Friday, February 19, 2010

Universal Healthcare -- Gen 4: 9

I'd like to offer my deepest apologies for turning to the overtly political, but I've heard too many people compare plans in various countries to provide even basic health care to the public at large, regardless of economic status, as against a gospel plan of free agency and personal accountability. I don't want to advocate any specific political plan, but feel compelled to suggest that the gospel may actually be more for than against the abstract ideal of basic universal access to health care. Thank you for your patience over the next few days as I say things that would probably not be appropriate to say in Sunday School.

"And the Lord said unto Cain, Where is Abel thy brother? And he said, I know not: Am I my brother’s keeper?"

We are all partially accountable for the well-being of every one of our spirit brothers and sisters. Even if Cain had not touched Abel but seen accident befall him and then idly watched him bleed to death in his field, Abel's blood would have cried up from the earth against Cain.

Our accountability increases with our stewardship, influence, and means to lend help. Just as we are more accountable for the suffering of members of the church if we withhold our fast offerings and tithes from God, we have an increased accountability to God if we ignore the plight of the sick and the poor in our democratic society.

If we enjoy the material wealth and medical capacity God has given our nation and age and do nothing to see that the suffering are granted access to it, their blood will cry up from the earth against us.

16 comments:

  1. In our local area, I have seen clinics started by doctors and nurses who volunteered their time and conviniced colleagues to do the same, until some funding could be obtained to keep the enterprise going. We have another doctor who studied an alternative model of practice carefully, and then started seeing patients but not doing any insurance billing. He can do this at a cost lower than most co-pays, and says he takes home as much income as he ever did. He even does house calls for a modest extra fee. There are many ways that individual people, using their free agency, can help others in this area of their lives.

    Sheila

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  2. Amen to that. I also have seen an increasing number of doctors asking patients to agree to mediation instead of legal action in the event of a mishap. Given the huge cost of malpractice insurance, more mediation can mean lower costs for everyone.

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  3. I'd also like to point out that pretty much any plan I've heard of retains individual choice in many ways-- yes, some plans require individuals to have insurance, but I've never heard of someone choosing not to have medical insurance for a reason other than it being too expensive.

    And having a system in which everyone has access to medical care gives everyone the choice to seek treatment. This is honestly a choice our society has taken away from the poorest among us. In America, money gives you more options in almost every area of life.

    Giving people with money more privileges and opportunities than those without runs counter to all my values.

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  4. I think a lot of the concern I hear about health care plans has to do with two things:
    1) Too much government.
    2) Worries about a culture of entitlement.

    Both are legitimate concerns, and should be respected--but also set in context. Yes, there are problems with big government--but there are also problems with our current approach to caring for the sick that leaves millions of people behind. Yes, the feeling of entitlement is dangerous--but feeling a sense of entitlement based on your own wealth is at least as dangerous as when people treat some government program with arrogance and as if they carried no shared responsibility for it.
    The thing I like most about the abstract ideal of universal healthcare is that we all could contribute to something basic, important, and good. If the American people can that do that one way or another, I say God bless America.

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  5. I do want to emphasize that I don't think there's any one way to do this. I just think we should be spending more time talking about how to make health care more accessible than criticizing people of other political persuasions as they try to do something that is fundamentally Christlike. We can disagree about policy details, but let's all work toward the Christian goal of healing, physical or otherwise.

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  6. "Our accountability increases with our stewardship, influence, and means to lend help."

    So you're saying that if you go out to earn more money but you spend it on yourself instead of others you're just heaping up a greater weight of accountability on judgment day? Somebody needs to get the word out to business majors.

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  7. The fundamental problem, as I see it, with the current debate regarding health care is that 1)everyone ignores that health care is available to pretty much everyone; if you can't afford it, there are government programs in place, and in an emergency people are taken care of; 2) health insurance is available--it costs money, so choices have to be made if you want to purchase it; 3) insisting that the government pay for healthcare for everyone, without really considering what that will cost, and what the result will be in the behavior of those who are receiving and of those who are in control of determining who gets what, is dangerous and costly.

    Forcing philanthropy because it is the "right" thing to do on us all smacks of "I will make sure everyone returns because I won't let anyone choose not to."

    Truth is, we all make choices about our healthcare all the time, both in how we spend our time and what we choose to eat. Should I insist that my way of living and eating is the best way, and all should follow it?

    And, do I want someone else making that determination for me?

    For me, the answer is: I don't want a government worker determining what kind of healthcare I should receive. Therefor, treating my neighbor like myself, I don't want a government worker determining their level of health care either.

    When we changed from major-medical healthcare coverage to covering all doctor visits (with HMOs and PPOs) we started down this road. What if we simply returned to the days when insurance covered those costly illnesses/operations/accidents, and the normal day to day doctor visits--strep throat, asthma, colds, vacinations, well-baby checkups, even routine physicals--were paid for "out of pocket."

