Jesus Creed

Jesus Creed


Obamacare: The Big Question

posted by Scot McKnight

ObamaGrav.jpgHere’s my question for you, and I ask you to look inside and tell us what you think really do think:

Do you think every American citizen is entitled to basic health care as a human rights issue?

If not, why?

If so, how do you propose the uninsured (45+ million) and unemployed — 30 million of us right now — be covered?

There is a chaser question: Is it possible for universal health care to be provided to all Americans without raising taxes significantly?



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ChrisB

posted August 20, 2009 at 3:06 pm


“Do you think every American citizen is entitled to basic health care as a human rights issue?”
I believe health care is a right. I do not believe that means someone else is required to provide it for you.
In American government, rights are defined as protections against government, e.g., against government infringing on our right to free speach. In terms of health care, no one should be denied health care by government. That doesn’t necessarily imply government has to provide it.
Now, we do provide food to those need it. And we can decide to provide health care (indeed, we have). But no one is obliged to provide anyone any particular service or any particular medical care.
That doesn’t mean I don’t think we can and should do better. But is someone being denied some fundamental right? No.
“Is it possible for universal health care to be provided to all Americans without raising taxes significantly?”
If you’re talking about some kind of single-payer system or government funded insurance for all, no. Can we expand Medicare/Medicaid or simply pay premiums for lower middle class families? Maybe, but I doubt it.



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:mic

posted August 20, 2009 at 3:10 pm


Healthcare is not a right, and should not be treated as such.
Our definable rights are life, liberty and the pursuit of happiness. This was written to be a protection of our right to live and prosper, but stops short at providing government-run healthcare. The problem with overreaching like this is in DEFINITIONS. Who decides what healthcare should and should not be included in the coverage? Is a nose-job covered? Augmentation of various body parts? Probably not, because they’re not essential. But what then of abortion? Is it essential? When or not?
At this point, then it is up to the government to dictate what behaviors are acceptable versus the amount of coverage I receive. Do I get liposuction because I ate too many Big Macs? Are smokers given free care when they develop lung-cancer? Should homosexuals receive AIDS treatments? These are not that hypothetical.
And once one person or party or leadership group determines what is and is not acceptable, it is no longer my decisions over my own way of living. In other words, loss of liberty. And liberty is a definable right under the Constitution of our country.
To your second question, even proponents (such as the President) admit we cannot currently pay for his vision. So . . .



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Kate

posted August 20, 2009 at 3:15 pm


First question: yes, no reason Americans should be denied what most of the developed world enjoys.
Without raising taxes significantly?
Well, since the average American already spends about 7% of their income on healthcare (including insurance), that gives you a bit to play with.
Then switching care of the uninsured from expensive care in the ER when they’re really ill, to earlier primary care should see costs come down significantly. (But only evidence-based screening, not just check-it-because-we-can.)
Proper use of evidence based medicine (use the treatments that work, not what the pushy drug rep recommends or the patient saw in a glossy ad.) will also reduce costs, and incidentally prevent some health problems that result from inappropriate treatment.
According to the many European/Canadian/Australian etc examples, it should be possible to cut US healthcare spending in half while improving quality and accessibility of care. Not sure what all that wasted money is going on though? (I’m a doctor not an economist)
Insurance against litigation? May be significant.
Uneccessary drugs and surgeries? If UK private care is anything to go on, I would expect this to be a big contributor to excess costs as well as poorer health outcomes. I have often seen the wealthy harmed by surgeries, drugs or investigations they didn’t need but were persuaded to have because they used private health care.



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Larry

posted August 20, 2009 at 3:15 pm


Our definable rights are life …
If one has a right to life, how can one not have a right to the things necessary to sustain life? To affirm a “right to life” without also affirming a right to things necessary to sustain life reduces “right to life” to a meaningless slogan, devoid of all content.



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Larry

posted August 20, 2009 at 3:20 pm


Could we have universal health care without raising taxes? Sure, its just a matter of priorities. After all, Washington didn’t have any problem funding the Iraq war or the bail out of foolish and incompetent bankers. If we have money for that kind of destructive and senseless spending, we shouldn’t have any problem finding the funds for basic medical care for everybody.



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AHH

posted August 20, 2009 at 3:24 pm


I don’t like the word “entitled” in the question (I recognize it has been used by both sides). Makes it sound too much like something in the category of “life, liberty, & the pursuit of happiness” (not that all items in that Trinity should necessarily be top priorities for Christians).
Here’s a better way to ask it, I think:
With the resources of the United States, is it good and right for the government to ensure that all Americans have access to basic health care?
And of course as Christians our criteria for “good” and “right” should be driven by the Gospel (I’m not claiming that makes the answer obvious).
This phrasing makes it similar to the way “basic education” is provided, which is the closest parallel I can think of in our society. I’m not necessarily saying the answer must be yes, but I think the debate goes in unproductive directions when absolutist words like “rights” and “entitled” are injected (whichever side injects them).



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Kate

posted August 20, 2009 at 3:25 pm


:mic- “At this point, then it is up to the government to dictate what behaviors are acceptable versus the amount of coverage I receive… And once one person or party or leadership group determines what is and is not acceptable, it is no longer my decisions over my own way of living. In other words, loss of liberty. And liberty is a definable right under the Constitution of our country.”
Do you mean that if you have health insurance in America your insurance company must pay for any drug or procedure you feel you need because otherwise they would be infringing your constitutional right to liberty in your “decisions over your own way of living”?



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floridamk

posted August 20, 2009 at 3:32 pm


I think most people in America have access to health insurance and medical treatment. There are government and private health insurance programs. Most of the people without insurance have not been denied coverage; they cannot afford the premiums or they simply choose to not pay the premiums. My premiums recently increased to a point that I could not afford them, but no one denied me coverage. I shopped around for coverage that I could afford.
I would be in favor of a tax if everyone were taxed an equal percentage. I discovered this information in a bible study, “When Did We Seee You Hungry?” – “With this Jewish tradition tells us that even poor people should give money to tzedakah. While the Hebrew word ?tzedakah? is often translated as charity, it involves more than simply putting money in a coffer. The word tzedakah comes from the word ?tzedek,? which means righteousness. Doing ?tzedakah? involves being a righteous person. Tzedakah is a mitzvah?an obligation?not simply an act of kindness. On Yom Kippur, we announce that, only through tzedakah, repentance, and prayer can we avert the evil decree. Only by giving tzedakah can we live full, meaningful lives. The obligation to give tzedakah is not only held by individuals, but by society as a whole. Throughout Jewish history, much of tzedakah was done through tax-financed, community-run programs that provided for the poor, the hungry, the ill, and the children.”



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MattR

posted August 20, 2009 at 3:37 pm


First Question:
Yes, health care is a basic human right. But I don’t think the language of ‘rights’ quite describes it from a Christian perspective… maybe talking in terms of imago dei/icons of God, or the dignity of human life as creations of God. Why anyone can call themselves ‘pro-life’ and not care about providing health care for all, I don’t get. Until we care as much about life outside the womb as in, many will see this as a major hypocrisy.
Second Question:
Depends on what you mean.
I think we can provide coverage for all, or at least those who can’t afford it, without a tax increase on the middle class. And as far as cost?… as was mentioned above, a tax increase of a few percent is nothing compared to the rising cost of health care we currently pay!



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Jjoe

posted August 20, 2009 at 3:41 pm


It’s ironic that secular counties consider health care a basic human right, while Christians do not. Why is that?
Why do atheists and people who don’t go to church feel a greater concern for their fellow man than those who follow God?
And before you say it, that’s not a strawman. The facts are that:
– Many Christians oppose health care
– Secular nations see it as a fundamental human right
– Christians suggest the church ought to be doing it, but secular nations actually put their money where their mouth is.
Which of these are sheep and which are goats?



