Monday, April 9, 2012

The following is a face book discussion from about 2 years ago. The first poster is a young woman who was a college student at a very liberal college in Washington state. The second poster is her father, Shaun McCausland.


Okay. I know I may be opening a can of worms here, but I have to ask.

I've been taking a class this quarter called Disease in Modern Society. It's been a brilliant course so far and I've thoroughly enjoyed it, especially since it has had an emphasis on how various factors of society (such as inequality, marginalization, and poverty) affect the spread of disease. In order to stimulate these discussions, we've read two nonfiction books I'd like to recommend to everyone. One is "We Are All The Same" by Wooten, a story of a South African boy with AIDS... and "Mountains Beyond Mountains" by Tracy Kidder, a story about Dr. Paul Farmer, a truly Christlike man who has against huge odds created effective treatment programs in countries like Haiti, Peru, and Russia.

Reading these books, I've come to believe that access to good health care should be a basic human right, and that relieving suffering is an ideal which agrees firmly with my own moral code and the moral code of many others, especially, I would hope, my fellow Christians.

I understand that the subject of health care in our own country (the U.S.) is highly controversial right now. I'm not sure I understand all the reasons, though I have heard a little bit on both sides of the issue. There may be things I have yet to understand about why some people are so convinced that the newly proposed health care systems will actually make things worse. I understand that people are worried about freedoms being compromised, doctors doing a halfway job, taxes being raised, and having to pay someone else's doctor bills.

So what I have to ask is this.

How many people believe that we all have a responsibility to care for our fellow man? How many people believe that relieving suffering when it is within our power is not just something nice to do, but is in fact our duty? How many people truly believe that when a mother has a sick, wounded, or dying child, that she should have access to treatment for that beloved child, regardless of her income? How many people believe that Jesus really meant it when he said that sharing our substance with the poor, administering relief to the sick and the affilcted, is the true gospel?

Are we not all beggars?

So what I'm curious about is why we are afraid. I'm honestly curious. This is not a challenge or a criticism. I am ignorant about this matter, I will freely admit that. So educate me. Tell me, briefly, what is wrong with the idea of making health care available to everyone, even if the money for it does come from our pockets? Is it the fear of losing our freedoms? Is it the fear that we'll be encouraging laziness in our population? Is it a feeling of entitlement to our own hard-earned money?

Which aspect makes it the most frightening?

This is an invitation of straightforward explanation. I don't want to start an argument. I don't want any name-calling or contention. I just want to know what it is that makes such a seemingly good idea sound so bad to so many of my friends, family, and acquaintances. I want to understand so that I can make a more informed decision about where I stand.

All this is assuming that anyone actually replies to this xP

Rachel - excellent post, excellent thinking and excellent approach. If more people would start where you are starting, there would be more understanding and less of all the negative stuff. I will try to shed what light I can. To clear up all the concerns would take a book or maybe more than one book, but I will try to be brief. I do not have all the answers, but I think I do understand the questions, which is the first step.

The first and most important point you want to find clarity on is the moral and spiritual framework that we should work from when considering what to do with those who need health care. I believe that most of us who consider ourselves Christian would agree that we have a responsibility to care for one another and help when help is needed. I won't cite scriptures here, but there are many that support this. The question then becomes, who provides the help, who receives the help, what level of care should be provided, and should it be mandatory, or should people be able to choose how much they contribute to the well-being of others and how much they should be entitled to.

Health care can be divided in many ways, but in my mind there are four basic types of health care - prevention and strengthening health, basic care, emergency care and long-term management of degenerative or incurable illness or disability. The first area is fairly inexpensive and is comprised of mostly teaching, nutrition and avoiding toxins. If everyone ate an organic, raw food diet, most illness would simply disappear. That brings up the question of whether the government should regulate what we eat and mandate exercise, etc.

The second area, basic care, is treatment and support of natural processes (like birth) and simple, short term diseases. It is also fairly inexpensive, at least in comparison to the other two areas remaining.

Emergency care is about sudden, traumatic crisis management, whether for broken bones, injuries from accident or inflicted injuries or extreme for the doctors and hospitals that are astronomical which is a major part of the problem with health costs.

The final area is the most expensive by far - that of caring for those on a long term basis that are incapacitated, incurable or have debilitating weaknesses and disabilities.