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  8. Well said, Linda. You provide a cogent counterpoint to James' italicized statement. The question of what is right here is certainly complex. How do we strike a balance between two vitally important righteous principles: responsibility for the welfare of others and respect for their freedom to choose?

    I believe that alternatives to government-mandated care could be developed that help us better fulfill our responsibility to take care of each other.

    For example: http://www.kiva.org/ This is a link to a site that allows normal people to become micro-lenders. Micro-loans have been shown to effectively fight poverty in many developing nations (less so in US for various reasons).

    Something like this could be developed to provide coverage for those who cannot afford it, whose quality of life suffers as a result.

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  9. Actually, I don't think Linda's comment is a response to James' statement at all. It doesn't address his points, and doesn't in any way go beyond the comments he was responding to.

    Part of what he said was
    "I've heard too many people compare plans in various countries to provide even basic health care to the public at large, regardless of economic status, as against a gospel plan of free agency and personal accountability."

    Which is precisely what Linda does when she writes
    "Forcing philanthropy because it is the 'right' thing to do on us all smacks of 'I will make sure everyone returns because I won't let anyone choose not to.'"

    Then she goes on to discuss a specific sort of plan in which government workers decide how much health care (and what kind) people will have access to, after James said
    "I don't want to advocate any specific political plan, but feel compelled to suggest that the gospel may actually be more for than against the abstract ideal of basic universal access to health care."

    I don't even see how what Linda describes has anything in common with any proposals on the table.

    Until I see solid evidence, and not just rhetorical flourishing, demonstrating that providing universal access to health care would actually decrease, rather than increase, the ability of the poor to make choices about health care (in America, anyone middle class or wealthy already has full choices, and wouldn't lose any choices under any proposed plan) I'm going to support universal access.

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  10. Andrew said, "How do we strike a balance between two vitally important righteous principles: responsibility for the welfare of others and respect for their freedom to choose?"

    I think that is one of the central issues in terms of how the gospel informs this debate. My main motivation for writing is to show that it's not just an agency debate, as I often hear in the local political climate, but also one where our obligation to care for others becomes involved. If I were in a predominantly liberal LDS setting, I might be highlighting the other side. Bottom line: the gospel speaks to both sides' concerns in this issue and we ought to acknowledge that.

    Personally, I don't agree with Linda that the current system provides as much access to health care (especially preventative health care) as I think a society with our resources could and should open to the public at large (especially if reform included elements like tort reform that keep costs down). And I do think the gospel invites us to also consider: could we do more?

    In terms of the agency side of the debate: I feel like our spiritual agency is not entirely the same as our economic agency, although there is overlap. That is to say: I don't see taxes as interfering in any way with my right to choose between right and wrong. As such, I don't feel that potential government spending on healthcare is even remotely related to Satan's plan to have elimated spiritual agency.

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  11. LionofZion,

    A note on appropriate tone here: be nicer.

    Linda made an honest comment of her considered view and deserves to be respected in that. If you read carefully, you'll notice phrases like "for me" that indicate that she's expressing her own opinion, not trying to convince you of something unless her ideas happen to resonate with you.

    It is fine to disagree with her, but your tone comes across as somewhat dismissive of her perspective. That is not, I think, how God would want his children spoken to.

    Please share your own thoughts and convictions in the future while being more careful in the way you speak about someone else's.

    Thank you.

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  12. James, I appreciate your balanced view on the subject. I wholeheartedly agree with your emphasis on the importance of our shared responsibility to take care of each other. (I keep wanting to say naechstenliebe when I'm trying to describe it.)

    Regarding agency, I would rather willingly give the same amount of money to aid people who need health care, rather than be required to give or be penalized. (I know that this statement can often be interpreted as "I would rather not give," but since I'm the one that knows my heart I guess you'll have to trust me on that.)

    What you've said to that is "let yourself be taxed willingly. Rejoice that your taxes are doing good." (paraphrasing) Alright. I'm ok with that. Unless by mismanagement the government fritters away the money I could have put to better use by helping people with it myself.

    I'm with you on the what and the why. It's the how that becomes the issue. I understand, thought, that debating the how is not your purpose here.

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  13. Yeah. I think that's a good summary.

    I am inclined to believe that with all its ability to mismanage funds, the government is able to reach a broader population more helpfully than any charity I know. Because it can simply levy taxes, it also doesn't spend nearly as much money as almost all private charities in the process of convincing people to give--which can end up being where a lot of your contribution goes.

    I am also, frankly, quite capable of frittering away funds myself (buying fritters, for example, which don't do anyone a lot of good but are oh-so-tasty). So I'm maybe a little more forgiving of gov't waste than someone who is a better steward of his own means.

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  14. *hanging head*

    I am duly chastised. Trying to get better at that.

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  15. If they make you try to get better, experiences like these are great! It's good to be aware that all human beings tend toward the reactive and often, especially in internet discourse, forget to be sufficiently respectful.

    I always appreciate your comments. You have great things to say--and as you learn to listen with greater charity, I think you'll find that what you say becomes even better.

    No need to feel guilty. Missteps come with growth.

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