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Christine

posted August 20, 2009 at 3:48 pm


The figures tend to be all over the board on the number of uninsured. A recent report that I put some stock in indicated that 50% of the 47 million uninsured CHOOSE to be so. A large percentage of them are single men in their 20s who don’t see the need and would rather spend their money on other things. Another signficant portion are those who DO qualify for Medicaid or for state assisted programs, but choose not to do the paperwork.
I was a Barack supporter, but am deeply disturbed by the continued disingenuous where he asserts, even now, that if you like your plan and your doc, you can keep them. Not necessarily so if a public option is on the table and employers due to costs elect to go with a less expensive health plan, ie, public option.
But I digress! I AM intrigued with what Massachusetts has done which has worked incredibly well to bring down their uninsured rate by requiring that folks DO elect health insurance, and if they don’t they lose a tax deduction. It’s been a whopping 1% of their state budget.
Although that doesn’t tackle the unemployment question as Scot mentioned, it is an incentive for folks to purchase insurance (and in my state, on a very reputable plan, it’s $150/month for a single male in his 20s!), and the problem can be addressed without embarking on the very costly path we seem to be headed towards.
Do I think it’s a right? No.
Christine



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Travis Greene

posted August 20, 2009 at 4:08 pm


I’m not a huge fan of the language of rights, so I’d rather flip this one around. Do we, as a nation, have the responsibility to see that everyone has access to basic healthcare?
Or even simple pragmatism: Would it just work better if we did healthcare collectively rather than individually?
I respect my more libertarian friends who think a truly competitive free-market system would drive down costs and therefore increase accessibility, while giving folks more control over their decision-making when it comes to health. But I am distressed by the tone of some who seem more concerned about having to give up some percentage of “their” income to help another human being (horrors!) than they are about that human being not suffering and dying and going bankrupt in the process.



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Kenny Johnson

posted August 20, 2009 at 4:17 pm


Jjoe,
Excellent question. I think whether healthcare should be subsidized or provided by the government is debatable among Christians, but I think saying that not everyone deserves basic healthcare is not something we should be debating. And I assume most of here, even those who have said, “healthcare is not a right” would agree with that.
My own feeling is that yes, as the world’s wealthiest country, we should use the power of the government to insure that all people have, at the very least, access (meaning they can actually use it and aren’t denied by money or anything else) to life-saving, and life-lengthening healthcare.
As a society, we thought it good that all our citizens be educated, but we don’t think they should also be healthy? It seems strange to me.



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RJS

posted August 20, 2009 at 4:19 pm


Travis,
I agree – I am not a fan of the language of rights and entitlements either. I think that the system would work better with some more equitable shared risk for big ticket health care items.
Basic healthcare? … well what is meant by this? I find the issues getting all tangled up.



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samb

posted August 20, 2009 at 4:24 pm


“Do you think every American citizen is entitled to basic health care as a human rights issue?” No, but if you change the wording as suggested above to “With the resources of the United States, is it good and right for the government to ensure that all Americans have access to basic healthy care?” Or “Should Americans be denied what most of the developed world enjoys” then yes.
I don’t think we can do this without raising taxes at the beginning. The goal to lower health care cost must be met. Then we can lower taxes later. Everyone should pay some additional form of basic health insurance to help spread the cost. Also, we need to build into any plan powerful incentives to encourage us to live a more healthy lifestyle.



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Dave

posted August 20, 2009 at 4:24 pm


I say no. Healthcare is not a basic human right of every American citizen.
Why would I want to pay money out of my income to the US government (the same US Government that sent taxpayer’s money from the stimulus fund to pay for pornos and $700,000 worth of ham) to be alocated as they see fit for health care? I don’t think that we have any right to force anyone to pay for other people’s health care out of their income.
The question is about funding health care through the government. The government isn’t the church and this nation isn’t a Christian nation (see the outcry about the Patriot Study Bible). We need to stop confusing the two.



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ChrisB

posted August 20, 2009 at 4:29 pm


@Jjoe
“Many Christians oppose health care”
Name one.
What you meant was “Many Christians oppose health care reform.”
Also not true.
Many Christians oppose government run health care.
Many Christians think the proposed solutions will create more problems than they’d solve.
Many Christians oppose a federal solution for every problem.
Many Christians would like the conversation to be more than simply “Obamacare: yes or no.”
@Scot,
Maybe a good question for another day would be, “Setting aside for the moment the notion of government-funded health care, what other ways could we broaden access to health care insurance and lower health care costs?”



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Dan B.

posted August 20, 2009 at 4:39 pm


Quickly, I echo some of the above. It’s a responsibility of us to care for the neighbor’s health (think what”Thou Shalt Not Kill” implies when one thinks about the positive side, “thou shalt. . .”)- who does it, how it happens of course is where the debate enters.
More to the point of this present debate, I find it strange that people aren’t paying attention to the bill Sen. Coburn of OK(who is a doctor) has introduced. http://coburn.senate.gov/public/index.cfm?FuseAction=Files.View&FileStore_id=d4eab376-d507-4fb9-9f17-8b479a10affc
This is a plan that avoids creating a government or even coop option, but instead focuses on common sense pieces that truly can reign in costs while also keeping the choice with us as individuals. It pushes some great pieces by spurring competition between different health insurance providers, allowing individuals to shop for plans that fit their needs (presently we get whatever our business chooses for everyone), mandates that all people can be covered, focuses on prevention programs and funding that rewards prevention programs that work, tightens up federal spending by reducing fraud, reduces litigation costs through independent panels that could view many of these cases, brings medical records into the electronic world, gives tax cuts to help all people afford paying for a plan that fits their needs. All of this is done with government supervision rather than being run by the government.
I think there’s a lot to love in this and I encourage you all to start pushing this with your representatives.I like it because it maintains free market principles which encourage competition and choice which control costs while also allowing for supervision and government subsidies which inject more grace into the system.
I think this is an option that allows all Christians to be for something positive rather than simply against something negative.
Peace!



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tscott

posted August 20, 2009 at 4:43 pm


Basic health care is the question….if it’s similar to basic education in the USA then no. Now healthcare is a different issue. You think I’m just being semantical. The devil is in the details.



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Robyn

posted August 20, 2009 at 4:56 pm


Personally, I prefer the term “public good” to “human right.” Health care is a public good that, like education, should be distributed based on need rather than on income or ability-to-pay. Unfortunately, neither (health care nor education) is something to which people have equal access. But then, I am an idealist and would like to strive for the most just and equitable treatment of all that is humanly possible.



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Your Name

posted August 20, 2009 at 5:02 pm


As to questions 2 and 3: I’m not really an expert, so I’m not sure about the minute details regarding how it would be done, but I am not opposed to a public option. I see other countries have “universal” health care and wonder why on earth we couldn’t do it. I don’t know if our taxes would go up. Probably. But if you took the $8,000 a year it takes to insure my family of 3, cost that is shared by me and my employer, wouldn’t that be enough? Would it take that $8,000 PLUS addiitonal taxes? The U.S. already spends more per capita on health care than any other nation. Perhaps the problem is where and how that money is spent. Surely there are minds more educated on the subject than I, dare I call them “experts,” who could figure out how to do this?!



