I know you like the late Senator, and at one point I did too, but this emotional appeal to use his death to pass a bad bill is inappropriate. I, too, would like to "lay aside the rancor, lies, fear, and even hate that has come to dominate the health-care debate in America this summer" and President Obama must lead the way. Why did Senator Obama oppose Republican efforts to reform health care? Why is top-down, big government the only way to go? Why are insurance companies--owned by and employing ordinary Americans, being demonized? I'd like to invoke the wisdom of another Democratic President. Twenty-nine years ago he signed the Staggers Rail Act, ending the folly of government regulation of railroads. Our environment and out health, are both better. A revival in rail transportation resulted--and yet today we are acting as if it would've been better to nationalize the railroads, as we move towards national health. The most ardent supporters of Obama's bad bill ultimately want national health care. Why not be honest about THAT? To quote President Obama himself: “THOU SHALT NOT BEAR FALSE WITNESS.”

Amen! If Obama's bill is so good, the discussion should focus around it's merits, rather than using emotional ploys.

Mr. Wallis, please take the time to educate yourself on the topic of how government intervention affects a society. All the good intentions in the world mean nothing if we can't understand basic economic law and foresee the problems that will arise when government is let in. If you aren't willing or don't have the time to learn the other side of the coin, please refrain from trying to convince anyone to share your views.

Government involvement not only will make things worse than they are now, but is, in fact, responsible for the problems our system experiences today.

Following are some quotes from a very good article written by a doctor who has worked full time for 22 years in emergency care and who really understands our current situation and what's at stake in this health care debate.

On Obama's bill:
"That coverage would be "universal" is touted, but the fact that there are a finite number of physicians is never mentioned."

"It is a fact that the number of physicians has not kept pace with the increase in population. Yet this is not for lack of people willing to work as doctors. Even today, there are many more applicants to medical school than can be placed in the limited number of slots. Government rules and the abuse of government power by special interest groups such as the AMA are responsible for the mismatch between doctors and the population requesting services. The AMA and specialty groups use government, for instance, to restrict doctors in one state from practicing in another. No such arbitrary rule applies to nurses; nor should they apply to physicians."

"Not all healthcare services require an MD. By using the force of government, the AMA has been able to restrict the scope of practice of physician assistants (PAs) and nurse practitioners (NPs). When, more recently, PAs have been granted greater responsibility, it was not due to their sudden increase in skill, but to a successful battle against entrenched interests with political power."

"It is immoral for a professional organization to participate in, or to lend legitimacy to, any attempt by the government to control how care is defined and who will provide it. If doctors will be prevented by the government from offering their services outside of a government plan, this is further confirmation that coercion is at work. Indeed, if doctors are prevented by law to work outside of the plan — as is the case already in Canada, North Korea, and Cuba — it will mean the wholesale corruption of the profession of medicine."

"As doctors, we took an oath. We created the profession of medicine and claimed our standard required us to use our own best judgment at all times for the greater benefit of our patient. We claim we base our treatments on "the evidence."

"It requires freedom and an independent mind to evaluate the evidence. The evaluation process is the art of medicine. You cannot legislate integrity and competence into doctors whose minds and judgment have been regimented to follow "best practice" guidelines."

"It is a betrayal of our duty to our patient to use any consideration of some greater social good defined by the government to alter the best course of action for the patient. Our customer rightly expects us in the doctor-patient relationship to have his welfare as our absolute priority. It is immoral to use "average number of years of life a procedure would buy" — or any other government-inspired social utility — as a justification to limit the options we offer our patient. An attorney would be considered unethical if he used consideration of the greater good of society to influence his representation of an accused murderer."

Excellent points. I would be interested in finding out the number of doctors we have per capita, compared to other countries. Do we have a doctor shortage?

Now, in terms of "best practice" guidelines, surely you're aware of how medicine has developed to a point where the correct course of action for most situations is in the medical journals, albeit ever evolving slowly. In fact, deviations from best practice guidelines that result in harm are probably the quickest way to end up with malpractice allegations.

