Universal Heathcare - A Moral Dilemma

All this talk of Universal health care in the US has gotten me into some lively discussions. I've found out 2 things,

1) People who believe in Universal Health Care believe it is a right we should provide to everyone and they don't care about the cost in terms of Dollars

2) People who do not believe in Universal Health Care believe that the government controlling anything will turn it into a disaster.

Now those are broad generalizations. Me personally I come down closer to the second than the first but I digress.

The Dilemma

There seems to be something that is overlooked in most of the discussions I've had but it came up last night. I have to credit my brother. He mentioned it precisely, that we are presented with a moral dilemma, on the one hand, we aren't comfortable putting a value on human life. On the other hand, without changes, health care in the US will consume more and more of our income.

That is no more clearly evident by what is going on with Medicare in the US. Without changes it will soon consume the entire federal budget. Now with talk of Universal health care, and the trillions of dollars it will add to our debt, it just magnifies the issue that the only way to control cost is to ration care.

How do you ration care? You tell certain people there is no cost benefit to treating them. Whether it is because you are terminal, elderly or some other reason yet to be determined, this means somewhere someone is sitting down with a pencil and paper to determine what the value of a human life is worth.

Answers in the Declaration of Independence Vs. Constitution?

This sounds like a moral dilemma. In the Declaration of Independence the first inalienable right was the right to life. In the Preamble of the Constitution it clearly talks about promoting the "general welfare" as one of the reasons for establishment of this country. To promote this "general welfare", choices need to be made because as a country we can not pay for everything. (Notice it is not individual welfare!) I"m not a constitutional scholar but this does not seem to solve anything.

Seems we must decide this based on other criteria.

What is the Value of Life?

Deep question. My sense is that for most people it depends on how close it is to themselves. If it is you or someone you love, it is invaluable. If it is someone you never met who lives on the other side of the country well then it doesn't matter so much. That is my perception.

What I believe is quite different. I believe life is sacred. All life. I do not believe I am worthy to judge the value of someone elses life. I find people who do quite scary.

Now I know right now insurance companies decide who gets care and who does not.  The difference is that first you can appeal that decision to the government and they have the power to fix that.  Second, the insurance company has to make a profit.  If their service or reputation gets too bad, they will not make a profit and go out of business.  There is motivation and ways to pressure an insurance company.  Neither of these exist when the government is in charge.

Finally the big scary part of this is the use of what is called Comparative Effectiveness Research methodology. It basically places a monetary value on human life and decides in the abstract if the cost of treatment is to be given. It is one thing if an insurance company uses this type of process, at least you can sue them to overturn it but it is wholly another to try and sue the US government.

The very people who are supposed to benefit from this plan, the ones who can least afford to defend themselves like the elderly, mentally disabled and handicapped are the very ones who will have their care rationed. Make no mistake this plan means 2 things rationed care and higher taxes.

I really don't like what if's but what if someday they decide to factor in genetic predisposition to decide whether a person gets care?  Is it that much of a leap from what they are talking about? After all if you are genetically predisposed to getting cancer young why should we bother to care for you if you don't have the same life expectancy of someone who is not predisposed to cancer?  It is risking the cost of that health care. 

I believe that life is precious and a gift.  We can not play God.  Having the government decide who gets care and who does not and doing so without consequence is in a sense deciding who will live and who will not.  Our fore fathers declared that life was an important enough value to risk everything to protect.  Seems to me we should protect life as well.