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tscott

posted August 20, 2009 at 5:03 pm


Just like education, you have to leave those that don’t want it(they tell you by there actions)out. But people are afraid to let them out of school. For fear.. reasons. They are just children who don’t know what they need. And the system has degenerated to a sham of what it once accomplished. Talk of fool me once. Let’s talk about retirement also, and what Social Security has accomplished. Or welfare and what it accomplished for those financially insecure. Or giving mortgages to those without homes that didn’t have the downpayment or monthly means to pay for them.
In Washington in 1993 to become a missionary to Burundi we did side trips to those working with the homeless. Mitch Snyder was all the buzz and as a Viet-nam vet I had some empathy. He was in, and receiving all types of federal budgeting. His centers were atrocious. Rape, drugs, obvious money grubbing. A well thought of Episcopalian church was doing much better, but was not much more than a place to get fed. A young Roman Catholic friar with a row house in a poor neighborhood was doing the real work with the homeless- I’ll name it-The McKenna House. Homeless people were leaving the program with places to live and with work. The process was complicated, hard work,
may I say prayer filled. The biggest secret though was that some people, through up front, screening had to be left out.



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politheo

posted August 20, 2009 at 5:08 pm


I think there are some great points made in these comments that get to the larger point.
First, to answer the question, “Do I think health care is a basic human right?” Not necessarily, but if we as American’s and followers of Christ claim that “life” is a basic right, than if we have any sense of compassion we can’t just oppose Obama’s proposals without a compassionate alternative to people who are suffering physically and financially because of the broken, compassionless system we currently have.
I don’t think the federal government can solve this solution, but I understand how liberals see the problem as something that is inhumane to ignore.
I agree with someone who mentioned that we need to learn to separate our citizenship in the Kingdom of God from our citizenship in the USA, and with that said, as members of both we have to look to one them for the answer… I choose the former! So, what is our Kingdom going to do about millions of people in the richest nation on earth who can’t take care of their kids when they get sick? How are we going to “heal the sick”? How can our “people” help the other who are in need, since we all know that this manmade government can’t do it?



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Kyle

posted August 20, 2009 at 5:19 pm


@Dave #16
“The government isn’t the church and this nation isn’t a Christian nation (see the outcry about the Patriot Study Bible). We need to stop confusing the two.”
Here’s the thing: If you’re going to apply that thinking to health care and other economic issues, don’t you need to apply it to issues of a more purely moral nature? Abortion and gay marriage, to cite the two big issues.
This is my biggest concern in terms of the way conservative Christians are engaging this issue: If we talk like libertarians on economic issues, we don’t have much ground to stand on when we advocate government intervention in other areas (for example: preventing two homosexual men from effectively entering into a contract [marriage] with each other.)
@ Travis #12
Agree wholeheartedly that it’s more about responsibilities than it is about rights. The analogy with education makes a lot of sense to me. Is there a “right” to education? That’s a pretty abstract question. But there seems to be a consensus that, as a practical matter, society has a responsibility (and, indeed, that it’s in our self-interest) to make sure every person has the opportunity to receive an education. This involves a lot of government mandates/funding/control. Does the same general principle apply to health care?



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Scott

posted August 20, 2009 at 5:36 pm


I believe that health care is a basic human right as far a society is able to provide it (which we are).
But how should we go about doing that is a very important issue. The following scenario happened just last week at my local hospital.
A woman who is morbidly obese is in the hospital to receive treatment for a health issue directly related to her obesity. She files government forms to get her $4 a week prescription paid for by the state because she claims she cannot afford it. Later that day, while still in the hospital, she eats a large meal from a fast food chain that costs over $7. Next to her bed is the untouched low fat meal provided by the hospital and paid for by the state.
Should the federal government pay for her procedures which are caused by her consistently poor choices? Should the federal government pay for her prescriptions when she has enough money to waste healthy food and spend almost twice the price of her prescription on one one unhealthy meal?
Please don’t get me wrong, I also know of a child who needed medical care and his parents could not afford it and I am without hesitation in allowing our government to pay for that care.
So where is the balance?



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Joel

posted August 20, 2009 at 6:12 pm


As a dual Canadian/American I’m honestly confused by the American reluctance to extend health care. In Canada, the quickest way for a party to be voted out would be to even suggest getting rid of our universal health care system. Sure, there’s room for improvement. My wife is from the UK where there is even greater health care coverage. Nevermind “rights”. Our systems stem from a belief that we’re equally valuable as human beings – no one more or less.



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Scott

posted August 20, 2009 at 6:25 pm


Joel, the issue for many Americans is more personal. Similar to what I wrote in my previous post, I heard a man today ask, “Should I pay for the medical care of my neighbor who smokes four packs of cigarettes a day?” This concerned man exercises regularly, eats healthy, and gets regular checkup exams. He is part of a medical co-op group that decreases his premiums because of his healthy lifestyle.



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Timmy C.

posted August 20, 2009 at 6:45 pm


Isn’t health care an intrinsic part of having a “right to life?” to coin a phrase?
No matter your income, you have a right to a lawyer in this country, but until reform passes, you have no right to a doctor.



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Barb

posted August 20, 2009 at 6:49 pm


“Should I pay for the man who smokes 4 packs a day, or the fat women who over eats?”
I think YOU already do–in the high cost of your insurance and everything else related to your health.



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Dave

posted August 20, 2009 at 7:18 pm


Kyle @ #24
I think you’re mixing apples and oranges by comparing the health care issue, which is government taking my tax money and spending it how they want to spend it, to abortion. Since I believe abortion to be murder I think that the government should also consider it murder. I’ll gladly fight for the government to outlaw murder. I will not support the government requiring income earners to pay for other people’s health care.



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Rachel H. Evans

posted August 20, 2009 at 7:28 pm


I think that most people believe that health care is a right, even when they say they don’t.
Here?s why:
Let?s say a ten-year-old girl is brought into the local ER with life-threatening injuries sustained from a car accident. Let?s say she needs treatment immediately. Now, let?s say her parents are uninsured and can?t afford the life-saving treatment she so desperately needs.
Should the girl be turned away because of her inability to pay? If you answered no, then you believe she has a right to health care.
The fact that most Americans actually believe that their fellow citizens have a right to health care (which is a good thing) is one of the reasons why the system is so screwed up right now (which is a bad thing). The truth is, we are already paying for health care for the uninsured. In America, a person cannot be turned away from an ER because of his or her inability to pay. So that little girl will get the treatment she needs, the costs for that treatment will be absorbed by the hospital, and you and I end up getting bills that show we paid $100 for a Q-tip when we stay overnight for surgery. Our ERs get crowded with the uninsured. Costs go up. Premiums go up. Everything goes up… except for fair and reliable insurance coverage, which goes down.
We may disagree about how to fix health care, but I hope we can agree that this basic sense of right and wrong that compels us to provide care for that little girl dying in the ER is not the part of the equation that needs fixing.
We all assume that health care is a right; perhaps a better question is whether AFFORDABLE health care is a right.
I’m not sure I would use the word “right” for the latter, but in the wealthiest country in the world, I think it’s a shame that so many of my friends and family either can’t afford health insurance or have been completely screwed over by their insurance companies. (I saw a cartoon last week with the caption, “A liberal is a conservative who got screwed by his insurance company.”)
How to pay for it?
Maybe cutting back on some of the wasteful spending in Medicare. Maybe repealing the Bush tax cuts for the wealthy. And I actually kinda like the idea of adding an extra tax to soft drinks!
Go ahead. Call me a socialist! :-)



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Scott

posted August 20, 2009 at 7:38 pm


Rachel,
I think you made some excellent points. Thank you for your voice.