I don't know the exact numbers, but if you take the exorbitant insurance rates that doctors and hospitals pay out of the equation, the first area is likely getting about 5% of the money, the second is getting about 15%, the third about 30% and the fourth the other 50%. It seems that if we would actually teach people correct principles (word of wisdom, exercise, etc.) much of that 80% part of the cost could be eliminated.

The next question is, how much of a persons health is their responsibility and how much is the community responsible for? Is it the communities responsibility to pay over a million dollars to care for and try to keep alive for 40 plus years someone who has spent their whole lives smoking, drinking, taking drugs, eating wantonly, - you get the idea. Agency dictates that we get to choose what we do, but we don't get to choose the consequences - our choices have already created them. To take this out to a logical extension - if one in twenty people choose to live this way, how can the other nineteen pay that million dollars. There are 11 people in our family, so less than two families our size would have to come up with the million dollars to pay for that one person's choices. How can that be done? If you think that amount is unlikely, check what the total bill is for a lung transplant, a heart transplant, long term care in a facility or home for even a short time, let alone 40 years or more.

Now add to that the insurance costs. Individual doctors pay from $50,000 to $200,000 per year for malpractice insurance, depending on their specialty and type of practice. They of course pass this along to their patients in higher fees. Then add to that all the extra tests, procedures, etc. that doctors do just to cover their butts in case anything goes wrong so they can stand up during a lawsuit and say, "I did everything I could - just look at all these tests", which adds countless more dollars to the bills.

I know I said this is brief and believe me, it is compared to what people really need to know.

The solutions -

1st. Increase the education of people in natural health and the toxicity of chemicals, pesticides, food additives, dyes, pollution, etc. Help them learn how to increase their health and their natural immunity. This would take much less money than any other option and would be the most effective in lowering costs.

2nd. Tort reform. This means changing the way courts award money to people who have had bad outcomes from medical procedures. If negligence is proven, those people injured should be taken care of whether until they return to productive, normal life if possible or while they live if the damage was permanent. Punitive damages should only be awarded in cases of fraud or gross negligence or intent to harm and should be capped at $1,000,000 per person so harmed. (Some have received $50,000,000 or more for a doctor making an honest mistake in addition to compensatory damages - those requiring care, etc.) This would decrease the amount that insurance would cost both for the doctor and the patient.

3rd. Recognize that the fourth area of care is the one that is most expensive and the most preventable, that the second area of care is affordable to most people if they are not having to subsidize the doctor's insurance because of exorbitant rates. With that understood, health insurance is properly only needed by most people for the third area - that of emergency care. Costs in this area can also be reduced by tort reform, but it will still be expensive for most people. This is the area where there should be some type of insurance available to everyone.

Interestingly, it is already in place and working. If you present yourself at the hospital emergency room or call for an ambulance in an emergency, they are required by law to admit you and treat you to the best of their ability. If you can't pay, they have to work with you to allow you to pay what you can and forgive the rest. They pay for this by raising the costs for those who have insurance or can pay through their own resources. Donations are also accepted to help pay these costs. You remember how many people in our community helped us pay the costs of medical and funeral expenses when Elijah died.

Finally, we need to determine if it is appropriate for taxpayers to be forced to pay for all types of treatments or just the emergency types or none of them. We need to see if the charitable community can cover the costs for many of these situations. Historically, most people - especially children - are taken care of by organizations such as the Shriner's hospitals, Primary Children's hospital (as well as other children's hospitals all around the country) and others. These hospitals will only charge what the people can reasonably pay. The rest of their operating costs are covered by charity from people like you and me. They have succeeded doing this for many years.

The problem with the current proposal is that it is not clearly addressing the problems as they stand. It is simply creating a huge government program at an even huger expense to us, our children and our children's children. That program will be about as effective as all the other government programs and as such, will run out of money fairly quickly. Then they will have the choice of the following - 1. Raise taxes even further than they will already have to be raised to pay for the stimulus and bailout, 2. Restrict access to health care to those the government considers "worthy". 3. Force providers to charge less for services (which will cause providers to either do less for people or simply go out of business.) When the number and quality of providers is reduced sufficiently, how effective will government provided health care be? For answers, look to countries where it has been tried. England, Canada and Russia are good examples. Many people in those countries come here because they either can't get care (they are disallowed because they have some other problem or they are "too old" or some other reason) or they can get care but have to wait so long because of the lack of providers that they will die before their appointment arrives.