Bad governmental intervention causes problems no doubt. But not all governmental intervention is bad. Our current system is probably saddled with a series of problems, and I hope (but am not confident) that correct interventions will address and reduce if not eliminate them.

Overall problem #1: total cost is too high - unless this problem is addressed, no amount of insurance reform can solve anything, since insurance simply spreads the cost to more or fewer people.
Associated with that are (probably not inclusive)
1. Defensive medicine - currently, being sued is already bad enough, even if one does prevail in court. I've heard stories of tort cases outside of medicine being filed to de facto extort money (if the defense fights, the plantiff's *lawyer* simply drops the case having performed little work, and leaving the plantiff high and dry). Tort reform with damage caps on "pain and suffering," along with regulations on contingency arrangements can help. More radically, maybe adopting the British system, where the loser pays both sides' attorneys fees would help too. It would jive nicely with the biblical command discouraging lawsuits in general.
2. Shifting doctors to a salary system. The salary can still be a good one, but that would discourage the running of unnecessary tests and procedures. There has been documentation of how doctors subconsciously end up *generating* enough work to keep themselves busy, when the extra work translates to more personal pay. Mayo clinic doctors are paid off a salary, and it delivers some of the best care in the world.
3. Drug reform - Maybe the patent lengths on drugs are too short, forcing drug companies to charge an arm and leg when they do have a "hit" to tide themselves over the lean times. Maybe longer patent lengths, combined with price caps would allow drug prices to be more stable and low, and smooth out the boom/bust cycle of the drug companies. At the same time, advertising of prescription drugs on TV "talk to your doctor about drug X" probably is responsible for additional costs with more office visits, and patient demands for drug X which is inevitably under some patent.
4. People need to understand that while IMHO we have a right to good health care, we do not have a right to "perfect" health care. When formulating guidelines for good care, such has to be taken into account. The story about pap smears costing 10X what they used to due to unreasonable demands for a "perfect" one has caused them to be unavailable to those with lower incomes. In the end, no net lives were saved.
5. Actual competition. Doctors and hospitals have to be allowed to (and maybe forced to) put out price sheets, so that people will be allowed to shop around. Right now, prices are opaque, and a patient has little way of knowing how much something is going to cost, or how much it would be at another facility.
6. Paperwork reduction - I hear that 1/3rd of the health-care dollar nowadays goes toward filing the claim forms, processing them, and so on. The number is ridiculous, but it's probably due partly to each and every insurer and practice having their own specialized forms, weaving a web of incompatible stuff. Just like nuts and bolts have standardized sizes, standarizing forms (maybe even electronic ones) can lead to savings.

Not addressing net costs is a recipe for failure; dealing with them wisely is imperative for good stewardship.

One of the very few intelligent, practical and constructive posts about health care I've seen on God's Politics for quite a while.
Thank you.

Interesting comment about the AMA and Obamacare from Ngchen.
Here is another perspective on the percent of GNP spent on healthcare. The most obvious point is that simply using the number to say "too much" or "too little" is misleading. It also looks at the "big picture" of healthcare as part of our economy, rather than as a government run entitlement.
http://online.wsj.com/article/SB100014240529702...

I read the article you pointed out; the problem with the author's thesis is a mistake many people make. Namely, spending by itself is not good; spending that produces good results proportionate to (or exceeding) the spending is. Waste, for example, is not good, and no one can reasonably argue that hiring people to stand around and do nothing is good (despite the fact that they'll spend their paychecks, which will spur others to do the same).

I don't have a problem with delivering quality health-care. The argument that South Korea among others spend a lesser fraction of their GDP on health-care, and still have economic problems just like we do, is fallacious, in that causality and correlation are confused. They might be having problems in spite of having a lesser health-care burden, or we might be chugging along OK in spite of a heavier health-care burden, for instance.

