Problem: Risky Behavior - Obesity, Smoking, Drinking, Drugs, Sex, etc.
Nobel Prize-winning economist Gary Becker has an interesting post suggesting that "the higher US mortality rates (compared to other countries) are due much more to differences in personal habits and personal care than to defects in the US health delivery system." In fact, when looking at the US health system's performance on cancer and other serious diseases, it tends to vastly outperform other countries.
Diabetes is quickly becoming an epidemic of obesity, and the cost of diabetes care alone is increasing by over $8 billion every year and accelerating, spending, with over $174 billion in health care costs in 2007. Add in alcohol related costs of $174.9 billion, smoking related costs of $137 billion, drug related costs of $114 billion, and the highest level of sexually transmitted diseases in the industrialized world (over 65 million people infected and 50% of the population at some point contracting an STD), is it any wonder we spent $2.4 trillion in health care in 2007?
Solution: If we want to control costs, altering our behavior would seem as good as place as any to start, as the numbers suggest that changing our "lifestyle" choices could reduce the need of health care by over 25%. And 25% of $2.4 trillion is a lot of money. Unfortunately for fame seeking politicians and lazy-ass Americans alike, there is no real government solution. I would have little to no problem with the idea of taxes on junk food, cigarettes, and alcohol if they worked, but in reality the taxes most often lead to criminal behavior and can't be allowed to work to actually change behavior.
Asking people to take personal responsibility is oh so passé, isn't it? Yes, I concede that standing on a soap box alone changes nothing. Yet, without a realization that the problems of Health Care are of the results of millions of people making terrible individual decisions, the buck will forever be passed, and no legislation or reform or tax or new system will make Americans any healthier.
There is a moral argument for providing health care to those who need it and can not afford it, but on the other hand, "handing something off to the state so citizens don’t have to take responsibility for themselves and others doesn’t doesn’t really contribute to the moral fabric of a society."
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25 comments:
Again, here we return to the same question: "How much should the government interfere in/meddle with/assume "responsibility" for it's citizen's lives?
I agree with Ayn Rand :) on this. As little as possible. First of all, government beauocracy/spending -- let's face it -- goes to those holding the purse strings first. And second of all never solves the problem.
It's not the government's responsibility.
It used to be considered the responsibility of the wealthy -- noblesse oblige:
the moral obligation of those of high birth and powerful social position to act with honor, kindness and generosity towards those of lesser means.
It's some kind of twisted sickness in our nation that we shove this responsibility off onto the government -- thinking a collection of men continually humiliating themselves in public can somehow live up to this responsibility better than the individuals who earned the money in the first place. How can they get generosity right if they can't get honor right?
Huh? What? Did someone say "Ayn Rand?"
(Rebecca, I know what you meant to say in your entry above, but I need to make something clear to all, just in case they think otherwise.)
Just to make sure we don't mislead others here or others misread what Rebecca said, Ms. Rand never said anything about the "moral obligation of those of high birth and powerful social position to act with honor, kindness and generosity towards those of lesser means." There is no "obligation" of the rich to do anything "toward others." Each person is a human in and of themselves and do not have any natural right to oblige anyone to support them, that includes government and the rich. The act of generosity, as I stated in an earlier blog, is a VOLITIONAL act of giving away a value.
As for my response to the main entry, I am in favor of the total privatization of medical insurance. Government shall not infringe upon these business unless there is an act of fraud or breach of contract.
And YES, that may mean that an habitual smoker WILL PAY MORE for insurance. That may mean that an obese person with a family history of diabetes WILL PAY MORE for insurance. Both examples include chosen human behavior and genetic dispositions.
She never said that Ayn Rand supported wealthy giving. Why so worried that someone might misinterperet Ayn Rand?
Again, I think we all know what she means.
I agree with the Professor. I think government should govern...only. Not provide.
No one is worried; no one said anything about being worried. Why are you worried that I may be worried, when I never worried nor used the word "worry?" LOL
Lumbee,
If government should govern only, I would like to here your alternatives to
-Government-Provided Defense
-Government-Provided Roads
-Government-Provided Education System
-Government-Provided Libraries
I have a wide libertarian streak, and as much as I would love there to be simple and clear way for Government to get out of all services it provides, I can't with full confidence see how the privatization of some services would be successful as for-profit ventures AND successful in improving/maintaining our society.
Perhaps you can straiten me out, I see "govern vs. provide" as a bit of a false choice.
That said, I am picking on you mostly to see how you respond.
I am against a government "option" (road to single payer serfdom) on health care, and my next post, should I ever have the time to write it, will attempt to show examples of the free market solving many of the current problems in health care.
Government can play a role on improving health care, and my argument is a constitutional one. I'm sure I'll get back to this in the body of a post, but just to get the discussion started:
Section 8, clause 3 of the US Constitution - The Congress shall have Power: To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes:
This constitutional grant was in favor of regulation of commerce in the interest of uniformity between the states.
