People of faith need to be the steady moral drum beat driving the debate and keeping our politicians accountable. This is a critical and long-overdue opportunity to fix a broken an inequitable system which must not be derailed either by powerful special interests or by those, on any side to just want to score political points. It is up to all of us to make sure that doesn’t happen.

Yes. Yes. Yes. Long overdue overhaul, and much needed reform. Which is exactly why more government involvement is not the right solution.

You have a good point. IMHO, our current system seems to inherit the worst of both worlds. On the one hand, health-care is heavily regulated in terms of tort, who may practice, what drugs may be prescribed, and so forth. Government has perhaps foolishly mandated that people get the proverbial Cadillac, or nothing at all. On the other hand, there's price opaqueness, which makes it hard for market mechanisms to actually work. And yes, there is a moral dimension to the problem. Is it ethical to have a society where people with treatable/curable conditions are nevertheless allowed to get sicker/die because they're unable to pay for the care? (In spite of them holding a job, or at least are honestly trying to.)

I have repeatedly pointed out my misgivings on any "reform" that does not address total costs. There are numerous "right" leaning reforms that I at least would be really for, such as malpractice reform (reducing defensive medicine), open listing of prices and reviews by patients, changes to the patent laws to make drugs less expensive, and so forth. Also, studies have shown that paying providers by the amount of procedures performed leads to more procedures, but not better outcomes. So moving to a salary system would make more sense. The current system has a lot of inefficient "moral hazard" built into it, and does need changes.

Combine that with say an individual mandate coupled with a "must-issue" mandate, and we might be onto something. (Individual mandate - needed unless we're REALLY willing to let those who can't pay die preventable deaths, and must issue to avoid people with chronic disease from being unable to get coverage anywhere, or have them tied to their job due to coverage issues.)

There are some interesting points here, Thanks, Ngchen.

Jim, on the other hand, gives us "Same old Same old" plus the added astonishing claim that health insurance for Americans is apparently more important than feeding the hungry! The moral core of the debate is that Jim Wallis decided that the US government is the only acceptable vehicle for bringing in a quasi-religious utopia, and all other means and visions are to be derided as mean spirited or outright evil. Left out of the debate is true reform of the health insurance system, allowing companies to sell across state lines, and offer coverage tailored to human NEEDS, not the whims of ideologically driven state insurance commissioners. If you like abortion, you buy a plan that covers it. Otherwise, don't. This option, and many many others, are left out of the debate. Jim is an unpaid cheerleader for Obama's statist vision of the world. Jim's certain he's the only one capable of holding the moral high ground. Sorry, I was a big fan of yours back in the 1980's, but no more.

Due to technical issues with browser windows, I can only post near the beginning of the discussion. So, in response to: jdquest wrote, in response to WitnessforPeace:

What a good example. "Somebody" should assign everyone his section of the highway system to go out buy the materials, build and then maintain.

WitnessforPeace says: thanks for your feedback on my Interstate highway example[below].

As for human life questions, I think people are afraid that abortion will come into the tent via a government mandated set of minimum benefits, including abortion under "certain conditions." The Hyde Amendment, protecting me from funding other people's abortions through Medicaid, could soon be bypassed in a big way: lots of money, lots of abortions, and lots of troubling moral questions--not addressed at all in Jim's self proclaimed "moral imperative" above...

The worst lie that's being told here is that government-led reform will be a humane solution. There are so many examples around the world of the dangers in government run health care that one doesn't have to look very hard to find how bad it can be...if truth is really what we want to hear.

Just look at what happened in the Soviet Union. Government bureaucrats and Communist Party officials, as early as 1921 (three years after Lenin's socialization of medicine), realized that the egalitarian system of healthcare was good only for their personal interest as providers, managers, and rationers — but not as private users of the system. So, as in all countries with socialized medicine, a two-tier system was created: one for the "gray masses" and the other, with a completely different level of service, for the bureaucrats and their intellectual servants. Years and years later, the Soviet medicine had a earned a secure place in the medical hall of shame for reasons too many to list here. Infant mortality was among the highest in the world. There was massive malpractice in which the doctors at fault were never even reprimanded. It became necessary to bribe hospital personnel to receive even a basic level of care. Hospital staff were severely under paid, resulting in extreme apathy. It was common for them to come to work drunk. The general attitude was, "They pretend to pay us, so we pretend to work."

Bottom line: Socialized medical systems have not served to raise general health or living standards anywhere. In fact, both analytical reasoning and empirical evidence point to the opposite conclusion. But the dismal failure of socialized medicine to raise people's health and longevity has not affected its appeal for politicians, administrators, and their intellectual servants.

