A Few Thoughts

Candidate Obama promised to reform health care
Candidate Obama promised to reform health care | Source
"Obamacare" is generally acknowledged to be patterned on a bill Mitt Romney signed while governor of Massachusettes
"Obamacare" is generally acknowledged to be patterned on a bill Mitt Romney signed while governor of Massachusettes | Source
The Supreme Court of the United States, where the arguments were held
The Supreme Court of the United States, where the arguments were held | Source
Solicitor General Donald Verrilli, charged with arguing the White House side of the argument
Solicitor General Donald Verrilli, charged with arguing the White House side of the argument | Source
Obamacare becomes law, but will it stay that way?
Obamacare becomes law, but will it stay that way? | Source
Health care costs rise faster than inflation, but there is no clear consensus on what to do
Health care costs rise faster than inflation, but there is no clear consensus on what to do | Source
George W. Bush, who signed the expansion in Medicare drug coverage into law
George W. Bush, who signed the expansion in Medicare drug coverage into law | Source

May I stir up a hornet's nest?

Dear blood relatives and related family of man,

I downloaded and have been listening (when I can) to the audio of the Supreme Court Case about Health Care Reform (also known as "Obamacare.") It's been not only interesting but quite an education.

Dan Carpenter, a liberal columnist who writes in the Indianapolis Star (the local paper,) opined that it would have been easier to simply extend Medicare to everyone instead of "bending to the business interests." What he is referring to is that it would have been easier to simply go with the oft-reviled "Single Payer" form of insurance (the single payer being the federal government,) rather than attempting to force everyone to contract for private insurance (I've been listening too long, I'm starting to use legal speak!) I don't agree with some of the finer points of his analysis, but the big picture I tend to agree with. Whether you agree with the idea that the government should force everyone to have health insurance or not, it would have been far easier to simply mandate that everyone join Medicare (probably via an actual tax, most likely an increase in the FICA tax working people now pay anyway.) Granted, the "Obamacare" mechanism of trying to mandate that everyone pay for a private insurance policy (if they are unable to get into a large group policy through their place of employment) is far and away less convoluted than the "Clintoncare" debacle that would have mandated a confusing menu of regional oversight and I don't even remember what else. That, however, is not the issue. The issue is; Can the government force people to buy a product they would not have otherwise purchased? And the corollary is; If the government can force people to buy this, what can prevent them from mandating the purchase of anything? Is "Obamacare" the first step on the "slippery slope?"

I am trying to look at this dispassionately. If I come across as having mixed feelings, that's probably because I do. Of course, I'm unemployed and my wife has a potentially fatal illness which is racking up medical bills as we breath. You might think that would automatically slant me in favor of the bill, but not necessarily. I am also a conservative, and a Christian, which does mean I'm not automatically for it, but it also means that I look at the actuarial tables (as best I can, I'm no math wiz!) and can see the logic behind wanting to get everyone "on the bus."

Still, I find it ironic that both Bill Clinton and Barack Obama, who have both been accused of being socialists, attempted to pass something that was in essence more like a fascist system of the government setting the pace but ordering private business to carry the burden, while George W. Bush (who is often accused of being a fascist) passed what is essentially a socialist piece of medical health legislation when he got Congress to pass the drug coverage portion of Medicare. And make no mistake, we have been using that for my wife, who is signed up. It would have been easier to simply try to expand Medicare. Not easy, but easier.

Of course the big argument for a lot of people is about how much power the government should have. What right does the government have to force people to do anything, and once the government has claimed and exercised that power, what's to prevent it from forcing people to do anything? Chuck Colson, famous "hatchet man" for President Nixon and thought leader for Evangelical Christians, said that all governments are automatically Statist, meaning that no matter who gets in power they start trying to accrue more of it to themselves. And it is true that once a government grants itself a power or a right, the chances that it will give up that right is next to zero. Especially when there's money involved. The federal income tax in the US was supposed to be temporary. And of course, governments always are willing to give up money, right? That's why Social Security is never, ever in danger of insolvency, right?