Thanks for reading it. I don't necessarily agree, either.
From attending many medical events, I know that doctors are very sensitive to cost issues, both from a business standpoint, and as in response to Medicare legislation. Obamacare would make massive changes, when thoughtful and evolutionary change has not been fairly considered.
I think a bigger point is that many of our most costly healthcare problems (diabetes, heart disease) are driven by lifestyle choices. Are we to deny healthcare to the obese, or to smokers? This is a public health emergency, but there is no emergency in healthcare delivery. Yet Obama addresses the latter primarily, while blasting insurance companies and pretending that we don't have an outstanding healthcare system as an integral part of the US economy
Blessings,

Thanks for reading it.  I don't necessarily agree, either. 
From attending many medical events, I know that doctors are very sensitive to cost issues, both from a business standpoint, and as in response to Medicare legislation.  Obamacare would make massive changes, when thoughtful and evolutionary change has not been fairly considered.
I think a bigger point is that many of our most costly healthcare problems (diabetes, heart disease) are driven by lifestyle choices.  Are we to deny healthcare to the obese, or to smokers?  This is a public health emergency, but there is no emergency in healthcare delivery.  Yet Obama addresses the latter primarily, while blasting insurance companies and pretending that we don't have an outstanding healthcare system as an integral part of the US economy

Yes, there is a shortage of medical personnel, particularly in rural areas and especially in obstetrics (too many lawsuits). Government involvement always distorts markets, usually steering rent seekers to very particular programmatic choices. For instance, if a health bill passes incentives for any three specialties but no GP's, then the industry will gravitate in that direction. The question is, do you want Washington choosing who gets what, when, and where?

You have obviosly done much homework and I appreciate your unemomtional statements.

I do wish the focus of the conversation were more on what we all agree on: medical costs are simply too high, and too many people are not getting enough care. If only we could be clear about what is what: costs are one thing. Caring for the poor is another. We don't need one catch-all/ cure-all.

COSTS: We have a system that is far from opaque, and with so much cost-shifting going on (from employee to employer, from the uninsured to the insured; medicare to the insured; ER visits to other hospital services, etc...), it is hard for the doctors and hospitals themselves to explain what the cost of their services will be, let alone for the consumer to know how to make sensible choices. Here are my thoughts on how we can adequately tackle this:

1)The health exchange. Let us buy the policies we need, with only the coverage we need, and let us buy them across state-lines. My state has so many regulations, only 3 insurers cover the entire individual market. So I must pay for chiropractic care that perhaps I don't want or need (likely b/c chiropractors lobbied for it at the state level). And I can't shop elsewhere if those insurers keep raising my premiums without explanation. In other words, while we could argue till the cows come home about a single-payer (universal) system, maybe we could agree that what we really need is ONE system of regulation-- on a federal/ intra-state level, no plan can go without covering these minimum requirements. The rest is up to the consumer and the insurance agencies... a smorgasboard, if you will. Get the states out of the business of regulation and the lobbyists that come with it. Get a national health insurance exchange up and running so we can shop across state lines and free up competition.

2)End employer-based healthcare. For anyone facing a serious illness, the likelihood of losing your job is pretty great. Cobra payments would likely gobble up more than half of what you could get from social security. People not owning their own healthcare and making sensible choices early on about coverage puts them at grave risk.

THE POOR
1) Expand Medicare/Medicaid to cover the poor. The poor need to end up on someone's books... let's take the burden off hospitals and those who can afford insurance and just face up to the cost of our societal burden. Perhaps we can focus more funds on better preventative care and save societal money in the end, while doing better at taking care of our most vulnerable.

2) Last, I am not against a public option. But as long as states and a few big insurance companies have a stranglehold on competition, the insurance companies profit margins will remain fat, wise consumers won't have the desired effect of trimming costs/ forcing better outcomes, and those who are struggling to afford insurance just won't buy it. Let's make the whole system a little more nimble, and have the public option be yet another competitor to a robust market. People will find that the government doesn't provide for them like a more savvy, private company would, and only those who have no other option would choose it. But something is better than nothing, and this way we can require every American citizen to have their own insurance. No one can slip through the cracks, and no one entity will have to bear the responsibility/cost of making sure they don't. Again, this way we can societally encourage preventative care among those on the economic edges... (those most likely to have health issues such as smoking addiction, obesity, diabetes), and the benefits will be reaped by everyone.

