My Thoughts on the Healthcare Debate

I promised to post about my thoughts on universal healthcare. My first thought is that there is absolutely nothing specific out there.  If someone can point me to an outline of the proposed Obama* plan I would appreciate it.  The best I can find is this and it is a list of principles with nothing specific suggesting how it might work.

My second thought is that I’m not sure that it is the government’s duty to provide healthcare for its citizens.  I understand that the U.S. will benefit from having a healthy citizenry.  This country already takes great pains to have healthy people.  That is why we have the USDA, the FDA, and the CDC.  I'm not trying to be insensitive here, there are members of my family who are among the millions of uninsured.

My third thought is that I believe the government will do a terrible job of providing medicine for everyone.  I know what you are thinking; healthcare is already in terrible condition, so what is the difference?  The difference is who is paying for it.

There are 2 great problems with the medical establishment today – greed and bureaucracy.  Greed means that doctors, hospitals, drug companies, and insurance companies need to make as much money as possible.  This causes prices to rise and the bill to be a concern for any sick person.  Bureaucracy makes companies impersonal.  By establishing standards of treatment and rules for procedures, companies can deny your grandma the treatment that she needs because of a policy.

What are the two biggest problems with the U.S. government? Greed and bureaucracy. Politicians are motivated by the same things as CEOs.  However, they are also less directly responsible to those who got them their job.

The irony is that bureaucracy and greed are also what make healthcare work.  How does greed help?  Drug companies do R&D not for altruism but because they know that discovering a pill to stop the growth of cancer will be worth billions to them, and if they accidentally discover Viagra in the process, that is pure bonus money.  Hospitals buy new equipment and pioneer new techniques because they know these things will bring them more patients and more income.  Bureaucracy makes companies more efficient, which keeps costs down and speeds their functioning.

This does not translate when we transfer this concept to the private sector.  I have a fear that a single-payer system, or overly harsh regulation will kill ambition.  Causing the money that healthcare organizations spend improving to be added to the bottom line because the rewards for R&D are so limited.

Fourth, who is going to pay for it?  I am yet to even hear the beginning of an answer to this question.

My final thought is one of ethics.  I will never support my tax dollars paying for abortions or embryonic stem-cell research.  So far the administration has been very cagey about whether these things would be covered, but based on track record it seems extremely unlikely that this administration would accept a health care proposal missing these things.

Those are my thoughts, my mind is not made up on this issue, but it will take a lot of convincing to think we need a complete overhaul.  As always, feel free to try and change my mind in the comments

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* Although I am a staff member of LaGrange Park Baptist Church, the views and opinions expressed in this blog are my own and not that of the church.  They may not be construed as an endorsement or attack on any candidate or party on behalf of the church.  They are my views as an individual.

What Should the Government Do pt. 2

Yesterday I asked a question - What should the government be doing [at all]? Today the question is different - What does the government do well?

I am asking this question again as I think about healthcare.*  I am generally opposed to expanding the government for any purpose, but I obviously see the need for reform in healthcare.  So although it is a cynical question, I wonder what is the government truly good at?

There are many things that the government does adequately.  And there are many things that I do not think can be done by a non-government entity, so whether they are good at it or not they are still tasked with it.

There are, however, so many things that our system of democracy seems perfectly made to ruin.  I don’t believe Social Security should have ever been created in the first place, but that is irrelevant.  The simple mathematical fact is that in 32 years, when I become eligible, there will be no Social Security money for me to draw.  I will have paid 40+ years and thousands of dollars for nothing.  Our democracy is set up in such a way that privatizing that money or even locking 50% it to my account will never happen.  Young people, who would benefit from that change, don’t vote, and older people, who are afraid to change things, do vote.  That is not ever going to change.

Democracy, at least our system is also set up so that lawmakers regardless of party need to be constantly spending money in order to give the appearance that they are working for their constituency.  That appearance is necessary because they need votes to keep their job.

Having hopefully established that there are many things the government is bad at, I return to the original question?   What does the U.S. government do well?

I believe that they are good at defense.  Only 2 attacks ever on American soil illustrates this.  People argue whether or not we should be involved in the global war on terror, but that does not change that fact that our military is excellent.

I also believe that the government has done a good job of keeping us healthy.  (This is not addressing Ben’s comments from yesterday) What I mean is that the FDA, USDA, & EPA keep our food and water clean and safe.  With few exceptions, there is not a place in America where it is unsafe to drink water from the tap, eat meat from the grocery, or take the drugs you buy in the store.

I think that is the list.  It seems to me that everything else that is in the domain of government responsibility is ruined by bureaucracy or too much involvement.  This is the case for education, much infrastructure and so much more.

So there’s my very cynical list.  Feel free to put your own list in the comments

Tomorrow, my thoughts on universal healthcare (for what that’s worth)

* Although I am a staff member of LaGrange Park Baptist Church, the views and opinions expressed in this blog are my own and not that of the church.  They may not be construed as an endorsement or attack on any candidate or party on behalf of the church.  They are my views as an individual.

What Should the Government Do

I have been considering writing a post about the healthcare debate that's currently raging in this country.  I am not really surprised by the amount of passion on either side, because our government is considering a major overhaul to something that is central to every person.  We all need doctors.  In fact we pretty much need doctors to come into the world. Rather than write that post and add more noise to an already loud argument, I thought we could try a thought experiment. Consider the answer to this question:

If the federal budget disappeared today, and you could decide how to spend all the tax dollars; what should the government be doing? For the purposes of this thought experiment, feel free to confuse federal and state governments.  Education, for example, is typically the domain of state governments, but if you feel it should be included put it on the list.

Here is my list:

National Defense - It seems to me (and the U.S. constitution) that military expenditures are non-negotiable.  Protecting the country is the government's most important function.   I would include homeland security, FBI, CIA, NSA, ATF, and Secret Service in this category.  We must also take care of those who have served in the past.  So we can't get rid of the VA either.

Infrastructure - Powerlines, roads, airports, sewers, dams, and satellites are the things that make life in a civilized nation civilized.  The government may not need to be directly involved in the building of all these things, but I do think they all need regulation.

Education - is necessary, and although there are probably much better models than what we have, I'm afraid the horse is out of the barn on this one.  We need public education.

NASA - So many things that benefit all of humanity come out of the space program, that I believe it would be foolish to discontinue.  I also cannot envision a private model of space exploration that could function.

FDA/FCC/USDA/EPA/CDC - Each of these agencies could be improved, but each is very important.  It would be great if government regulation were not necessary, but it is.

Lawmakers - we need to pay the people who work at making the laws for this country.  I do not want to abandon democracy and those who are willing to "serve" the country as lawmakers in all three branches deserve to make a living doing so.  I hope many of them get fired, because I believe they do not have the best interest of their constituency in mind, but that is a different post.

Treasury - Somebody has to manage the astronomical amount of money we are talking about here.

IRS - Sadly, this seems like a necessity.  Even if we got a 20% flat tax we would need the IRS.

You may notice some things missing from this list.  It's my list.  Feel free to make your own list in the comments.

Tomorrow, in part 2 of this series I'll ask you what the government is actually good at.