But then you get to the other side, and people who use an essentially economic argument to try to mandate forcing everyone "into the pool." This was the thrust of Monday's and early Tuesdays "Obamacare" arguments at the Supreme Court. There is a certain seductiveness to the logic here. You don't have to be a former insurance agent (like me) to know that the more people you have buying a product, the cheaper it is for everyone. In fact, this works for all economic models, not just insurance. The oft-cited reference to broccoli is a case in point. If everyone was forced to buy broccoli, it would be made in greater quantities and more cheaply (grown, made, same thing for this argument.) Young, healthy people don't tend to buy health insurance because they don't foresee getting sick. When I was young and (relatively) healthy I didn't buy it when it was optional, and rarely used it when it wasn't. Why would I? It was hard enough to get by as a struggling young person in a big city. I didn't go to the doctor? Why would I pay the money for insurance? If I went, I just paid out of pocket. It wasn't often, so I bit the bullet. But now I'm older and my wife is ill. And I have two special needs children. So I'm pretty well acquainted with the high cost of health care. And the blessings of Medicare and Medicaid. And I see all the people who suffer because they have no health insurance. Yes, you can go to the emergency room (some nearsighted people have used this as an example of how our system works well!) but that more often than not shifts cost onto other, paying consumers. A visit to a general practitioner is much cheaper, but if you don't have insurance it's not feasible. And again, I'm unemployed and not on Medicaid. A visit to our family doctor, who is just as nice as she can be but still needs to make a living, is a luxury I can't really afford. Yet it is the young and healthy people who, if they were forced into the risk pool, would lower the premiums for older and sicker people to the point where more people could actually afford to buy in.

In many ways it seems to boil down to a "herd" argument versus an "individual" argument. This is not all that different, in many respects, from another debate which has died down a bit but not gone away. I am referring to the "vaccines cause autism" debate. Many health care professionals seem to have taken the view that a lack of positive connection between vaccines and autism means there must be no connection whatsoever. And since they treat diseases of large numbers of people, they see the upswing in cases of whooping cough as a dangerous sign. And it is. The theory of mass vaccination is that the larger the number of people who are vaccinated against any one disease, the less chance that random individuals who are not vaccinated either will become infected or will infect anyone else. But on the other hand are parents who are afraid their children might become autistic (especially if they already have an autistic child) see the fact that no other explanation has been provided nor (as far as we can see) has the fact that vaccines definitely do not cause autism in any way been positively established. We are hesitant to have our kids vaccinated because autism is a very real disability. And the health care professionals can come off as dismissive and arrogant when they fail to acknowledge the real concerns of parents. The health care professionals see the herd being damaged, the parents see the individuals being damaged.

As a little aside, for these reasons, as well as the obvious ones, I've been paying particular attention to the provision where the Federal Government is attempting to force religious institutions to provide free birth control (and possibly abortions) to their employees. And trying to say that the institutions themselves don't need to provide the free contraception but the insurance companies do need to is the very definition of disingenuous. I've also noticed something both interesting and disturbing. Most (not all) of the people who are arguing in favor of religious institutions being forced to comply tend to speak about pregnancy in terms of the disease model. This first came to my attention when Rabbi Sandy Sasso, who is one of the leaders of Temple Beth-El Zedek here in Indianapolis, wrote an op-ed piece in the Indianapolis Star which touched off quite a controversy. In her first paragraph, she wrote this:

"Imagine we had the means to reduce infant mortality and improve newborn health; that we could significantly reduce the number of abortions each year; that we could cut teenage pregnancy by 77 percent; strengthen family relationships; lessen a woman's risk of developing endometrial and ovarian cancer; and even provide short-term protection against colorectal cancer. Imagine the expenses were low and saved money in the long run. "

Think of it! Not only can contraception reduce pregnancy (the most obvious and for most people most desirable effect,) but it can also reduce the number of babies who die each year (after all, fewer live births mean few babies will die, and what you've never seen you can never lose, right?) It would also improve newborn health! Lessen the chance that women will get cancer! All by what? Preventing pregnancy! And what does pregnancy produce?

Do I really need to ask?

But the babies, the human beings that would be produced by pregnancy, are actually detriments to society, because of all those bad things they cause. At least, that's what that paragraph says to me. Of course, almost no one would say that a baby is a disease, but somehow pregnancy itself seems to become something different. The limiting or (in some cases) elimination of pregnancy among young women becomes some panacea for not only the transmission of STD's (which the use of pills and rings won't prevent) but also for all kinds of societal ills. I'm not arguing that there shouldn't be fewer teenaged pregnancies. I'm saying that when society starts looking at growing human beings as a detriment in any way, then things have taken a bad turn somewhere.

My goal here is not to argue the correctness of the religious view of humans being made in the image of God and therefor the incorrectness of forcing institutions that worship God to prevent the creation of human beings. Well, okay, maybe a little, but come on, even without that last sentence I don't think I need to tell anyone here where I stand on that issue. It's to point out that once human life on any level starts getting classified as a disease (and not for the first time in history, although perhaps with more subtlety than before,) we are on the famous "slippery slope." And I've been alive long enough to see how fast things can pick up steam once they get rolling. In fact, we have met health care professionals who seem to think that my wife's life is almost like a disease at this point, just draining the resources of our family and the system. And my daughter, who is severely autistic, has been classified almost like a disease by some people we know. It's also to point out that once basic health care gets classified as an economic function (which the Tuesday arguments centered around) then the government can start claiming almost anything as an economic model and regulating it as same. Back in the 90's, pro-lifers were sued under the RICO statute. That could happen again, to people who don't buy health insurance.