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John

posted August 20, 2009 at 8:09 pm


Note that most countries who offer high quality free health care are not spending half of their tax dollars on military-related expenses (http://www.warresisters.org/pages/piechart.htm). I like the idea of universal health care, but there’s only so much tax revenue to go around. I DON’T like the idea of government control of health care in any way, shape, or form.
As a start, we could mandate that all health insurers be non-profit entities with reasonable incentives and restrictions on executive salaries. My health plan (Blue Cross) is a non-profit, as are the two other largest providers in California.
Someone sent me one of those chain emails the other day:
Let me get this straight.. Obama’s health care plan will be written by a committee whose head says he doesn’t understand it, passed by a Congress that hasn’t read it and whose members will be exempt from it, signed by a president who smokes, funded by a treasury chief who did not pay his taxes, overseen by a surgeon general who is obese, and financed by a country that is nearly broke.. What could possibly go wrong?



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Jjoe

posted August 20, 2009 at 8:42 pm


What is the difference between abortion and lack of public health care? In both, children die because it is cheaper and more convenient.
While we debate political theory and discuss why government is evil, kids die. There are 32 countries with better infant mortality rates than the US, and every one of them has public health care. Even Cuba does better than our supposed best system in the world.
We will fight for kids while they are in the womb, but after they’re born, who cares?
We will provide government health insurance to senior citizens, but to working single moms making minimum wage? Let them eat cake.
It is a national disgrace — and a national sin on the magnitude of abortion and slavery.



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Jjoe

posted August 20, 2009 at 8:49 pm


I am sorry to be so strident, but I was raised by a single mother making minimum wage in the Ozark Mountains with 3 kids and no health insurance, and this issue hits home.
Call me a traitor, but I am flying my family to Canada in October to look at places to live. It is a more Godly country, less warlike and more concerned about the least of these, and God comes before country. We will see what He has in store.



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Anan E. Maus

posted August 20, 2009 at 8:57 pm


calling this “Obamacare” is a dismissive term.
Framing the debate here as a forum to express criticisms (only) is an unfair presentation.
The religious duty is quite clear…to help the poor and the sick.
And that means health care reform.
The opposing arguments are coming from businessmen who want to become multimillionaires at the expense of the suffering of others.
This is not what America should be.
Only doctors, not businessmen, should make health decisions.
HMO’s have run crazy. They need to be reigned in, if not declared illegal. HMO’s have killed many people.
The other players in this debate are Republican politicians who want to use the issue to diminish the Democrat’s power. Power games at the expense of the health and safety of millions of people.
We all have seen the issues – doctors not caring, being run around, difficulty getting care. And all the suffering it causes.
Enough!
And enough of the lies supporting these evil practices.
God is simple. God is love and caring. Let us care for and help the sick and the poor. Anything less is an affront to God’s will.



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Scott

posted August 20, 2009 at 9:23 pm


Anan,
I think you have some interesting statements but you have produced a dishonest caricature of those who disagree with you.
“Only doctors, not businessmen, should make health decisions.” If you are supporting this reform then you must have meant to say, “Only doctors and POLITICIANS, not businessmen, should make health decisions.”
“HMO’s have run crazy.” Agreed. But this does not necessitate a federally run health care system.
“The other players in this debate are Republican politicians who want to use the issue to diminish the Democrat’s power.” That may be true for some but not all. I am a democrat and I disagree with this bill. All those who disagree are not doing so as a power play.
“The religious duty is quite clear…to help the poor and the sick.” Agreed. But again, this does not necessitate a federally run health care system.



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Kyle

posted August 20, 2009 at 9:29 pm


@Dave
Is the comparison perfect? No.
But I’m afraid a lot of people are going to look at the situation and say (not unreasonably), “These people are pro-life . . . until it costs someone some money.”



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Ted M. Gossard

posted August 20, 2009 at 9:40 pm


I would say, YES to the first question. It just seems evident because we’re talking about Eikons made in God’s image, and I take it that God holds us accountable as to how we as humans, treat others. The state is a human institution established by God. It is a society to be civil according to the standards of God’s kingdom come in Jesus.
Second question is harder, and I think eventual significantly increased taxation across the board is likely. I do think that while we don’t want to bring on government run health care, substantial government regulation, will be needed. But this opinion is subject to significant change, though for some time I have favored something of a combination of government and free market. I just don’t understand it well enough yet to say for sure.



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Jim

posted August 20, 2009 at 9:41 pm


Yes, health care is a basic human right. I really would not like to think of a humanity without it. Of course, that has been our position in the US forever. It begs the question: What kind of humanity our we.
Another huge issue that is being over looked is the number of people who are working and paying almost 1/3 of their income to purchase health insurance and then paying at least 1/2 of every procedure done at the doctor’s or dentist’s office. How are people making $30,000 a year with a family making it?
I think one way to pay for somekind of single-payer system is to take a look at the Defense budget. Do we really have to pay more for defense than the rest of the world combined? Is that sane and does anyone feel any safer? Another place to look is the incredible profits made by health insurance companies.
I think health care is non-negotiable! Families, businesses, school districts, etc. are being wiped out by this current system.



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Ted M. Gossard

posted August 20, 2009 at 9:43 pm


Let me add that I say the state is to be civil according to the standard of God’s kingdom come in Jesus, because I believe it will be judged in that light. And that we in Jesus as the salt of the earth, and the light of the world are the standard bearers of this as the city on a hill.



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Skip

posted August 20, 2009 at 10:58 pm


Why is this question framed in terms of asking are “Americans” entitled to basic health care as a human right? Is the answer different for Americans than for citizens of other countries?
Governments have an obligation before God to protect basic human freedoms while maintaining order. Those basic human freedoms generally involve freedom from government intervention – not more government intervention! I don’t believe governments have an obligation to provide food, clothing, shelter, health care, etc except in the most extreme circumstances. Instead, the government should protect its citizens’ freedom to share and redistribute wealth as they see fit both individually and through mediating institutions such as churches and civic organizations.
I believe that we can affirm the kingdom imperative of taking care of those who need care (including health care) without embracing the notion that the government – particularly the federal government – should be the vehicle for doing so.



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Nitika

posted August 20, 2009 at 11:04 pm


I think Allan Bevere wrote a nice piece on whether there is such a thing as a “right to life” several months ago. I can’t find it though, can you post a link Allan? Health care as a “right” seems to be linked to the concept of “right to life”.



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Michael W. Kruse

posted August 20, 2009 at 11:35 pm


If health care is a right, then any denial of health care services to me no matter what the cost, even if it totals into the hundreds of millions of dollars, can not be denied. Any attempts to limit it would be a violation of my civil rights. There should be no insurance at all. It should be a basic service of government we demand whenever we need it, from aspirin to organ transplants and beyond. Same for 300 million of neighbors.
Furthermore if basic needs are a right, then surely food is a right. No longer should food be sold in stores. We should get it free from the government. We each have a civil right to be fed.
What we have is the right, as individuals, families and communities, not to be encumbered by the government in taking personal responsibility for ourselves and our neighbors in meeting our own basic needs … to pursue life, liberty, and happiness.
But what we know is, that for a myriad of reasons, there will be those among us who can’t provide for themselves. Sometimes families and support networks can fill the gap. It may be beyond these avenues to provide what is needed for many. A society of compassionate caring people finds ways to help fill those gaps and government assistance may indeed be either necessary or optimal. (See the Roman Catholic teaching on subsidiarity.)
But there is no positive right to have the basic needs of life given to you. When that happens we will have outsourced both the responsibility to care for ourselves and our responsibility to care for others to the government. It is totalitarianism.
I’m deeply troubled when I see so many uncritically equate “we” in moral imperatives (as in “we are to care for sick and the poor”) to “government.” There is more to society than atomized individuals and government. There is business, education, churches, voluntary associations, etc. that are part of society as well. “We” is the citizens in all our various societal configurations in which government plays a critical but subsidiary role.
So Rachel #31, I do not believe the little girl has a right to care. Compassion is also part of our life together. People who help the girl are exercising compassion. And a society of compassionate people finds a way to enable compassionate acts to happen when they are needed.
But the language of positive “rights” combined with equating “we” to “government” in moral imperatives is a moralizing sledgehammer to silence debate.



