Sunday, August 30, 2009

Yours truly got an article published at AT.
You can read it at the American Thinker website. It actually started as an answer to a question. Which was essentially: Barring cost as a separately debatable topic, why not socialize the delivery of health care? The government already provides a number of critical services, such as fire departments, police and national defense. Why not socialize health care?

By constraining my response to not include a discussion of cost, I was actually able to focus on a number of social and philosophical reasons why it is a bad idea. My answer below.

Healthcare is a personal service, not a group service such as National Defense, Law Enforcement, and Fire Suppression. Each of those entities do not serve the individual, they serve the community as a whole. The police are under no obligation to protect you personally; if you need that, you need to hire someone. Fire departments suppress fire for the good of the area; if your building needs to be sacrificed so be it. Should you need better protection, again, you need to have your own equipment and staff. The Armed Forces? Well, 9/11 should tell you that even with their protection from foreign threats you are far from personally protected from harm. And should an armed force actually fight on US soil, you would find quite quickly, the fight is not about protecting you personally or your personal property, but protecting the freedom and sovereignty of the US as a whole.

Health Care as a group service is the horrifying tale where the individual becomes subservient to the greatest good of the state, just as in the above examples. The vexing problem with a socialist system for distributing health care is twofold. First each of us, should we not be killed suddenly, will reach a point in our lives where the health care we need to continue to live is either too costly, or does not yet exist. This establishes the paradox of an impossible question.

Philosophically the health care we need to survive cannot be a right if we all must face not having it and dying. The follow on part of that thinking then establishes a question, in the case where cost is the limiting factor: who determines if the care is too costly?

This is the second aspect of the problem. In the socialized system, eventually, someplace, somewhere, sometime, a government representative apathetic to your individual fight for life, will with a rigid budget and rules, make the decision that your life is no longer worth the peoples' effort to support it.

You will argue that private insurers make that call all the time, that statement while having the color of truth is completely false. Who decides what insurance to buy? I do. And in doing so I decide what is covered and what is not, and what limits if any are on the care provided. So the level, scope, and cost of my plan are completely at my disposal. So if I reach a point in my own care that lies outside my coverage, I can look only at myself and the agreements I made. But all is still not lost even in this case, should I decide the cost is worth it, and my assets sufficient, I can personally fund the care. Or I can make the decision to stop, if I decide the inevitable was upon my doorstep. See all of those 'I's in private care?

That is one true dread of socialized medicine. It robs the impossible question of the only humanity that can be offered, that it be I or my family, those most impacted, those emotionally vested, and those that must bear the cost, who make the decision of when to stop. I fear that decision to be made by the apathetic government bureaucrat, regardless of qualification. Again robbing from the most merciless point in life the comfort of choosing my own fate.

We walk this Earth not as ants with collective minds set to one purpose, but as conscious individuals, each physically, emotionally and mentally unique, with unique dreams and plans. The one size fits all egalitarian approach to medicine is itself a poison to this uniqueness, pretending that every life can have the question of physical care answered with one set of rules. It places within the providence of government the care of the individual's body, giving the former complete jurisdiction over the latter. If you accept the government has such juris dicta to speak what parts of your body might receive replacement or healing care, you must accept that your body is no longer your belonging, and also be ready to accept your caretakers instructions on how you might use the vessel they maintain. What foods you are allowed to eat, what activities you may participate, and for the utterly unscrupulous government what you may say and think.

No egalitarian goal of more equal distribution of care (note I will not say equal, because elitists will always have care far and beyond that of the peons beneath) is worth robbing health care of its humanity and individuality, a mirror of the humans it serves, as care of the mortal coil should be, personal and private.