This has been pointed out before, by people I both agree with and disagree with, but when government reserves the right to say who is worthy of life, and when the government reserves the right legislate every area of your life (and to some extent, both of these things have already happened,) then we're all in trouble.

A little P.S. to my UK relatives - I don't fully understand National Healthcare in England. My limited understanding is that people work, people get heavily taxed, and the government pays for health care out of those taxes. My understanding is also that it's a fairly straightforward transaction handled with limited bureaucracy. I once heard an Irishman say that Americans are undertaxed but overbeauracratized. The bill that was passed here in the US is not even close to that simple. I was urged to support this reform by one of my relatives (who shall remain Auntie!) but I don't think she quite understood how complicated this whole thing is. Or maybe she did, and I'm not giving her enough credit. Gee, it's not like I've ever been wrong before, right? Anyway, I know you all love a good debate. I hope you do, because otherwise I'm stirring up a hornet's nest. Gosh, good thing I've never done that before, either.




copyright (C) 2012 christopher w neal all rights reserved

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Comments 33 comments

internpete profile image

internpete 4 years ago from At the Beach in Florida

As a young adult, I tend to want less taxes, less government in my life, and less money leaving my pocket. Thus, I lean towards as little government run anything as possible. When I am old and in need of healthcare, I might change my mind... Some great points here, nice work!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

internpete -

I know just what you mean. I'm a bit ambivalent about it all myself. And a sick wife definitely changes your prioirities.

Thank you!

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Rad Man 4 years ago

Well done Chris, you have touch a lot of things that I often question myself. I hope you don't mind me giving my two cents. Wait Canadians don't have cents anymore.

I've asked an American friend to try to explain the American Health care and American Christianity to me, but he was not much help so, I'll try a little here.

Why do American Christians not want social healthcare? It seems to me that Jesus preached helping EVERYONE, not just those who could afford it.

Why do American Christians vote republican, when it's the democrats that would have more christian values (besides abortion, actually I don't think abortion was mention in the bible. I do think the church wants more christians)?

Publicly funded healthcare in Canada takes care of everyone equally. You can buy extra healthcare for dental or prescription if needed or if your lucky your employer can supply it. It just seems like the Christian way to me, and because everything is regulated by the government big farma, doctors and hospitals can't over charge. Ever wonder why retired American's go to Canada to get their prescriptions filled?

On another note, there is no link between immunization and autism, but there is a big link to antibiotics and some forms of autism.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Rad Man -

Thanks for reading and commenting!

As for the question, couldn't you have asked me something easier like a detailed explanation of String Theory or when I believe America will elect it's first lesbian Buddhist for President and why?

This in fact could be a long enough answer for a hub!

In fact, I think it will be!

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Rad Man 4 years ago

Please share.

internpete profile image

internpete 4 years ago from At the Beach in Florida

Chris - looking forward to the hub you will be writing!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Rad Man and internpete -

It's up! You can follow the group link at the bottom of the actual Hub!

phdast7 profile image

phdast7 4 years ago from Atlanta, Georgia

Chris - A thoughtful, reasonable presentation of the many facets and complexity of health care, who needs it and why, who has access, what happens when the govt mandates it, what happens to those who fall through the cracks. I appreciate the fact that you examine the issues from all angles. I am truly sorry for the situation your family finds itself in. Affordable (not free) health care or an expansion of medicare would assist so many people and with proper oversight costs could even be brought under control. SHARING

feenix profile image

feenix 4 years ago

Hello, Chris,

This is a useful, awesome, interesting, informative, thoughtful and brilliant article.

And it is of particular interest to me because I am a retired health-insurance executive and I worked in the health-insurance industry for nearly 40 years.

Also, I have broad knowledge of both Medicare and Medicaid.

That said, I have been "preaching" for years that the simplest and most logical way to make health-insurance coverage available to everyone in the U.S. is to expand both Medicare and Medicaid, and especially Medicare.

I could go on about the way such a plan would be carried out, but I will just say that if such a plan were carried out, that would go a very long way towards solving America's "healthcare problem."

Wesley Meacham profile image

Wesley Meacham 4 years ago from Wuhan, China

I like the fact that you offered more than one perspective in the argument. It gets tiring to read all the opinions of people who just know that they are right and that everyone else is wrong and that if people would only do things their way everything would all work out.

