My Thoughts on Health Care

As Christians, as we pursue understanding the issues concerning health care, we must consider our call towards justice and engaging with the alien, poor, and widow. I ask we consider the call of biblical justice and call to serve the poor. My friend recently passed on a verse that seems to be pertinent;

The righteous is concerned for the rights of the poor; the wicked does not understand such concern. (Pro 29:7)

As I viewed the news on town hall meetings I wondered if the un/under- insured were actual represented? Or were they serving the food, at the nearby McDonald’s or checking someone out of Wal-Mart?  Implicit in this though is the need to differentiate between under/un-insured.  I grew up in a family that was the former. My mom worked several jobs for the county to make sure we had insurance – my dad was/is on disability –, but the coverage was minimal. My mom shifted coverage between myself in my siblings. Sometimes she perhaps did this illegally,  but this is how we had medical/dental care. The craftiness of my mother was practical, but her working various jobs and piecemeal “ing” health care for us took a toll on her soul.

Politically, we also need to refrain from overstating the idea of public health care – and both sides need to less hastily compare to Canada; we are different countries with different cultures, needs, etc. The option that Obama and others are trying to put on the table is a public option, not a complete “government overhaul”.  When we overstate what is occurring we get into irrelevant ideological battles which, lead us towards divisions rather than decisions. That being said, a public option may not be as dangerous as many may believe.  I think of the parcel industry and the relationship between USPS, FedEx, UPS, and other companies, the public USPS option works with the other options and individuals can choose.

As a young American who has only experienced health care in contemporary age,  here are some imperfect ideas I believe can be utilized with or without a public option;

–          Tort reform. Simply a good idea.Too much money is going to litigation and protection from lawsuits.

–          Adjusting payment of doctors, many doctors are paid hourly, so the more the work the more money they receive. Perhaps setting salaries will help doctors slow down, give good care and cut overall costs. Additionally, despite the worry of litigation driving up doctor’s bills, most doctors are still being paid inordinate amounts – at some hospitals/offices at the expense of RNs, PRNs, CNAs, etc.  Although it would be a massive cultural shift, perhaps we can reevaluate a doctor’s pay scale. Yes, they need to be making enough money to be in line with their schooling and expertise, but what that exactly looks like may still need to be reduced.

–          National health care providers should exist. The model of not being able to go out of one’s state to find health care seems a little silly. Also, the elimination of networks seems like it would provide greater access.

–          Assure essential elements of any health care program. This is sticky; it is complex. There are some things like in-vitro fertilization and abortion that have been on the table concerning this, but need to be taken off.  However, there should be simple basic elements – which I am not qualified to compile – that should be covered in any plan. The issue is not having basics, but what we define as basics – again I acknowledge this is complex.

–          Conversely, we need to put some reigns on Medicare. There are perhaps too many of our seniors using Medicare flippantly because they are in fear of medical problems rather than actually having medical problems and because they can do so. My sister is a CNA and I have a good friend who is an RN, I can’t believe some of the things converged by Medicare – Viagra, to name one. A larger societal (and very much Christian) value would be taking more personal responsibility for our elderly and then allowing Medicare to supplement.

–          An indirect, difficult, but impactful way to deal with health care is to make the FDA do its job and eliminate/reduce the unhealthy food and the ubiquitous fast food market. Everyone knows it is not good for them, but choices are not always made with the head, they are made with the stomach, with what is readily available, and with the norms of our society.

–          Reevaluate our ER policy, it sounds horrible to turn people away from service, but if someone goes to the ER with something that is diagnosed as a non-emergency they need to be sent home.  Otherwise the costs of ER services drive-up cost of health care for everyone. The fear is that people will then not go to doctors, but if we normalize going to family doctors, and other non-emergency services many would begin to attend those first.

We should promote just social systems, but if public systems are unjust we must, as Christians, STILL must provide care for those who need it.  Be it free clinics, alternative insurance agencies, etc. Not having s just political or governmental system does not we are exonerated from creating our own justice systems – not solely being just individuals, because the two are intertwined.

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    • indyfromaz
    • October 11th, 2009

    But that doesn’t give Democrats the control over your every breath that they want.

    • Perez Christina
    • October 11th, 2009

    interesting views

    • jacksmith
    • October 11th, 2009

    CONGRATULATIONS! President Obama on your Nobel Prize. It’s well deserved 🙂

  1. Interesting post. Let’s see how things turn up. Anyway, I like your writing style. Subscribing to your RSS feed. 🙂

    • Mark Baird
    • October 11th, 2009

    Following is a GAO report on medical malpractice and could not find any evidence to substantiate the claims of lawsuits impacting health care costs, access to health care or defensive medicine (with one possible lose connection relating to OBGYN). But of course you will not see this report on any media outlet swinging left or right.

    http://www.gao.gov/new.items/d03836.pdf

    Remember the CBO report regarding the cost of a single payer system that we all grasped to support our arguments against a single payer system…

    Well, there is the CBO report which had this to say about tort reform:

    “But even large savings in premiums can have only a small direct impact on health care spending–private or governmental–because malpractice costs account for less than 2 percent of that spending.”

    http://www.cbo.gov/doc.cfm?index=4968&type=0#t3

    And of course there is Tillinghast-Towers Perrin (one of the largest in the world that provides risk management for the insurance and reinsurance industry).

    According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail.

    Of that 1 to 1.5 percent what portion of that is “frivolous”?

    http://www.towersperrin.com/tp/getwebcachedoc?webc=USA/2008/200811/2008_tort_costs_trends.pdf (Page 10)

    And then of course the report from Towers Perrin that states that the total tort cost in the US is 2% of the GDP. What percentage of that is “frivolous” and of that percentage what percentage is “frivolous” corporate lawsuits. So how much are “frivolous” lawsuits driving up the cost of everything? Maybe less than 2 cents on the dollar or maybe even less the 1 cent on the dollar?
    http://www.towersperrin.com/tp/getwebcachedoc?webc=USA/2008/200811/2008_tort_costs_trends.pdf

  2. Mark,

    I actually agree that tort reform would do little – at least at the beginning. If were are trying to use it as a silver bullet we are seriously in trouble because as you have shown savings are minimal. However, I am not opposed to minimal savings and I think there is more money getting sucked into the legal process than is often accounted for – not just malpractice issues. $30.4 billion may only be the hair on the end of the tail, but if we are talking about and English Mastiff – like health care costs – that hair is pretty significant and large. Nevertheless, you are right. I and many still overemphasize what tort reform will and can do. My thought is that it is a part of a broader reform, but not a core issue.

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