more health care

A few people have emailed or written comments responding to my “socialized medicine is wrong, wrong, wrong” post. I’ll address some of these responses here.

Emergency-room care

Just saw your latest blog entry on socialized medicine, and had the following question: what would you propose doing about someone who walks into an emergency room, deathly sick and with no insurance? Speaking of socialized medicine, I hope you’re feeling better. [I was sick at the time]

Before delving into specifics, this brings up an important point. I’m not involved in public policy, and I get frightened when asked “what would you propose doing about…” because what do I know? I basically just point out my perspective and oddly enough some people choose to read it.

I recognize that a free-market health care system is not going to be perfect or fair: not everyone will get the same quality of care, and not everyone will get the same bang for their buck. While various solutions may have various degrees of success in this regard, anyone who talks about completely fair and equal results from any system has little credibility with me. Too often government solutions are made out as if they can solve a problem perfectly, and be perfectly fair to everyone, and the harms and costs (monetary and otherwise) are not discussed. The other side seems under-spoken to me, and that’s a primary motivator behind the original posting.

The uninsured emergency question is pointed. Under whatever system we have, this situation is always going to come up. I did a wee bit of internet research on the problem: according to this document, only 30% of our health care costs go to hospital care. Then some fraction of that is emergency-room care. More federal and state health-care money is already being spent than it would cost to cover emergency-room care, so instead of more government, we might just need different government. It seems unfair to say that a need for socialized emergency-room care means we need government paying for all aspects of health care. I concede that public funding of emergency room care makes some sense, though I imagine the states could take care of that much, and it seems very unlikely that the federal government needs to have anything to do with it.

Vehement disagreement

I’ll try and paraphrase so the quotations don’t get too long. To see the original message, look at the comments on the original post.

  • me: what if I don’t want traditional health care?
    anonymous: let’s incorporate preventative care into our health care system.

    Preventative care has to do with a lot of other aspects of our lives, such as diet and exercise. Having the government dictate diet would be a tragedy, and having it subsidize certain diets would also not work. Different people need different things, and the government is notoriously bad at keeping up with the times, or even making the right decision in the first place.

  • me: what if I don’t want health care?
    anonymous: no one doesn’t want health care. [example of someone who does]

    This is almost not worth responding to, because I’m just repeating my original posting:

    Or maybe I’m truly crazy and buyng a new kayak is more valuable to me than getting painkillers for my arthritis. In a free system, the choice is mine; in socialized medicine, I’m paying for the painkillers.

    Furthermore, there are real-life examples of people who have chosen not to receive “health care”. Ivan Illich is one. I personally reject certain types of “health care” (many symptom-relievers, for example) that I’m no doubt paying for via higher premiums.

  • me: why should I pay for people who aren’t taking care of themselves?
    anonymous: you are already paying for it (via insurance premiums).

    True. I should have mentioned in my original posting that I’m not a big fan of health insurance either, especially the kind that covers every little thing. If I wasn’t already implicly paying for care through my employer, and if there were half-decent options for individuals available, I would probably have a very different kind of health insurance. Or in fact I might not have any. I, like you, reject the current system. I just disagree with you on what to do about it.

  • me: where is the incentive to take care of yourself?
    anonymous: people take care of themselves better when they can afford it.

    If you had 30% of your income taxes back plus some of your insurance premiums, do you think you could afford to take care of those teeth? I agree with your preventative care idea but I’m skeptical about a one-size-fits-all definition of “care”.

    I espouse, at least to some degree, the ideas of self-reliance and self-help. I understand that not everyone does. But should those of us who do be penalized for it, and discouraged from practicing self-reliance?

  • me: fru-fru lala argument about giving and receiving vs stealing and welfare.
    anonymous: Health care is a necessity … rich people inherited their wealth and don’t want to help others with it.

    The problem with the argument “health care is a necessity” is related to one of my previous points. It’s all interconnected. Health and diet and exercise and the environment are all interconnected. And they’re interconnected in nontrivial ways, that differ from person to person and from location to location. So how can the government know what’s right for everyone in every place? And again, will the government pay for what makes me healthier, even though it’s not what many others need? Will the government start taking control of diet and exercise too?

    In response to your point about rich people having “hard-inherited” money that they’re not willing to share—I disagree, at least with the generalization. Take a look at the beginning of this post.

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