I've always been against government intervention in the lives of people. I tend to see all taxes and most laws with this mindset. However there are many things which I know could or simply would not be done without government involvement.

I'm curious about a lot of things concerning the proposed mandate, including how far reaching it would be. Currently I don't pay any taxes because I'm not in the country and my income is less than a certain amount. Would I also be exempt from having to buy health insurance if it was mandated? Probably, but who knows?

peoplepower73 profile image

peoplepower73 4 years ago from Placentia California

I hate the term "Slippery Slope." It's the same thing as a person who worries about everything saying "What if." You can get in an airplane and say what if it crashes. But the chances of it happening are pretty damm slim. The real issue here is how much power should the government have when it comes to promoting the welfare of the people for services that are difficult or impossible to provide for themselves? Great thought provking hub. Voting up and sharing.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

phdast7 -

Thank you very much for the comments. I agree in a way, that an expansion of Medicare and Medicaid would help a lot of people, but I see it as a short term solution unless a lot of people are willing to accept the sort of long-term higher tax rate associated with it.

Thank you for reading!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Wesley - I agree (and I know it sounds self-contradictory) with your view against further government intrusion. The extreme conservative view that government should only be responsible for the army and police and people should get to keep more of their own money is also seductive but neither likely nor even entirely reasonable. We as a society need to decide what it means to be "compassionate."

Thanks for reading, and thanks for the comments!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

feenix -

I think that a national discussion about healthcare that truly weighed all the different perspectives is long overdue. Thank you for your comments and your compliments!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

peoplepower73 -

Thank you very much and thank you for reading!

Gerg profile image

Gerg 4 years ago from California

Thanks for providing some rational, well-articulated thoughts on this issue, Chris. Your chain of logic is compelling...


Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Gerg -

Thank you for reading and for your comment!

Mr. Happy profile image

Mr. Happy 4 years ago from Toronto, Canada

Interesting write. I appreciate the fact that You looked at the situation from different angles.

To begin with, I do not favor mainstream doctors and what the pharmaceutical industry provides. I think people's health has become a business for others, a manner of making profit. In my opinion one's health is beyond money and thus, doctors should not get paid per visits. They have no interest in healing people if their way of making money is by having more and more people come to them. If they healed everyone and less people went to see them, they would go hungry.

Cancer procedures and treatment mean serious profit and there is no cure. No wonder.

With that said, I do think that any sick person should get treatement whether they have money or not. As I wrote earlier, I think health goes beyond money and profit. So, I guess I am inclined to say that a health care system for all should be in place.

I don't really see a problem with the government telling people that they have to be part of a health care system. I mean, people are forced to have driving licences, birth certificates, etc.

We are social animals, we live in societies and I guess we need social systems in place, with some rules and social safety nets for troubled times and such.

Thank You for the write. This is a difficult topic to explore as there are very passionate opinions floating around.

All the best! (And thank You to Mrs. Theresa for sharing this article.)

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Rad Man 4 years ago

OMG, Mr. Happy seems almost Canadian. Very well said.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Mr. Happy -

You make several interesting points. Thanks for the read!

And thanks to Mrs. Theresa!

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

I've discussed this a bit with one of my English relatives and a Part III may be coming soon...

Wesley Meacham profile image

Wesley Meacham 4 years ago from Wuhan, China

Having worked in a Cancer Treatment Center I can tell you that part of the reason that there is no "cure" for cancer is that every cancer is different and reacts to different kinds of treatments. Breast cancer acts differently than esophageal cancer and they both act differently than squamous carcinoma or non-small cell lung cancer.

I would not say that most doctors are in medicine for the money. Don't misunderstand me, I certainly believe that having a career which generates substantial income is a motivator for becoming a doctor. However, based on most of the doctors that I have known I think that a more important motivator is some strange kind of "god complex." Some of them want to help people because it gives them a sense of power. Others are more genuine and want to help people for the sake of doing good. While I understand the basis of Mr. Happy's statements, saying that doctors have no interests in healing people is much to broad of a statement.

I don't know if I would compare the requirement to have a driver's license (which you only need if you drive a car) or a birth certificate, with requiring people to purchase a product. Health insurance is a product. And I'm not sure that I want my government telling me that I have to buy something that I have to pay for every month. Although... you could make the argument that they already do with taxes. The only difference here as I understand it is that the health insurance product would come from a business that I would be paying.

