Health Care, Part 3: The Best of Everything

Everyone cannot have the best health care. No matter how much some may wish otherwise, it is impossible by definition. For “the best” of a thing to exist, there must necessarily be “the worst” of that thing, with a continuum of relative goodness in between. Some would argue that this fact of life is unfair, and that we as a society should collectively correct it. Why should Mr. Rich have better health care than Ms. Average or Mr. Poor? After all, if health care is a basic human right, and we all have equal rights, then we should all get equal healthcare, right?

Let’s examine this argument. If our goal is to make sure that each person the same quality of health care as everyone else, then by definition we will all end up with a level of care that is somewhere on the line between “worst” and “best”. Sounds good, you say? Let’s assume for the moment that we could actually pull this off(We can’t). Let’s pretend that our lawmakers are perfect and incorruptible (They’re not). Let’s pretend that people will still work just as hard to create new drugs and innovative treatments even after their economic incentive is removed (They won’t). Let’s assume, for the sake of argument, that a logistical system could be put in place that would be streamlined, efficient, and free from bloated government bureaucracy (Yeah, right!). In this wonderful imaginary world, when we finally achieve our goal of equal health care for all, the end result would be healthcare quality that is precisely average. That’s not an opinion, it’s a mathematical fact.

Okay, so maybe you think that’s better than what we have now. If you believe forcing everyone to have average healthcare quality is the fair and just way to do things, there is still a basic flaw in this system. The central problem is that someone has to decide how good “good enough” is. In a market system, this happens by millions of individuals making daily decisions about their own needs, based on their own unique situation. Some call this greed, others call it self-interest; either way, it is widely distributed. In a controlled system, the answer to the question “how good is good enough?” must be an arbitrary one. Someone, or some group, must make that determination. Even in pretendland, where perfect and benevolent politicians exist, the question of fairness and morality comes into play as freedom and control is taken from the individual and placed in the hands of someone else.

Now let’s put this Peter Pan scenario back into the context of the real world, where human nature introduces several complicating factors.

First, bureaucracy happens. If you believe that the federal government can improve efficiency of service by streamlining and centralizing, you might as well stop reading now; you are obviously living in pretendland, and nothing else I’m going to say will have any effect on you.

Second, third parties make poor decisions. In a pure market system, each healthcare transaction is a decision made between a patient and his/her physician, the two people who can make the most informed decision, both in terms of quality and cost. When a third party payer is introduced (whether insurance company or the government), some of that decision making authority is removed from the patient and physician. The further removed the decision maker, the less informed the decision.

Third, incentive works. People work harder when they have something to gain from it. Averaging of results removes incentives by limiting rewards for risk-taking and hard work. This stifles innovation and lowers quality for all. So the problem is compounded; not only do we all get average health care quality, but the definition of “average” actually gets lower and lower.

Finally, power corrupts. This is the fatal flaw of Marxism, Leninism and all other theories of centrally planned economies. Utopian idealists believe in their hearts that the solution is to find the right people to be in control. They think that non-greedy, fair-minded types with lots of higher education will be able to make it all work. But even if you start with a well-intentioned, benevolent, non-corrupt ruling class, they will soon be replaced by ruthless, power hungry people that are attracted to the power like bugs to a streetlamp. The power to make arbitrary decisions regarding life and death issues, with trillions of dollars at stake, is at best a sure formula for corruption and at worst a giant step towards totalitarianism.

Everyone can’t have the best of anything. If we deny this fact, we produce results that are at best average, and at worst, disastrous.

HR 3200 Health Care Bill Comments – Part 2

I’ve given up trying to read HR 3200 in its entirety. I’ve given up not because it is too long, but because there is no point in finishing it. In the words of Congressman John Conyers, “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?” However, where Conyers seemed ready to vote it into law without understanding it, I think it should be voted down precisely because it is practically impossible to understand.

It’s not enough to say that members of Congress should read the bill – or even understand it – prior to voting for it. The very fact that it is so massively complex is reason to vote against it, regardless of its content. Interpreting such a law and putting it into practice on such a massive scale would be a nightmare on par with our current tax code.

That said, I will attempt to address some specifics of the bill. To be as balanced as possible, I will accept the explanations of the bill’s proponents, rather than the extreme interpretations of some opponents. When evaluating the impact of the bill, one must consider not only the strict interpretation of its language, but the possible implications that result from it. Even if we assume that the authors of the bill have our best interests in mind, good law should never be dependent on the good intentions of its current proponents, but must guard against (1) potential abuse by future administrations, and (2) unintended consequences.

