Thursday, December 23, 2010

Thoughts on Discussing Health Care Policy with Those Who Favor ObamaCare

An interesting, brief conversation today with a relative who supports the PPACA (a.k.a. ObamaCare.) This individual also happens to be a physician, and someone I admire for his great compassion for others.

One of his concerns was that prior to the law, people with pre-existing conditions were unable to get insurance.

I don't do very well in short, on-the-spot conversations (how can I briefly explain that our current system of pre-payment for medical care by third party payers is not actually insurance?) but I do think about them later so if the issue ever rises again, I will be better prepared to respond. Here's a bit of retrospective my thinking.

If someone supports ObamaCare because of a sense of concern about the disadvantaged, a key point for me to make is that being compassionate is also a value for me-- BUT, I do not view coercion as compassionate. One of my primary goals is that we as a nation or a community find solutions to life's challenges that preserve a standard of voluntary interaction and that never condone any initiation of force.

In regards to pre-existing conditions and insurance, I wish I had said: you can not and will not help people who are sick by destroying the insurance industry, which is what the legal requirement to cover pre-existing conditions will do.

Coercion is not compassionate
The good is destroyed when you abandon voluntary interactions in favor of force.



Michael said...

you could have said need is not a value.

Realist Theorist said...

A few days ago, my doctor told me that he saw no other viable option except going for some type of single payer system.

It was clear that he was assuming that everyone has a right to healthcare. I commented that if some of the other approaches create a "two tiered" system, that was fine: poor people need not have 5-start single-patient rooms and so on at someone else's expense.

He seemed unconvinced, but when he next returned to the examination room to send me on my way, he said: "Run for president and I'll vote for you my friend".

The sense I get is that a lot of doctors are so beleaguered by the current system of insurance that they simply want to remove the pain by dealing with a single payer, even though they realize that such a system will screw them in other ways over the longer term.

Many of them have bought the notion that -- as doctors -- serving others is part of their moral duty. Of course, they also think they should be allowed to make money. I think they don't know how to make the moral case for themselves. They see a single-payer system as something that will address the moral dilemma, and they hope against hope that such a system will let them earn a good living too.

Chris Hibbert said...

>> One of his concerns was that prior to the law, people with pre-existing conditions were unable to get insurance.

But were they unable to get treatment? People seem to worry about insurance without paying attention to whether it affects treatment. I think the important things to worry about are whether people are going untreated, and whether any proposed fix will make it more or less likely that there will be improving treatment in the future.

One of the biggest problems with obamacare as an approach to treating a perceived lack of insurance is that it sets up the incentives all wrong. If you guarantee that everyone can get insurance (really treatment) when they need it, then there's little incentive to buy ahead of time, which is what makes an insurance system work. So the whole system will be more squeezed for money, and since we insist that everyone should receive whatever treatments are available, the obvious place to squeeze is on developing future technologies.

short-sighted people win in the short term, and everyone loses in the long run.

If we instead relied on a charity system to assure treatment for those who couldn't afford it, most people would strive to be able to afford insurance to ensure coverage so they wouldn't have to rely on the kindness of strangers. By changing the system to guarantee service to all, we reduce the incentive for people to pre-pay, undercutting the whole shebang.

HaynesBE said...

Thanks to all who have commented. It's Christmas Eve, and I am going to immerse myself in family for the next few days, but I will get back to thinking about what you have written in a few days.

One of my goals is to be able to have a brief statement ready at hand(an "argument while standing on one foot" sort of thing) to encapsulate the idea that what many think they are doing out of compassion, isn't really compassionate at all. And while I do not see compassion as a primary virtue, and certainly not a duty, it is trait I value.
Most people who act from compassion mean well. They are good people--and I want to be able to demonstrate them that when they use government force in attempt to achieve compassionate ends, they are not meeting their own goals.

Merry Xmas all---Peace on Earth and Good Will to Men!!