Most countries enslaved by the Soviet empire moved out of a fully socialized system through privatization and insuring competition in the healthcare system. Others, including many European social democracies, intend to privatize the healthcare system in the long run and decentralize medical control. The private ownership of hospitals and other units is seen as a critical determining factor of the new, more efficient, and humane system.


If you're truly interested in truth, take the time to find out what health care in England is like.

Socialized medicine will create massive government bureaucracies impose costly job-destroying mandates on employers to provide the coverage, and impose price controls that will inevitably lead to shortages and poor quality of service. It will also lead to nonprice rationing (i.e., rationing based on political considerations, corruption, and nepotism) of healthcare by government bureaucrats. In truth, any time the government interferes, the inevitable outcome will be, reduction in the people's free choice and protection of bad doctors and institutions from the natural consequences that come from people's free choice.

In supporting the call for socialized medicine, American healthcare professionals are like sheep demanding the wolf: they do not understand that the high cost of medical care in the United States is partially based on the fact that American healthcare professionals have the highest level of remuneration in the world. Another source of the high cost of our healthcare is existing government regulations on the industry, regulations that prevent competition from lowering the cost. Existing rules such as "certificates of need," licensing, and other restrictions on the availability of healthcare services prevent competition and, therefore, result in higher prices and fewer services. In other words, the reasons the system has degraded to the point it's at now is because of government meddling.

amen!

Yes, doctors are highly compensated, but not in comparison with lawyers. (Some reform of the tort system is essential as a partial solution.) In my experience, this attracts medical students who are highly qualified and motivated by excellence. Cutting down on defensive medicine and expensive, unnecessary diagnostics (XRays and MRI's for everything) is important. But nothing is as important as keeping bureaucrats and political cronies out of the system as much as possible. (This is difficult.) We keep electing lawyers to the White House and Congress in excessive numbers. If we had smaller districts and far more congresspeople, it might make sense for most of them to be lawyers. As it is, they have plenty of lawyers on their Congressional staffs, and the elected reps themselves almost NEVER read an entire bill—proving they don't need to be lawyers themselves.

I totally agree with your comments on tort reform.

The story of Israel's demand for a king provides us with some excellent basic principles to live by.

We should look to God as our provider, healer, provider of justice, etc. When we begin looking to government for those things, we're asking for trouble.

God's system involves freedom...the people interacting more directly with God, whether than having all of these middle men. People are allowed to make choices and people (doctors and hospitals) are allowed to experience the natural consequences of their choices.

Freedom, exactly. And I think the reference to Israel's demand for a king is relevant, whether one is a biblical "literalist" or whether you follow and concur with the line of reasoning God used with his people: "Practically speaking, this is what you are asking for--do you REALLY want this? Think about it!" which is what I hope people do, instead of just accepting Obama and Rev. Wallis when they assure us that all the changes will somehow be for the better, except for those bad, bad people who are motivatated by profit-- instead of by the undefined "morality" in Rev. Wallis's canting piety.

What! The government has no business in justice?

Quote:"We should look to God as our provider, healer, provider of justice, etc. When we begin looking to government for those things, we're asking for trouble."

Good point. "Romans 13:4For the [one in authority] is God's servant to do you good"
I think NATCOZ's criticism was directed at a government that sees itself as autonomous, not as a servant of something higher--the personal God who gave it a function, and the rules, like the Ten Commandments, that define "good."
And, on a personal level, why are some people so passionate about this being THE Solution, and THE Time to do good by expanding government dramatically? In what are YOU placing your trust?

Government is certainly the provider of justice. I don't see this as a justice issue, in biblical terms.

The goal is to find an affordable health care solution for the largest number of people. I simply don't trust government to provide that.

It's true, we are following some rabbit trails. But I think a solid philosophical understanding will give us firmer footing for further discussion.

Prior to Israel demanding a king, God, through God's judges/prophets were the providers of justice. I think one reason Israel demanded a king (aside from the problems with Samuel's sons) was because they wanted justice on their terms. Since God has a larger perspective than we do, his idea of justice can sometimes be to slow for our taste. So when daddy doesn't give you what you want, what do you do? We go to mommy. We look for an alternative authority to appeal to. Problem was, there was no such authority...until they invented one by placing a man in that position...king. One of the functions of the king was to provide justice, but that doesn't mean justice is best found via a king...or a government.