HR 3200 Health Care Bill Comments – Part 1

I’ve downloaded HR 3200 and have been attempting to read it. I’m not sure if my chronic headache is a result of this exercise, or because I just quit drinking Mountain Dew cold turkey. So far, I’ve read about half the bill, and I doubt I will finish it.

I’m trying to read opinions both for and against the bill, and discussing it with friends on both sides of the issue. I watch both NBC and Fox News every morning, and have even tried watching Keith Olberman in addition to Glenn Beck (that just made the headache worse). I’m putting my thoughts together and I’ll post them soon…

My Best Man is a Liberal!

An old high school buddy and I, recently re-united via Facebook, find ourselves at opposite ends of the political spectrum. He’s left of center, and I’m pretty far to the right. Naturally, the topic of health care is a point of disagreement, and we are participating in an ongoing debate. Fortunately, our good manners, the depth of our friendship, and a mutual desire for truth have kept our discussion civil and, I believe, quite productive. I don’t think either of us is likely to fundamentally change our positions, but hopefully both of us will come away with a better understanding of BOTH sides of the issue. In the words of Dennis Prager, “I prefer clarity to agreement”.

What’s cool is that in high school, we didn’t think about anything but cars, trucks, music, and girls. Now, 25 years later, we still like cars and music, but have become responsible citizens with families, houses, and jobs. We read books besides Road & Track, and take an interest in world affairs and political issues.

My point is this: Amid all the name-calling, yelling, and anger we see in the world of politics, Shep and I have agreed to look for common ground and understanding. It’s easy to call someone an idiot if you don’t know them. Perhaps if we try to building relationships with people instead of painting them blue or red, Americans might have a more productive debate on important issues. We should all be passionate about what we believe, but let’s talk to one another.

White Trash in My Yard

I’ve always disliked the term “white trash”, not just because it insults a white person, but because it also insults non-white people. I’m not sure exactly why, but to me the term carries a subtle implication that all black people are trash, and only some white people are trash.

Of course, I’m uncomfortable calling any person “trash” – no matter what their skin color – as we were all created with equal value. Somewhat less offensive is the term “trashy people”. By describing them instead of naming them, we refer to the type of person they have become, rather than labeling their very being. I suppose to be precise, I could use the adverb form of the word – describing their behavior instead of their person – and call them “people living trashily”. But that just sounds silly, so generally I simply avoid using the word trash when referring to humans.

That said, I have several choice names for those people who throw actual trash into my yard. “Idiot” comes to mind, but “Loser” is probably more accurate. I say this because a disproportionate percentage of the debris found on my front lawn is lottery related. We live on Main Street and are amazed at how many people apparently just throw their garbage out the car window. Fast food bags are popular, as are beer cans and cigarette butts, but losing scratch-off cards are the clear winner. We live about a half mile from a convenience store, so I guess that’s just far enough for some upstanding citizen to figure out that he’s a loser and then throw the offending card out the window onto my grass.

It’s telling that most of the trash I find in the yard is related to behaviors that are financially and physically unhealthy. I rarely have to pick up empty yogurt containers, completed Mensa puzzle books, or old copies of the Wall Street Journal. No, the trash in my yard comes from … well, losers.

Inspired to Blog

I was reminded that I have a blog when I came across an old friend on Facebook this week. I had not seen Scott Hunt since grade school, but recognized his face in an old photo posted on Facebook. Turns out Scott is a blogger and a writer, and is starting a “novel” concept called a Communovella. Check it out here. I look forward to following this!

I want my DTV!

I was so looking forward to the switch to all digital television. Not because it affects my TV, but because it would mean we would finally be rid of those helpful public service announcements about the switch. Apparently now we will get six more months of them. Why? Because the omnipotent federal government doesn’t have enough $40 coupons to give to people to cover the cost of a converter box.
Rhetorical Question #1: Who would have thought that the US government could miscalculate the number of coupons that would be needed?
Rhetorical Question #2: Why do we think it’s the government’s job to buy converter boxes for people, anyway? Is watching television an inalienable right? If it is, why didn’t the government buy everyone a TV set to begin with?
Rhetorical Question #3: How many people are there out there still watching TV on an analog set using an aerial antenna? Really?
Rhetorical Question #4: If someone (a) is still watching TV on an analog set using an aerial antenna, and (b) can’t come up with the $40 for a converter box, how are they supposed to go to and order a coupon? I have a feeling they are not very internet savvy.