Monday, August 17, 2009

Good People, Good Intentions

Listen children to a story that was written long ago. It was a great land with plentiful food and industrious folk. The people of this land valued their freedom very much. Within the cities peoples of all sorts gathered, and busied themselves amongst the industries of the day, smithing, accounting, assembling goods and such. The land was ripe with opportunity for those that had the will to pursue it. New ideas though flooded from all parts of the world, and gave rise to a profession, that would hold sway like it never had before in history. This profession provided a mere personal service… But the very fate of your life depended on it, or so it seemed. But how much it could move the threads in the tapestry was a sure function that depended not only on the quantity but also quality of service received. The profession was established from ancient times as private and paid, so of course those who had means received the best and brightest attention, while many that had not received none. It was then the great ideals struck the people of the land. Equality, it was said, was written in blood on the very paper s that made them a people. The rich should not be the only ones bending the skeins of fate to their favor; and did not society benefit when all were made better? An egalitarian initiative was sought to provide some of this great service to those less fortunate for even the smallest sum could in many cases accomplish wonders. The majority would still pay their monies for even greater quality but now some sense of egalitarianism was preserved as a public free option was introduced to the less fortunate. Then the peoples governing body saw the costs, and looked at the benefits, while many of modest means struggled to pay for their services, indeed in larger families the cost could become prohibitive. The next big step was seen, make the public option available to all, so that the modest and hard working would no longer be burdened with impossible choice of who had to go without inside of the family. Taxes would be levied, and though almost all would pay some, those with greater means would shoulder the lion share, for was it not true that their wealth was dependent on those below? With almost the same breath of a universal public option, the government spoke the universal requirement. All regardless of inclination or perceived need would be enrolled somewhere upon a plan that met the wise governments minimum standards, lest fines be levied. Soon houses of professionals that catered to the desires of modest of means disappeared, except for a small few that that catered to those whose special beliefs required special attention. The only private professional houses served the very rich, and lo, despite the aim of egalitarianism, they still had premium services offered at a premium price, which for the most part they gladly paid. The rest of the people participated in the public system. At first it was much like being private with nothing between the public customer and professional deciding what the best course might be. But government again looked at cost and inequity, and step by step, rule by rule, top to bottom, and generally in the name of efficiency and greater service, homogenized the system. Now the state would decide what course was best for all. A few generations later, the governments program would be considered a right, and while all had access to it, nearly all agreed that the service was a great disappointment on many levels.
If you have not drawn a clear picture of what I’ve put to words; it is clearly the United States of America, and a brief evolution of public education.
We entered on that path with the concept of a greater benefit for society and a value of egalitarianism echoed in the words that all were created equal. All would be given the chance at greatness then, only they had to stand up and take it. We reasoned that it was not a simple act of forced charity, because with such opportunity and education we would have a better citizen for participation in government, and a more productive person for participation in society. Now we stand with a similar circumstance, with a similar question. It would behoove us to ask ourselves some very difficult questions here. First examine our experience with our last great egalitarian effort. How did it go? How did it start? Where did it end in final form? What were our ultimate accomplishments across the board toward our goals in relation to what we had spent? What did we give up in the process?
We then need to look at our current debate and what our options are. A public option, would we ever expect it to stay “optional” given our experience with education. What of universal care; what is the payment back to society that justifies society’s indiscriminate outlay for a personal service. What level of involvement would we expect our government to have, today, tomorrow, and the next generation? Are we as comfortable with politicians deciding which medicines get purchased and what treatments are approved, as much as we are with them deciding which textbooks are approved, and what material must be taught? Though we might have been created equal it is not long after such we certainly become unique individuals; do we expect a one size fits all system of medicine to fare better than the same did for education? Or is diversity and choice far more valuable then homogenization and egalitarianism in this case?
In the end we must all face the impossible question. The moment when the care we need to survive falls as either, sufficient care does not exist, or is far too expensive. Our current system offers this moment, this question, the only humanity that can be offered. When I am approaching that moment, that horrible moment, it will be I or my family, those greatest impacted, who will answer that question. That is the only humanity that can be offered to death. It is what makes me different than my dog, I get to decide when I’m put down. It sounds horrible, but a horror story like none either Lovecraft or King ever penned is a government man behind desk and papers, with a big red stamp reading unapproved, arbitrarily administering a sentence of death.