In our country, there are very few people who can't get care if it is urgently needed, even if they can't pay for it. I can't pay for health care or insurance. I went to the emergency room last year. I received decent care and a doctor consultation with a specialist. I was not charged because I was unable to pay. They did not raise anyones taxes. I don't believe that anyone need go without care in an emergency in this country.

RB (name withheld to avoid his embarrassment)
Shaun Shaun Shaun.... Please read the Bill. People are being turned down by insurance every day in this country. Private companies, in states that have legalized euthanasia, are already refusing to pay for terminal illness treatment and offering assisted suicide coverage. All you boogey talk is already happening. Obama is not modeling Russia, ... Canada or the UK, the bill models France's policies which are widely regarded as the best in the world the Doctors and citizens of France. Insurance companies lack the moral obligation to help people, while our goverement program will be dsigned to do so, beyond profit motive.

There will be no "Death Panels", There is no mandatory suicide clauses. We HAVE the money. Our nation HAS the resources. We, as a nation, need to do what's right and stop fretting over lies and missinformation.

If yo don't want the goverment program, you don't have to be a part of it. You have the right to keep your current care. How is that so hard to understand?

The reason people are scared is that they believe the government will waste the money taken from us to pay for this and that health care will decrease in quality and availability. A good example of this is the recent cash for clunkers deal. The report I saw noted that even though they spent 1 billion dollars for the program (soon to spend 2 billion more of our money that they take through taxes) only 120 million of it went to the people trading in their cars - the rest went to run the program and pay for implementing it. That's is why we don't trust the government to run health care. Medicare takes money from every check you receive as an employee - so does social security. If the government put that money in the bank so it would be available to you when you need it, they would have literally trillions available now. Instead they have spent all that money and are taking money from other people to pay for the benefits of those who are collecting now. That is why many of us don't think the government is qualified to run this program.

Stop being a tool, Shaun.

2 billion is what the Iraq war used to cost us a day.....

RB, please keep to the intelligent dialogue we have started here instead of name-calling. If you have specific disagreements with what I have posted, bring them up and directly address them with your facts and experiences. If you can't address the specifics and be civil, please go away.

I agree that the insurance companies are turning people down. I agree that some are not doing a good job. I believe that much of that can be addressed with tort reform as noted above. I also believe that the problem you are concerned with will get worse if the government is in charge, not better. That is why I don't like this bill - and yes I have read a readers digest version of the bill, but no I haven't read all 1400 pages - have you?

I've read all the "scary parts". It sounds like your arguement has been reduced to a matter of opinion:

"I also believe that the problem you are concerned with will get worse if the government is in charge, not better. That is why I don't like this bill"

I DO believe the goverement can handle this. So does Rachel, so do many more Americans. So there.

That's fair. Can you give me examples of how the government has done well with other large projects? You pointed out well how much we wasted on the Iraq war. If they are good at this type of thing, I need some examples. (was the "so there." necessary?) I can respect you if you respect yourself enough to be civil and mature in your comments - even if we don't agree.

ER (name also withheld)
You can't base this administration's potential on the activities/failures of previous administrations, especially ones with such radically different policies... if they didn't change from president to president, we could never advance after a bad one. Germany's healthcare system is fantastic now, but just 60 years ago, it was Naziland.

That is a fair point and I don't base anything on previous administrations. I am equally concerned by the last three administrations and how they all moved us towards centralized governmental power and away from individual and state's rights. So far, I haven't seen anything that indicates this administration is taking us in any new directions. It seems to me that we are just going faster into debt and governmental power.

I do not beleive myself to be uncivil in my comments, perhaps you're a bit too sensitive.

The US government, considering the majority of other nations, actually controls very little in this country. Education, Medicare, Medicade, Military, Police and Justice.... Most Banks go, or until recently have went, mostly unregulated. Social Security has dried up as baby boomers have. This is becasue back when social security started, the average life expentancy was about 65.... It was designed so that people would die before they have to collect. Unfortuneately that's no longer the case. People don't retire becasue they're unable to work, they do it nowadays because they want to play golf, relax, and travel with the help of a goverment meal-ticket.

Perhaps the government would function better if we gave it the power it needs to function. A half-ass funded program can only perform half-assedly.

Perhaps we should stop allowing perfectly fuctional people to suck the system dry simply becasue they're in thier 60s.... People live until 80 on average. I say work em dry....

1 comment:

  1. I have learned a lot more about this and the landscape has changed to an extent. I have changed to a small extent what I believe we need to do. The principles however, remain the same. You can read those principles on the website at or you can comment here to start a dialogue.