participates in the discount. Enforce with insurance fraud statutes.
Step 3: Revive charity hospitals: this will give doctors a place to donate care, students to train, and provide for the needy without huge tax based entitlement programs.
Step 4: Tort reform: prohibit any patient who has recieved discounted or free care from suing, and implement a loser pays system.
Step 5: Remove the barriers to increased use of mid level providers such as Physician Assistants; they provide 80% of the care, at the same quality, and for far less money than doctors.
Results: Health care costs drop like a rock; insurance premiums (including malpractice) become affordable, and access to care increases. Additionally, Medicare/Medicaid fade away, taxes go down, government budgets become reasonable.
November 7th, 2009 at 9:01 am
Kill the bill- not enough info from our Gov. Who knows what they will place in there.
November 7th, 2009 at 10:09 pm
House just passed the bill. What happens next?
November 9th, 2009 at 7:13 am
Pelosi and her befuddled minions have succeed where no terrorist was capable of doing. She and her cohorts have managed to introduce a bill that would fiscally cripple our formally fine government. This is truly a sad day when our elected leaders care so little about our financial health that they would recklessly introduce a bill that does nothing to cure the problem but rather perpetuates the big government control that our forefathers struggled so hard to prevent.
November 9th, 2009 at 5:14 pm
Dr. Joe – That is a great insight about responsibility and something I think we can all think about now that a House Bill has passed that could provide health care for a lot more people. To what extent is each of us, and the government, insurance companies, providers, hospitals, RESPONSIBLE for health care? Thanks for the great comment.
November 9th, 2009 at 5:15 pm
Dan-The House did pass the bill over the weekend. I will post an article on what happens now and hopefully everyone can let me know what they think as well. Stay tuned. Thanks for the comment!
November 9th, 2009 at 5:20 pm
Kim-thank you for those comments. I really enjoyed reading your take on a SOLUTION to health care. We hear a lot about the pro’s and con’s of health reform, but you have laid out a solution, and that is amazing. Thank for reading healthgavel, and commenting!
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