Also, people often ignore the fact that if you don't have health insurance you can still go to a hospital and see a doctor. There are Charity hospitals and medical schools such as LSU Med Center where people can be treated for whatever problem they have even though they can't pay for it. I've been there, I've used their service, I didn't have to pay a dime. They sent me a bill in the mail. I made two phone calls and the bill went away. It may not cover everything. You can not choose the doctor that you see. You have to sit in a gigantic waiting room a hundred people other people, half of whom haven't showered in a few days. It also takes a long time to get in to see the doctor. But they do run lots of expensive blood tests and x-rays and all that and in the end it is free.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Wesley, thank you for your insights and explanations. Your comment about "people often ignore...(t)here are charity hospitals" is one of those double-edged swords. I'm not saying there shouldn't be such institutions, my wife has Stage IV uterine cancer and right now we are largely dependent on the kindness of strangers. But it does help to drive up the cost of health care.

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Justsilvie 4 years ago

Really well done Hub Chris!

I know there are many, many, many sides to this discussion, but the bottom line for me is I believe every civilized society has the interest of ALL its people at heart. And healthcare is something that should just be in that basic package. How we do that seems to have kept us from doing anything for a number of years now.

But I am always surprised that so many people ARE so indifferent here in the US to their neighbor’s plight?

We are a rich (and yes we are still filthy rich), materialistic, consumer driven and greedy super state and at the same time professes to be such a Christian Nation that we run our political campaigns with that issue as a vote gathering tool. SO what ever happened to Christ’s concept that “what you do for those in need, you do for me”. Why is the concept that if we all chip in we can serve all the people so foreign and repugnant to some?

As I said well done Hub, makes you just ask more and more questions, so I need to stop now.

Best wishes to you and your wife.

Kathleen Cochran profile image

Kathleen Cochran 4 years ago from Atlanta, Georgia

My neighbor survived state 4 breast cancer and I can only hope for the same success for you and your wife. Like Wesley, I worked for a cancer organization too, and there are many reasons to be hopeful for those fighting this disease today. Twenty-five people are alive every day who would not have survived 25 years ago because of advances in treatments. That's real hope. The American Cancer Society put the full weight of its most recognized reputation behind the passage of health care reform, and their only concern was for their patients. We need to think long and hard before we wipe this off the books and start over. It took 50 years just to get this beginning.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Justsilvie -

Thank you very much for your comments, and you ask some good questions. I wrote a part two to this and am thinking that a natural part 3 is coming pretty soon. Thank you very much.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Ms. Cochran - Thank you so much for you comments! I've found that when people are actually faced with people in need, it usually brings out the best in them. And I believe that ACS has the patients at heart. As I've said before, I think there is a real discussion to be had about health care and I don't think we as a nation have really had it yet. Thank you.

Kathleen Cochran profile image

Kathleen Cochran 4 years ago from Atlanta, Georgia

Chris: Someone raised you right, but you are more than welcome to call me Kathleen. And thanks again for the facinating hub. I've learned a lot from all the comments too.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Kathleen -

I agree, the comments section for this hub have been an education all by themselves!

dmop profile image

dmop 4 years ago from Cambridge City, IN

I personally think the government is far too involved in our lives as it is, but I do see the need for health care for those in need of it. I don't really have a good answer, but making everyone purchase health insurance doesn't seem like one to me. I think the biggest problem is the burying of real cures for the sake of profit, and it extends all the way to the FDA. For example there definition of a drug is as a product meant for the diagnosis, cure, mitigation, treatment, or prevention of a disease, while a supplement is defined as a product that is meant to simply "supplement" or "enhance" a normal diet within the daily allowances recommended by the FDA. This ultimately means that a retailer can't sell any supplements to prevent, mitigate, or cure anything. We need to stop pushing drugs with severe side effects and start looking at natural supplements as cures.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

dmop -

There's no question that natural supplements can have tremendous benefits. Thank you for reading and for your comments.

Vladimir Uhri profile image

Vladimir Uhri 4 years ago from HubPages, FB

I do not doubt the gov. healthcare is attractive. People like if they do not have to pay.

I see it differently I came from socialistic country. I use to be nurse and after one year became study for being medical Dr. with two specialty. In socialism which we are on the way is money making industry. This is why grab this industry future government is gazing for. Believe me government is unable to manage or create anything, just taking money, taxes and use control. Defending constitution and county was only Founders designed. The socialists came and promises anything (healthcare, peace, good life... ) but nothing delivered only hate and discomfort . Almost all people are confused.

Chris Neal profile image

Chris Neal 4 years ago from Fishers, IN Author

Vladimir Uhri-

Thank you for your comments. I agree that government is unable to produce anything in and of itself. I like to think that there are services that government can provide, but historically speaking that has seldom been the case. It is insteresting to hear from someone who actually came from a socialist country. Thank you!

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