Thoughts on health care reform

The core of the health care debate springs from an assumption that we as a society have a moral obligation to assure at least a basic level of health care for all members. Before proceeding we must recognize that health care has a cost - a very high one at that. Unlike our unalienable rights, we really can't guarantee unlimited universal health care, simply because we can't guarantee that enough health care will be produced. Try as we might we can't force health care to exist unless people produce it. So we're faced with a limited resource and the question becomes: how close we can get to the ideal of universal health care? This really brings us back to the original premise; do we as a society value it enough? Do we have sufficient good will to take care of the poor and needy? If not then I rather doubt that government mandate can create it. If so then we have to create an environment where that spirit of charity is protected and given the freedom of expression. Likewise, it is necessary to provide incentives for frugal use of health care lest people be tempted to take more than their fair share of this limited resource and take it away from those who need it more.

A price-coordinated system where people have to bid for the scarce resources of health care makes the most sense for achieving the second part but of course does not well answer the question of how to provide for the poor and needy, the main point that got us talking about this. We've got to couple the incentive to conserve with an incentive to manifest this collective goodwill to willingly give to those in need.

How do we do this? I don't know exactly but in my humble opinion it's not the federal government's role to do it. If government is the answer then it needs to be at the state level, where people are more accountable for how their tax dollars are spent (not to mention that it’s constitutionally prudent (see amendment 10) and because experience shows that the federal government is wasteful and prone to corruption and misuse when it delves into issues beyond those granted by the constitution).

There are some hard facts of life that we have to acknowledge. You simply can't guarantee any level of health care to everyone. There simply isn't enough to go around, so I think there needs to be some type of two-tiered system where everyone has access to some level of basic care and then there's another level for those who are willing to sacrifice and give up other things in life to get additional resources for medical care. For example, consider the parents of an autistic child who want to pay for cutting edge care that isn’t really a matter of life and death but it’s something they want to try. It's expensive but if they value it enough they should be able to pay for it and get it rather than waiting in line for forever.

In a nutshell here are my suggestions:
1. If people want to give to the poor via the government let them choose how to do so at the state or local level. In other words, get the federal government out of the picture.
2. Create a two-tiered system where specialized, non-life critical care carries a cost. This helps ensure that the most costly medical care gets to those who want it most.
3. Tax health care benefits (only those used, ie when you go to the doctor not if your employer or somebody pays part of your insurance) up to certain level to help incentivize frugality.
4. Remove the tax incentive for employers to provide health benefits. It is illogical and absurd for health care to be coupled with employment. Model it more like care insurance that is independent of who you work for and is priced according to a consumer level market.
5. Tort reform. Create a system where a person incurs a cost when losing a frivolous law suit. In other words, if you’re going to sue your doctor you need to have “skin in the game” not a system where you have nothing to lose for suing someone.

Thoughts? Feedback?

Eat the Rich

There seems to be a growing sentiment of hostility towards the producers in our society. I'm speaking particularly about the belief that those with more, the rich, should be taxed more than those who have less. This idea seems to rest on the notion that opportunity and luck dictate wealth and therefore it is unfair for anyone to have more than anyone else. But is this really fair? Do we strive for a world in which everyone is equal in what they have? Certainly there are people who produce more, who do more, and accomplish more in our society and I find it impossible to believe that this is bad. So often I hear the accusation that the rich are greedy, selfish, and uncaring. Such an irrational stereotype is not only untrue it promotes a type of thinking that would undermine a true notion of fairness and equality.
Admittedly there are greedy and selfish rich people who steal and cheat to get what they have but the vast majority of the wealthy people in the US are highly productive people who are no greedier than the general populous. I would even make the argument that those who demand an unearned handout from the rich are more greedy than the rich who are reluctant to have their property forcibly taken from them ala Robin Hood.
Trying to identify the underlying motives such as greed, charity, etc. however, is not very useful. It is more practical to look at the actual outcomes of government and social policy. The rich are the ones who drive the economy of our society; they create jobs and produce the things that all of us need like health care, cars, computers, software, food, and everything else. Burdening the producers with ever growing taxes is reminiscent of the goose and the golden egg, wherein one becomes so greedy for the goods that he kills the very thing that produces it.
I find it profoundly hypocritical for the thieves and abusers of power who occupy many political positions to label the rich as greedy and to suppose that they would be better stewards of their wealth. History has shown too often that their purported noble intentions betray an underlying greed and lust for control and power that far exceeds the accusations they point at the rich.
I believe that there is sufficient goodwill in the hearts of mankind that if given the right to property, freedom, and an environment of morality, the rich will give to the poor. They will help them far better than the meddling hand of government can because it will be done in the framework of charity and sincere kindness. If such goodwill does not exist then we are hopeless and no level of government intervention will save us.