One of the tendencies.of governments is to crowd in on or invent other purposes for itself. So a government which started out with very few and restrictive roles gradually grows totalitarian. This is how government justifies it's existence. It can come in the form of a hostile takeover, or it can come as a sales pitch convincing us we need government. The concept of "state" takes over the government. Essentially, all along the way, the government is replacing God. So really, the state grows from a distrust of God.

God is our provider of justice? Absolutely! Unless we take matters into our own hands, in which case he'll back away. He says, "vengeance is mine." The implication for us that we should be patient and trust him. And if we can't, we'll go looking for another method...invented authority of government to give us justice now.

well put, Natcoz! And in respone to nathansmart: That's a great example of demonizing the rich, and reducing ordinary people (corporate employees and stockholders) into faceless pawns of an external evil force. While I don't deny that corporations have the potential, just like governments, to do evil, it's a fundamental Christian belief that the primary source of evil is the sinful individual, who expresses his or her fallenness in individual and corporate ways. The moral fallacy in Jim's "moral imperative" is
that he and his followers aren't evil, it's those “millionaires” and Republicans and coporations who are the problem. Not only is that obviously a false belief--or it should be obvious to a Christian--but it ignores that sad irony that millionaire Wall St. brokers and other assorted characters have learned to profit from the system and thus are massive supporters of big government, Obama style. Just look at 2008 records of campaign donations for proof. “All have sinned” which is why top-down solutions that ignore human sinfulness are bound to fail.
______________[begin quote]
nathansmart wrote, in response to WitnessforPeace:

When you give the power to corporations to decide our most important issues (especially issues of life and death) and you allow them to put a profit-motive on them - you are giving away your freedoms (just not to a government).
___________ [end quote] Unlike government, which essentially has no competition when it centralizes power, corporations, for all their faults, are answerable not just to shareholders but to competition from other coporations, who will provide a better insurance product if government regulations are streamlined, fine tuned, and in general lifted--like Jimmy Carter did to rescue the railraods from decades of regulatory strangulation in 1980. It worked, big time, and the environment, and our nation, are both better for his work on this issue (Staggers Rail Act of 1980)

What you describe in terms of what happened in the Soviet Union was very true. But that may well have happened because EVERYTHING was socialized there, and in the worst way. People got paid for doing the same amount of work, whether they worked well or poorly, and productivity was so low that the money they got was worthless. So yes, the joke then was that the people pretended to work and the government pretended to pay them. Under the Soviet system, money had very little value since even with money one couldn't get the stuff one wanted with the shelves being empty and such. That's clearly not the situation here, with money being readily traded for all sorts of materials goods.

The British NHS has its problems; the Canadian health-care system has its problems too. Our system has its problems as well. If we're honest, we'll admit that there is an asymmetry of information, and medical care is currently not a free market. There are perverse incentives on all sides; on the insured consumer to overconsume, on the provider to overprovide (since they're paid for doing more stuff, not to mention defensive medicine), on the insurance companies to minimize payments (so they have an incentive to deny any and all claims), and so on. On the bright side, reports of the Mayo Clinic and Cleveland Clinic engaging in actions that "work" at lower cost suggest that true reform is possible. Capitation schemes (where physicians are paid per patient, rather than for services rendered) create an incentive to do less, and *might* create a situation where lower quality care is rendered. But hopefully, if the rate paid is still a reasonable one, the physicians will provide the care they think is best, because they're in it to "help people" and their work is no longer subconsciously affected by financial considerations.

Tort reform has a lot to do with excessive regulation. People have to accept that we can demand good medicine, but not perfect medicine. Maybe a scheme similar to Workers Compensation, as is being tried in France, can help in that regard. I am thinking how reforms of drug patents (when there is a patent, there is a government-mandated temporary monopoly) can further help things. Trade longer patent periods for price caps, and maybe drug companies won't be stuck into destructive boom/bust cycles the way they often are now.

With all that being said, I remain firmly convinced that the status quo is unacceptable, with health-care currently eating up 1/6th of ALL spending. Paperwork is responsible for 1/3rd of health-care spending today, and hopefully the administration's push for electronic medical records can cut down on that.

and what is the solution then?

There are a lot of things for which there is not a solution in our world. This is not an excuse for making things worse. Can you accept the possibility that we will not get near perfection in this life? One thing is clear. Government is not the solution but may be the Final Solution if we put our trust in it.
Since neither I nor anyone can solve all the world's problems, it may be best to try to solve has been brought to me.
What I don't want to do is try to find out how to solve yet another government-caused problem.

Well put, thank ou dclark1

wow.