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Jeremy White

posted August 21, 2009 at 12:45 am


I agree with Skip above. Health insurance is no more a human “right” than owning a house or a car simply because it is difficult to function without them. Health care is a service industry – and while there are numerous problems to fix in our system, going the dismal and disastrous way of Canada and Great Britain is not wise, ethical or freedom-promoting. Ironically, I write these words less than 48 hours after Canada has announced that its health care system is broke and unsustainable!
No artist who graduates from art school is forced by the government to subscribe to a regulated standard for what his or her work can sell for. The market determines that scale. As imperfect as it may be, the free market is the best way to maintain both quality and equality. We are entitled by our founding documents to “life, liberty and the pursuit (not guarantee) of happiness.” Nowhere do those documents suggest that we are guaranteed “health, wealth or prosperity.”
I am a politically moderate pastor with obvious conservative leanings in this area – and someone who is actively involved in humanitarian and compassion ministries globally. Our church’s efforts to alleviate hunger, train workers and plant churches in places like Rwanda, Mexico and the Middle East represent the heartbeat of the church where I pastor. I say that to assure anyone reading this that I am committed to seeing lives transformed by the compassion of Christ through His church and other private means of goodwill. I also affirm responsible but limited government intervention in various ways.
That being said, the government has no place to stand between patients and medical professionals who have spent a multiplicity of years and dollars preparing to be the very best at the art and science of their chosen practice. Even with our multiplicity of imperfections, the United States already has the most compassionate, ethically sound system of medicine in the world. Yes, there is corruption and greed and such – and those are the issues that if stopped will bring costs way down. But under the Hippocratic Oath taken by all doctors in this country, emergency room services cannot be denied to anyone – including illegal aliens. In essence, we already have free health care.
I’d like to also comment on the so-called 47-million uninsured. It is well substantiated in bi-partisan research that if we subtract the number of people who could afford health insurance but choose not to have it, those who already qualify for state or federal coverage but do not take advantage of it, illegal aliens, and those classified as “under-insured” because they choose only to carry catastrophic coverage, the real number is around 15 million. Additionally, upwards of 85% of Americans are happy with their current plan. Am I supposed to be convinced that the 250+ million Americans who are happy with their insurance plan should be forced into a government-run system because of a problem that exists for 15 million? How about fixing the problem for the 15 million without punishing everyone else?
There is a reason that the DMV is less popular than going to the dentist! There is a reason that the postal service is struggling to turn a profit while Fed Ex and UPS thrive. There is a reason programs like Medicaid and Social Security are unsustainable by every bi-partisan report and opinion out there. Simply put, over the long-haul the government cannot manage things as well as the private sector. And I haven’t even begun to address any of the ethical atrocities in the language of the current House and Senate bills (which anyone can get online if they’re looking for a cure for insomnia)…
Finally, the original question posted suggests there are “30-million of us right now” who are unemployed. This is also patently untrue. Unemployment is at just over 9% of the work force – not the American population. We don’t count children, retirees, stay-at-home parents, etc. in that figure. The actual work force is about 130 million. 9% of that leaves us at about 12 million without jobs. Don’t get me wrong – this is way too large a number! But there is a huge difference between 30 million and 12 million, for the record. As for solutions – they include a plethora of things from eliminating frivolous malpractice suits, moving from paper-based to an electronic-based system, tax reform, and the list goes on. Please GOD don’t let us go down this unethical, disastrous path when there are so many superior options…



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John M

posted August 21, 2009 at 1:07 am


Writing from Australia here…I wonder if you realize that rest of the civilized, industrialized world is looking on here stunned that this is even a question you guys need to raise! Most (if not all) of the world’s western nations have public health care in some form. Our system here in Australia isn’t perfect. At times you might see or hear, amongst all the right-wing scaremongering that seems to be taking place in your country, references to various other national health systems like ours, and the problems we have. Perhaps some of those problems are being used as evidence against public health care. Let me tell you this – we wouldn’t trade it for anything! Because as a (relatively) rich nation, we all understand the obligation we have to those less fortunate, to ensure that all people receive the same basic access to a safe and healthy life. And everyone in our country can afford to see a doctor and have medical treatment whenever they need to (although for those without additional private cover, there might be a waiting list for elective, non life threatening surgery).
The US holds itself out to the rest of world as a pillar of justice and a protector of human rights. In a nation as wealthy as your own, it is simply staggering that you even need to ask this question. It is shocking to us that we see this on our news bulletins as a matter of ‘debate’. As we see people on our TVs weeping in your public forums and pleading not to turn your country into ‘communist Russia’, we can’t help but be frustrated and sad. We watch all this taking place from our democratic, free market, capitalist nations that happen to also have public health care.
It might be a luxury in impoverished nations, or countries not founded on the same principles as our own. But health care is a fundamental human right for all in the West – with the exception of the West’s most significant power and influence! It would be laughable were it not so tragic.



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Napman

posted August 21, 2009 at 1:21 am


Is healthcare a right? Not in our constitution. If we pass a law requiring the government to provide health care to all, then we would be entitled to health care. But it still would not be a right under our US constitution. After all, we could change the law.
I find it amusing when people confuse caring for the least of these with an endorsement of massive government programs. Believers in justice for the poor and helping those in need are not required, on pain of contradiction, to hold that accruing vast new powers to the federal government is the best or only delivery method for either. Recognizing the risks of government solutions, their inherent inefficiencies, tendency to stifle innovation and being subject to the whims and will of their fickle political masters, should leave the door open to alternatives to solve our very real health care problems.
I do not believe health care is a right, and believing so seems like believing we all should have a right to go to Harvard. Not all of us have equal access to health care in part because not every doctor is as good as every other, many hospitals offer inferior care to others, and some patients will respond well to a given treatment that others with the same condition will not. So what is this right really supposed to secure? In my view such a right is either too general to mean much or promises outcomes that no government can ultimately guarantee.
But more importantly, rights are conferred in our constitution upon individuals and units of society to limit the reach of government power in our lives. Health care makes little sense in these terms as a candidate for a right and calling it such provides no guidance at all for evaluating the soundness of policies intended to provide a reasonable and affordable standard of health care to all.
I



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John M

posted August 21, 2009 at 1:32 am


And PS, to Jeremy White (#45), re:
“the United States already has the most compassionate, ethically sound system of medicine in the world”
With all Christian brotherly love and respect Jeremy, please tell me you are kidding!
In my travels and experience over many years, I’ve discussed with people from all over the world issues like health care and health systems and so on. Without exception, while we all have complaints and grudges and so on about what is wrong with our respective systems and how they might be fixed, there is one issue on which we always find universal agreement – thank God (literally) we don’t have the US system! The US health system is unanimously feared, deplored and derided.
The cost of medical care, the cost of insurance, the lack of access for what we would consider basic health care – it seems to us neither compassionate nor ethical.



