Thursday, June 28, 2012

Health Costs Defy SCOTUS Ruling

If you spent any time in the United States today, you'll be forgiven for thinking that nothing newsworthy happened except the Supreme Court's ruling on Obamacare.

Throughout our media spectrum here, that's all anybody's really talking and writing about.

Granted, what many people are saying about the SCOTUS decision isn't entire accurate.  The Supremes' majority opinion has little to do with whether or not Obamacare is good legislation, and everything to do with whether it's constitutional.  Republican Chief Justice John Roberts pointed that out.  And since, despite President Obama's disingenuous insistence to the contrary, the individual mandate component of the health care law is funded in part by what amounts to a tax, and our federal government has the constitutional right to levy taxes, five of the nine justices deemed that technicality sufficient to allow virtually all of Obama's Patient Protection and Affordable Care Act to stand.

Yet this act provides no patient protection from unaffordable care, and the cost of heathcare lies at the crux of our national debate on this issue.  Some people argue that they oppose Obamacare because it represents too much intrusion into private health matters, and that may be true.  Others oppose Obamacare because it implements unprecedented restrictions on religious liberty, and that is indeed disturbingly true.  Still others say Obamacare is simply a shell game in which taxpayers get stuck with paying for the healthcare of others.  A common interpretation of the complex law holds that people below a certain income level will be exempted from participating even in the individual mandate.

But don't taxpayers get stuck paying for the medical care of the indigent already?  And isn't that because of the cost?  It has nothing to do with the availability of healthcare.

Just Because It May Be Constitutional Doesn't Mean It'll Work

Some politically conservative critics of the Patient Protection and Affordable Care Act scoff at the notion that heathcare costs lie at the heart of our increasingly unaffordable medical industry.  Ideas that people like me advocate seem to threaten the very concept of Americana some right-wingers hold dear.

For example, I believe we should prevent ambulance-chasing lawyers from abusing our malpractice standards.  We should staunch the blatant fraud running amok in our Medicare and Medicaid systems.  We should reduce pharma extravagance, which is partially obscured by what may be excessively restrictive processes for FDA approvals of new treatments.

And we should all be encouraging healthcare consumers - that's you and me - to take more responsibility for how and what we eat, whether we smoke or drink alcoholic beverages, and how our pursuit of reckless habits and pastimes - ranging from rock climbing to skateboarding to not keeping ourselves hydrated in the summer - makes us more costly to insure.

I'd have thought right-wing Republicans would be all over things like reducing waste in our pharmaceutical industry, but then, I guess that would mean Republicans who hold executive positions in such firms would get paid less.

Why wouldn't right-wingers like the idea of holding Americans more accountable for how they maintained their health?  After all, if heart disease is one of the main medical concerns in the United States, and since most causes of heart disease can be easily controlled by diet and exercise, what's not to embrace?  I guess maybe that whole if-you-like-risky-activities-like-rock-climbing-you-should-pay-higher-insurance-premiums bit doesn't sit too well with folks who'd rather spend their spare cash on enjoying the great outdoors, rather than stale insurance invoices.

After all, risk is what built this country!  It's un-American to penalize people who take risks!  That takes the fun out of everything dangerous!

I could reply with this question:  what gives you the right to expect to pay the same insurance premiums I do when you're the one taking all these physical risks to your health, and I'm not?

Healthcare Isn't a Civil Right, but It's Not a Commodity, Either

But there's something even worse than the discrepancies of logic represented by people who seem to oppose the very notion that healthcare costs aren't the main problem:  the insinuation that it's OK to deny people healthcare because they can't afford it.

You won't hear these right-wingers phrase it like that; only Democrats wage class warfare, right?  But if you distill healthcare to just another commodity whose costs rise and fall based on crude free market theory, what are you doing?  You're putting money above life.

When you say, "Healthcare is a commodity; we simply need to pay the costs," you're saying that if only rich people can afford good care, you're OK with that.  Even if you're not rich, which obviously, means you're either not ever planning to get sick, or you've got a strategy to make it into the One Percenters club before you do get sick.

Either way, isn't that a terribly immoral way to look at healthcare and society?  "The love of money is the root of all sorts of evil."  It's not sacrilegious to admit that some things are more important than money.

Free market economics does not reward its players based on morality.  Indeed, morality is what keeps free markets from destroying a nation's economy.

Think about it:  human traffickers make a lot of money.  According to a bare-bones analysis of free market and supply-and-demand economics, the money human traffickers earn makes their industry just as valid as the nursing industry, or coal mining, or making surf boards.  But human trafficking is a despicable industry, isn't it?

All things are not equal in free markets.  Unless you have absolutely no moral compass or sense of ethics.

"United We Stand" is a Foundational American Slogan

Having said that, a civilized society should be able to come together and figure out those things that are important, and how they're going to pay for them.  Even though we're a republic, and healthcare is itself not a civil right, we should be able to agree that inequities in access to healthcare based on ability to pay is not in the best interests of national unity.  If I get mad because I can't afford a Lexus, I can still purchase a cheaper vehicle that I can afford, and it will get to the same place a Lexus can take me.  If I die because I can't afford medical care, and there's no cheaper way to avoid death, how is that ethical?  What does that say about the 'inalienable right of life" that's enshrined in our Declaration of Independence?

Isn't one of the purposes of government to help its people when there's no other way of accomplishing something?  I'm not saying that government-run healthcare is the solution.  But sometimes, laws and rules need to be established so fairness and access can be maintained.

For the most part, insurance works towards this noble goal of accessible healthcare because a whole lot of policyholders pay premiums but don't all need the same costly care at the same time. Hence my focus on costs. To the extent that components of our healthcare system are wasting money in areas that are not pertinent to healthcare - from the insurance companies themselves to hospitals to we healthcare consumers - we need to get rid of that waste to help control costs.

Isn't that an economic theory, too?  Lower costs mean greater access, right?

If you haven't read this essay carefully, it may sound like I'm an advocate for Obamacare.  But that would be because you may not understand what Obamacare really is:  a personal-responsibility-diluting, faith-bashing, pro-abortion, cost-ignoring government encroachment into not only the economics of healthcare, but the politics of personal freedom.  Even if it wasn't any of those things, Obamacare still does not address the fundamental problem with healthcare delivery in America:  its cost.

Republicans will rightly rebuff the SCOTUS decision today as too much concentration on constitutionality and too little concentration on whether this legislation really is the right bill for America.

I just hope that the common Republican aversion towards addressing blatant economic problems with our healthcare system doesn't scare conservatives away from working towards genuine, sustainable reform.  Since so far, Republicans have not made any attempt to take the lead on healthcare reform, I'm not holding my breath.  It will just raise my blood pressure.

And high blood pressure won't help keep my healthcare costs down.
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