The fact of the matter that we must all face is that whether you know it or not, you're already footing the bill for our healthcare problems. If you aren't, your employer is. Your job is likely at risk, or could be soon with the astronomical rise of premium costs. Maybe you're working more than ever before as they eek out the productivity of the few workers they can afford. Meanwhile, your state is paying for all the disqualified people with severe health issues. Your hospital is paying for all the ER visits of the uninsured, and next time you have a baby or a minor surgery, you will be appalled at how much your 20% copay amounts to... nor will they itemize the costs for you because they don't know, from year to year, what their services will cost, depending on how many uninsured they service at the ER. And meanwhile, people are dying from lack of care. So yes, like Jim Wallis, I agree we need to band together. But let's get serious about fixing things... not just applying bandaids that "seem" like they'll take care of the problem. Think, and pray, carefully!

Some of the points that WitnessforPeace makes in this post are really off the mark. Let's be clear about a few things... Single payor government run insurance is not even on the table in this debate (even though some Obama supporters would like it to be). Second, Obama did not come into this debate with a plan, just a set of guidelines that he would like to see followed in the creation of a healthcare reform bill. There is no "Obama Plan", or "Obamacare". He has asked repeatedly for a bipartisan bill to come out of congress, and the vast majority of republicans haven't even cared to negotiate, saying things like "If we can kill this bill it will be Obama's Waterloo".
I think the point that Kennedy and Wallace are trying to make is that whether or not you support a public plan, we have been commanded by God through scripture to take care of the poor, and heal the sick. Let's do that.

Amen again.
As I follow the good advice of not speaking ill of the dead, I implore those who are going over board about Kennedy to refrain from making him out to be something he wasn't. And shame on anyone who distastefully uses this man's death to push an agenda. Democrats don't need another funeral-turned pep ralley (ala Wellstone). And America doesn't need a guilt-trip health bill in this guy's name. And while some of us refrain from speaking ill of the dead, others need to follow Obama's advice and not bear false witness by exalting someone beyond truth.
Finally, as we think about the Kennedy family's grief, let us also recall the poor woman who didn't make it out of the water the night he drove her into it. Kennedy's death must be reopening wounds for them. And overexposure is mercilous to the victim's family. Think of how the Lockerbie families feel as they see the terrorist receive a hero's welcome in Libya. This is why I implore people not to exalt this man. In so-doing, his victim's family is slapped in the face again and again. And that is not compassion, it's evil. The best thing to do in this delicate situation is to allow the Kennedy's to grieve privately while the rest of us move on. Please, for the sake of Mary-Jo's family, let's move on quickly.

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Making the health care system equitably bad for most (not government employees and elected officials, mind you) is hardly a moral act.

Leftists like Wallis have no shame and will use anything to advance their political goals. Why stop here, why not co-opt the crucifixion and resurrection of Jesus?

"Why stop here, why not co-opt the crucifixion and resurrection of Jesus?"

1. Jesus > Ted Kennedy

2. This is certainly an emotional appeal, and emotional appeals are problematic for all the reasons we call out emotional appeals, but I don't think it is particularly shameful. I doubt Kennedy would mind having his death used as cause to advance his agenda.

Of course he wouldn't have minded: he was a leftist, too.

Right. But if I were to become a Senator (which: impossible) and devoted the majority of my efforts to, say, reforming adoption law, I certainly wouldn't mind if a James Dobson type argued that we should carry on my legacy by enacting this or that reform.

"I will not exaggerate others' beliefs nor make unfounded prejudicial assumptions based on labels, categories, or stereotypes. I will always extend the benefit of the doubt"
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