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Jeremy White

posted August 21, 2009 at 1:45 am


Hey John M. – thanks for your perspective. We obviously don’t see eye to eye on this, but I’m sure there are WAY more things that unite us than divide us. I would take issue with much of what you have said. I have also traveled extensively – mostly related specifically to humanitarian and compassion-related causes and missions. The US health system is by no means unanimously deplored. Britain and Canada, on the other hand, could be more closely described that way.
People flock to America from all over the world for world-class treatment of things they have no option for in their countries. Socialist systems have been an abject failure in nearly every context in which they have been tried. We both agree that our system needs radical change – but I would argue against the kind of socialist approaches. With all due respect to Australia as a friend of the U.S., I know of no one from America flocking to your country for treatment of any serious kind.
Additionally, I am not sure what line of work you are in, but if your government were to dictate that your profession were (nearly) completely under their thumb – would you want to remain in that line of work? I would guess not, unless you were struggling to make a living because your product or work ethic was inferior to the competition.
Thanks for the debate, I am definitely open to the idea that I could be wrong, but in all actuality the truth is probably somewhere in the middle of where you and I stand. If you ARE correct, you can chide me for the first billion years we spend in heaven together… :)



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Jeremy White

posted August 21, 2009 at 2:08 am


P.S. to my bro Joel (post #26)
re: “In Canada, the quickest way for a party to be voted out would be to even suggest getting rid of our universal health care system.”
That is precisely the point. Once a hand-out is administered as a right or written into law, it is almost impossible to reverse. By the admission of Canada’s own Head of Healthcare (her precise title escapes me at the moment) your system is a financial failure and unsustainable. Yet, who among your leaders is going to have the guts to stand up and support major reform when they will be perceived as “stealing” a “right” that should never have been considered such in the first place? My Canadian friends may enjoy basic coverage and routine doctor visits, but when push comes to shove, thousands of Canadians and Brits attempt to come to the U.S. annually for serious medical care that they either cannot get or are forced to wait in line for while precious time slips away in their fight for life.
Even statistics for prostate cancer and other ailments that are routinely cured in the U.S. are drastically higher in both Canada and Britain. These are simply facts. We may disagree with which system is more “compassionate” – but we can’t disagree over facts. Our system is broken and needs to be fixed, but I pray to God we don’t go in the direction of “universal” (a nice word for “socialist”) healthcare…



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John M

posted August 21, 2009 at 2:16 am


Hey Jeremy, thanks for your words of reconciliation! :)
I think your second to last paragraph highlights the polarizing manner in which the radical right wants this issue to be debated. You can either have a free, open (and exploitative market), or you are communist and under the thumb of government! Our system, for example, has an interplay of private and public. We still have private insurance for elective surgery, and for those that want a higher standard of care. But we have a safety net for all. It’s not perfect, but it ensures that everyone has some level of care available. So specialists in our country still drive Porsche’s and live on the upper side of town! It’s not like we have removed the incentive for excellence that crushes innovation and advancement (which is inevitable under strict socialism).
But the question is not ‘should we have the best health care available for those that can afford it’. Or even, should that standard be availabel to all. The question is, do with think every citizen is entitled to a basic level of health care. Again, it may not be a universal, fundamental human right, but in a country as wealthy as your own, it is staggering that it is not for your own people.
Also, two other things. Some people that can afford it flock to the US for health care. Many that cannot flee it. I met a poor woman in Thailand a couple of months ago that went there for medical treatment because it was cheaper for her (after scrimping from relatives, etc) to travel there to be treated than it was to be treated in the States, which she would never be able to afford in her lifetime! Like many things American, you have the resources and the prominence for people that have the money to seek your services. But that doesn’t apply to all.
Secondly, again, being in the Northern Hemisphere, you may not realize that people do travel elsewhere for medical treatment, other than the US. Many people travel to Australia in our region (Asia, the South Pacific, etc) for medical care. We may not have the resources of the US, but don’t worry, believe it or not, we get by just fine (incredible, I know!) and no one here (on the whole) is dying due to a lack of access to the latest in health care. In fact in some areas we are world leaders in research and medical care.
The point you are making really is, if I had some rare disease and I was well insured, I may not get the high level of treatment I would get with the US medical system. You may be right. In that case, hats off to you. But that is such a relative minority of cases. In the far broader realm of treatable health conditions, the vast majority people are looked after perfectly well in a public system, and what’s more, it’s available to all.
I’m guessing everyone here that says basic health care is not a fundamental human right probably is privileged enough to be able to afford the exorbitant cost of insurance in your country (or it is provided by an employer). Alas, it reeks of the smugness that comes with already being in a position of privilege.



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chad m

posted August 21, 2009 at 2:18 am


if health care is a “privilege” and not a “right,” who decides who are the privileged and what criterion are used?
that gets scary, and that’s where we find ourselves. for example…my sister has diabetes and has had it since age 2. she didn’t ask for it or develop it through poor life choices. however, she cannot get affordable health care because of her “pre-existing condition.” she recently had her insulin pump removed because she cannot afford it and she cannot get coverage that will pay for it. i guess she’s not privileged enough to get affordable health care.
i ask again: if health care is a privilege, who decides who are the privileged and what criterion are used?
take profit out of the equation. take money you and i might have to sacrifice is larger taxes and ask the question again. is health care a right?
shouldn’t a country like ours be able to say with great joy and pride, “YES, we believe every human being has the right to affordable and accessible health care”? i guess the US isn’t good enough to provide that sort of thing to every citizen. some are better than others, after all. my wife and i are privileged. we have jobs. sucks to be my sister. she’s not privileged.



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Jeremy White

posted August 21, 2009 at 2:41 am


To John M. (post 51): You make some great points. I wish we were at Starbucks hashing this out over a latte rather than pounding it out on a keyboard. But then again, 20 years ago we wouldn’t be communicating at all!
Just to clarify, i did not mean that nobody from your hemisphere visits Australia for health care. I just noted that I do not know of any Americans who do. I’m sure there may be, but I would bet it’s not nearly as common as people who flock here. Whether you know it or not, we DO cover everyone with health care. As I said before – nobody is turned down for emergency room visits – even for stuffy noses. A diagnosis is made, treatment is prescribed, and we have a system where people can access over 300 of the most common generic drugs for less than $10 per prescription.
Many of our problems stem from greed – no doubt about it. But to trust that politicians and those they appoint are any less greedy than the private sector seems hugely naive. As for your final paragraph, I am sure there are those “smug” ones out there who have never known what it is like to be without health insurance. I am not one of those people. God has provided in amazing ways for my family, but as a pastor and prior to being a pastor I have had several seasons of life when I was uninsured or under-insured, and my views on socialized health care were the same as they are today. For us, this debate really took shape in the 90’s during the Clinton administration – largely during the time I was uninsured or under-insured. It is not easy to walk by faith in that situation, but I never felt as though it was my right to force my fellow citizens to pay for my health insurance. Stealing from the wealthy is as wrong as stealing from the poor.
Thanks for listening. I love the conversation…



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John M

posted August 21, 2009 at 3:10 am


Hey it’s a great debate, and my perspective obviously comes from a certain degree of ignorance, in not living there. Appreciate your thoughts.
I think many of the responses here simply illustrate my first point – Americans don’t realise how the rest of the world perceives their health care system. Many do think they have the best in the world, and that everyone envies it. I think perhaps it’s because you equate ‘best’ with advanced medical treatment, not the function, fairness and accessibility of the entirety of the system. It seems that what you are saying is, we want to have the best treatment available at whatever cost, and no matter how limited the access becomes. I think that’s the part that many of us in other countries, looking on, can’t stomach. That the absolute most advanced care is paramount, no matter what the human cost.
I know so much of what we are talking here in terms of illustrations is anecdotal, but I know many ex-pat Aussies living in the US who simply cannot believe the inequity and expense of the US medical system. Again, I don’t think you guys realise, your system may have some attractive aspects. It may be very advanced in some areas. If I had a rare disease or a particular form of unusual cancer or whatever, and could afford the treatment, I might need to go there. You’re right. But overall, considering the entirety of the system for the population, it is not the envy of the world. It is the exact opposite. Something that makes us all very thankful for the, albeit flawed, systems we have in its place.



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Kate

posted August 21, 2009 at 6:28 am


Jeremy, #45: The “dismal and disastrous way of Canada and Great Britain” is, fortunately for us, a good deal less “dismal and disastrous” than that of the US, which US pays twice as much as %of GDP, but gets worse results overall. How is that a success?
” the United States already has the most compassionate, ethically sound system of medicine in the world.” Is this a joke? The US is the only industrialised nation to leave large numbers of it’s people without proper healthcare. (I don’t count free ER, that is too little, too late)
“The free market is the best way to maintain both quality and equality” in many fields, maybe, but the rest of the industrialized world has shown this to be false in the area of healthcare, where systems with least control (US) have higher costs and worse outcomes, and more controlled systems (Europe, Australia and others) have half the costs, and better results.



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Kate

posted August 21, 2009 at 6:48 am


John W #46&48: I couldn?t agree more.
“I wonder if you realize that rest of the civilized, industrialized world is looking on here stunned that this is even a question you guys need to raise! ” Yup, too true.
“we wouldn’t trade it for anything! ” ditto, the NHS in the UK
“It would be laughable were it not so tragic” Exactly.
Napman #47: “I do not believe health care is a right, and believing so seems like believing we all should have a right to go to Harvard.” What?! Read that again! Your statement makes sense only if you say: ?I do not believe health care is a right, and believing so seems like believing we all should have a right to go to public school?, a sentiment I would agree with.
Jeremy White #50 “universal” (a nice word for “socialist”) healthcare” No, universal healthcare does not mean you have to embrace communism, you (pl) seem to be suffering from commy-phobia, which is causing some real problems with short-sightedness in this debate.



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Scott Lyons

posted August 21, 2009 at 9:07 am


I agree with Scott (#25) when he says, “I believe that health care is a basic human right as far a society is able to provide it (which we are).”
That being said some of our arguments make no sense for us as Christians. For instance, (1) We need to look for other means or look to other institutions to provide health care reform or assistance for those who need it. Why are we discussing this only now that the government is seeking to solve the problem? The bottom line is that most Christians don’t want the government telling them they need to be righteous – forcing them to be righteous. I figure, if you ain’t already righteous, someone’s gotta help you. And if you already is, shouldn’t be a problem for you to be giving the money to those who need it (if you got it). Catholic social teaching couples subsidiarity with solidarity. And a good central government’s subsidiary function is to step in and assist when other institutions or local governments are insufficient. And the American health care system is insufficient.
(2) Some people do not deserve care because of bad personal choices. This line of thinking turns away from the essence of God’s mercy. Compassion is not merely for the innocent – indeed, mercy and compassion are divine when they are directed toward those who don’t deserve it. This Theology of Desert is typical in conservative circles, but it’s the theology of the unmerciful servant and not of Christ. Showing mercy and compassion ought not to hinge on the good decision-making history of the recipients. The man shown mercy by the King (in Christ’s parable of the unmerciful servant) was in debt because of his choices. We are debtors because of our choices and are continually shown mercy, but we cannot show mercy to an overweight person who continues to overeat? Or a smoker who is slowly, consciously killing himself? This is disheartening. So what if the system is abused by some. Isn’t it better to be used than to be unmerciful?
(3) People from all over the world come to America for top-notch health care. This only tells us that we have top-notch health care for those who can afford it.
As to the secondary question about raising taxes or not to pay for it. This is the crux of the argument for many of us, I suppose. Not, What is the right thing for me to do? But, What is it going to cost me? I am not suggesting that money and taxation are unimportant. But it shouldn’t be a counter-argument to the provision of health care for those who need it, especially when we can “afford” unjust wars and trillion dollar bail-outs.



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beckyr

posted August 21, 2009 at 9:50 am


I think part of loving people is to fight for available health care for all. Those who oppose it, I have to wonder how much they have been exposed to the poor and uninsured.



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Scott Morizot

posted August 21, 2009 at 12:36 pm


Scott (#27), as you described the concerns of the man (which are perfectly valid concerns), one question kept running through my head.
“Am I my brother’s keeper?”
It seems to me that Jesus answers that question in a way that is profoundly unsettling. It seems to me that our interconnectedness and responsibility for each run run deeper than is ever comfortable.
I’ve been poor and I’ve been comfortable and I’ve had friends across the spectrum. I’ve seen some real struggles, and I worry about my own children. Like Jjoe, I have something of a visceral reaction to the question or rather the debate.
On one level, as a nation, we’ve already decided we aren’t going to send people out to die on the street (at least as a routine practice) if they can’t pay for care. We need to take responsibility for that decision instead of closing our eyes and pretending there’s no problem. Our current refusal to take responsibility for that basic decision has created an unworkable and unsustainable situation. It’s one of the reasons we spend twice as much per capita for markedly poorer results.
I find it odd in these “Christian” discussions that everyone seems concerned about the “government”. I assume everyone is aware that the insurance companies expect and will almost certainly get a mandate that every citizen carry some sort of health insurance? Why is there not a discussion about how those private companies will be restrained once they have such a mandate. After all, in the past two decades since the health insurance industry converted from largely non-profit to largely for-profit, they’ve clearly demonstrated that as organizations profit is the top and perhaps the only priority. If they are not going to be restrained by some sort of public option, then how, exactly? What do you have in mind that will accomplish it better? After all, the various government plans that exist right now are all more universally effective at cost control and low administration costs than any of the private insurance.
I live in TX. I’ve experienced what deregulated, private, for-profit insurance looks like when there is either a legal mandate (auto insurance) or practical mandate (homeowner’s insurance). It got so bad here that even our (at the time) very conservative Republican-dominated state government had to enact at least some regulation.
Do you think strict regulation alone could rein in costs, set a standard of benefits, and largely eliminate predatory behavior? OPM does a decent job on the latter two through regulation of the FEHB. So I don’t dismiss the possibility. It has some success with the former, but not a whole lot. Still, that may be due to their more limited scope. FEHB is definitely large, but it’s still just a small part of the overall population. Perhaps consistent federal regulation of all health insurance in an exchange would have some cost containment success. I’m open to the possibility.
But it sounds to me like a lot of people are engaging in magical thinking about how these systems work. Something will almost certainly pass from the way things look. Whatever passes will almost certainly include a mandate for everyone to carry insurance. The private health insurance companies want that mandate badly and they have the funds to ensure it is in the final law. So how are we going to balance that? What’s your idea?
Hmmm. That probably wanders off topic, but oh well.



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Doug Allen

posted August 21, 2009 at 1:54 pm


#1 YES, I think every citizen has a right to basic health care, a corollary to the right to life.
#2 The most efficient and least expensive way to provide it has been used in many countries for decades. It’s a single payer system. Dozens of countries, many less rich than we are, have used it and have remained properous, capitalistic, freedom-loving countries. They also have better medical outcomes than we do.
#3 If we adopted a single payer system like Canada or Australia, and all the others, we could see our per capita expenses go down between 30% and 50%, following the start-up costs. We are now paying for emergency health care for every one. The taxes to pay for quality, universal health care would be much less than the premiums most of us are paying now. HOWEVER, if we use the bandaid approach and basically stay with the inefficient system we already have, then costs will continue to go up, fewer will be able to afford it, and procedures will necessarily become more rationed.
Doug



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Emily

posted August 22, 2009 at 12:58 am


No, health care is not a right. You don’t have the right to receive any and all health care services on someone else’s dime.
That said, we as a nation have no excuse for not providing affordable health care to all our citizens. As a Christian, I find it completely unacceptable that we let significant numbers of our own people suffer with a limited access to health care and others to go bankrupt as a result of health care. We are like the Pharisees who pass the beaten man on the other side of the road, because we can’t be inconvenienced to alleviate his suffering.
I don’t know what the best or most efficient system for delivering affordable health care to all is, but it seems to me like the government has to be involved. The insurance companies aren’t going to do it themselves! Single payer, insurance co-ops, public option, whatever. As long as it works.
And no one can call him or herself ‘pro-life’ if they oppose universal health care.



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Napman

posted August 22, 2009 at 1:12 am


@Kate
If everyone has the right to health care who decides how good it will/should be? Affordability, condition of the patient, age of the patient, expected quality years left? Everyone will want a Harvard quality health care experience. It is our right! But until the health care provided to the President by our government is given to every citizen by our government you cannot say the right to health care is a meaningful phrase.
The government cannot deliver equal care or equal outcomes under any banner saying health care is a right. The government can’t give Harvard or the best magnet public schools to every American child whether education is made a “right’ or not. I am sorry if I did not make this point more clearly. Whether it is called a right or not, health care in this country will not be solved by making it a right. And making it a right suggests that all citizens will have access to every test and treatment necessary to diagnose and treat their condition. No government provides this nor can one. So much for the “right.”



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Kate

posted August 22, 2009 at 5:21 am


Napman, you obviously have a hangup with the word “right”, which may be because you have a different understanding of it than I do. So lets forget that.
“And making it a right suggests that all citizens will have access to every test and treatment necessary to diagnose and treat their condition. No government provides this nor can one.” Ours does, most of the developed world governments do. What’s wrong with yours?
I just don’t see why Americans shouldn’t be priveledged (if that’s a better word) with a top quality healthcare system such as we in the UK (and most of the developed world)enjoy for free. Our Prime Minister may get a fancier room when he’s ill, but he won’t get a better standard of care, so if that’s what you mean by Harvard standard, then we all get it.
It just seems sad that Americans should be burdened with such a low quality of healthcare, possibly face bancrupcy when hit by serious illness, spend so much of their GDP on healthcare etc etc just because of hang-ups about creeping communism and government control.
An American woman is 10 times more likely to die in childbirth than a woman who gives birth in Ireland. Isn’t that rather pathetic for a country that is in many ways so advanced?



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Joel

posted August 22, 2009 at 11:44 am


Jeremy White (#50)
I think you’d find in a visit to Canada that the socialist/liberal label isn’t a scary word here. We’re a socialist democracy (by definition, I believe). As noted, my wife is British so we’ve had a fair amount of contact with their own universal health care system (NHS) – which covers more things like dental. My father-in-law just received a hearing aid from the NHS.
As for our system being unfordable and unsustainable, well – we’ve been running surpluses for most of the past 10 years. It’s only since our conservative party took power plus the current “economic crisis” that we’ve gone into deficit. But if to make our system “sustainable” means cutting out the poor so those that can afford to jump the queue can, well – most Brits and Canadians don’t believe that’s fair.
As for Canadians traveling to the US for necessary health care, I’m sure that is small minority. The one time I had a serious health emergency, I had an MRI and an EEG done within 24 hrs. Other less critical injuries have always been handled quickly and professionally. We were able to choose to have midwives for the births of our sons and had the 1st in hospital and the 2nd at home. My personal experience has been very positive. On the other hand, my American family have often struggled with health care coverage/costs. From my own personal experience it’s easy to see which system has been more just.
I don’t think most Canadians and Europeans I know have the same fear of government built in. When my mother questioned the fairness of her brother nearly dying and then working extra hours while sick to cover his health care costs in West Virginia, my aunt responded that, “We don’t need more big government”. Which is sort of amusing given the size and reach of the US government, but I digress…



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Napman

posted August 23, 2009 at 6:17 pm


Kate@63
I believe taxes fund the British health care system so it is only free if you do not pay taxes, Maybe you do not.
Women with breast cancer have lower survival rates in the UK than in the US. This is because, I have read, many British women do not receive the best cancer treatments-due to expense-if they are diagnosed with cancer at a more advanced stage. This, in my opinion, is unfortunate and speaks to the kind of limits one finds in government run systems.
As for the Harvard claim, if you believe that the PM receives the same level of care and immediate access to tests and treatments, provided by the government, as an unemployed factory worker in Liverpool, then we will simply have to agree to disagree. This is certainly not true in America where teams of specialists will review and treat the President on all but the most routine matters. No country can afford to provide all its citizens that level of care.



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Kate

posted August 24, 2009 at 1:37 pm


Ever treated an unemployed factory worker from Liverpool? I have, when I worked in a hospital there. Believe me, they get the same quality of care as the guy who owns the factory. My biggest concerns were the compromised care I sometimes saw given to those who paid for private care: care no longer driven by best evidence but best profit. Sure, they got their operations quickly, but that’s not so helpful when you didn’t need the op in the first place.
“only free if you do not pay taxes” Well, obviously, “free at the point of service” if you want me to practice my typing.



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John M

posted August 25, 2009 at 1:28 am


Kate – well put. Here in Australia, you can still get private care. You can (if you want to, or can afford to) still have your elective surgery immediately (everyone can have surgery for life threatening illnesses immediately), you can still choose your own doctor and your own facilities, what type of treatment you would like, and you can still choose to have a private room. IF you have private health insurance.
But the point is, everyone has access to SOME level of care, which is the essence of the question here.
Napman – the difference is that EVERY woman can be treated for breast cancer in a public system. If a woman can afford it and wants some unique or radical treatment by a leading specialist, she can have that. But even if she cannot afford it, she will get some level of treatment. In fact in most cases, she will get access to the same kind of treatment, just with less options and choices in terms of who administers the care and so on. It’s not always perfect, but there is no one who cannot get medical care of some sort.
It may not necessarily be a fundamental human right in all cultures at all times (who can really know definitively the answer to that question in the end), but in an affluent western society, we can afford to, and therefore should, ensure that everyone is protected from needless suffering in the area of health. Especially where people suffer simply because they cannot afford treatment, where treatment is readily available.
Furthermore, it actually makes treatment more affordable for all – both in terms of the cost of the treatment and private health insurance, because there is accountability that prevents flagrant profiteering.
“I believe taxes fund the British health care system so it is only free if you do not pay taxes” – do we really need to descend to that level of pedantry to make the case? It seems that for many in the US ANY form of additional taxation and/or government intervention is construed as the return of the red peril! But taxes are not necessarily inherently evil, and of course, the hope would be that any additional taxation would be more than offset for many in time by a reduction in health insurance premiums.
At the end of the day, the point I’m making is a simple one – almost every other industrialised, western nation in the world is free, democratic, peaceful and capitalist. Yet we all have some form of public health care (as imperfect as it may be at times). It’s ridiculous to the point of frustration that the richest nation in the world, the self-proclaimed champion of human rights, defender of the oppressed all over the, finds it a struggle to likewise for its own people. Whatever final form it takes, this should be a no-brainer. Everyone else is doing it without becoming Commies!



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John M

posted August 25, 2009 at 2:47 am


PS Just wanted to clarify, unless I’m mistaken – it seems that many people here are arguing that say, in your example Napman, where a woman is diagnosed with breast cancer, it is better that a majority have access to the highest possible level of treatment and a menu of alternatives, at any cost, than it is for all women to be able to access treatment?
Is that right? I think that’s the part that I’m struggling with. That you accept that some women will simply not be able to afford it and will be turned away to suffer with their illness, in order that the affluent majority continue to have access to all the luxuries that come with a bloated and exorbitantly costly range of premium choices.
And of course that concedes that in fact the level of care does inevitably suffer regardless of the public model adopted. Which isn’t necessarily so. But let’s say it does – then it’s better for some to have the highest, most luxurious level of care and a range of options, than for all to have access to a good, but perhaps slightly lower, level of care?



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