Why can this clause be used to ban medical marijuana, but not used to create uniform national minimum standards that for health care insurance?
I have not found a satisfying answer, but I think my insomnia is ebbing, so I'll stop there for now...
wait a minute. I quoted Ayn Rand as saying government should interfere as little as possible. Of course noblesse oblige is volitional. That's what makes it noble. Otherwise, it's socialism.
I dont think the government should provide education and I dont think the government should provide libraries. I think libraries should work in a non for profit status supported by private donors.
Education, I beleive is best handled privately as well.
As far as roads and defense....infrastructure and military and police is part of governing in my opinion.
I think the primary number one most important function of government is the protect the people. So defense both foreign and domestic is the most important thing in governance.
Infrastructure is governance as well, in my opinion...so, I think taxes should go to infrastructure and defense. Provision is for families, free market systems, etc.
Justus,
Just curious. Why are you interested in my take on this?
Because we are already well aware of where the professor stands :)
Hah! my first (and maybe last) emoticon because someone once told me they are for girls.
To Rebecca:
No, no, Becca. Volition and obligation are two different and opposing words. Please try not to pass "oblige" to be some fancy, foreign French word anywhere close to meaning volition.
To Lumbee,
Could you provide specifics as to how government could release itself from the stronghold of education and how would the private sector take over?
To Loathsome,
:0 ;) :) :P
I guess I must be a girl. LOL
I beleive the role of goverment should not include education.
How do we transition out at this point?
Different discussion.
OK, so you stated that education should be private. Who exactly will run these schools and how?
Professor, I speak for myself and not Josh, but we already have a lot of private schools, so I assume those that would run private schools would be the same group of organizations that currently do so. Whether or not they are capable is a different question and one that can be levied at the government as well, but anecdotally, it seems to me in most cases (a generalization) the private schools are generally thought of as higher quality than public due to the funding and support they receive.
That being said, the problem I would see with an entirely private education system is that it would likely leave out the opportunity of education to lower socio-economic classes which is not at all a good thing for a society or nation. That's the issue that should be addressed, and likely the reason we began to have public schools in the first place.
Lumbee, I was interested because I don't think governing and providing are necessarily mutually exclusive.
I hear the arguments for privatized education, and I sympathize, given how poor public education is in many areas, but I have not heard a good proposal on how to accomplish this. The profit motive alone is not enough to guarantee better performance, k-12 for everyone, and quality higher education in every state.
Anyways, we were talking health care, but like education, I have to heap some blame on those that simply say "no" without offering their own solutions. And as much the spinsters have tried to make out the Republicans as the party of "no" on health care, they actually have made some proposals. The problem is, most of the Republican options suck just as bad as the current ObamaCare plan. If there is a good proposal out there, it has not been well publicized.
Elaborate on your first paragraph please.
In a previous comment you seemed drew a clear universal line between governing and providing, and I questioned you because in some ways I see choosing between the two as a false distinction. You seem to agree that providing for a national defense and infrastructure are proper functions of government, and others would go further in the list of services government should provide. You may have been limiting your previous statement only to health care, but I wasn't sure, hence my question.
OK, let me ask a question. We see that privatized education, and privatized health care could leave out the poor. I agree. But, I dont pretend to have the answer. I do still hold to the philosophy that government is not the answer. So my question. Why is it our default stance, or our knee jerk reaction to say government will have to provide health care or education for those who cant afford it? I submit to you that the answer to this question is that we have been conditioned to think this way. You say, give me a better solution...I say I am not sure. But, why do we default to government handling it until we are sure? It wasnt always that way.
Am I making sense or just spinning my wheels?
Lumbee, I think you are making sense, or at least I understand what you are saying. At least you are honest about not having an answer. The reason for the default stance is because it is the existing condition. Because the government has taken up where private business has failed is why we consider it the best option. Right now, until someone can say otherwise, it is the best option.
Of course we can separate ideals from application, but if one lacks the other perhaps it is not such a great ideal.
Am I making sense, or did I just spin my wheel (don't claim to have more than one).
I dont think private business has tried with health care or education. I think we have been told there is a problem and that is why we are discussing this.
Okay, I know it's off the subject, but I can't let Professor get away with handing me the fancy-schmancy jibe without defending myself.
Clearly, there was a paragraph break between having government interfere as little as possible and noblesse oblige.
In my head it was clearly a paragraph. (I would insert a smiley, but choose to butch it out instead.)
AND, my point was simply an alternative to government supported health-care. From where I sit, a wealthy person CHOOSING which charity hospital he wishes to support with private donations has much more volitional freedom than the one being taxed so the government can decide which health care fraud to "support" next (lining their own pockets the whole way.)
Lumbee,
Stay on task, don't get sidetracked by my off-topic comments.
My question to you is: if privatized health insurance resulted in the very, very poor being neglected any medical procedure or medicine, whether it be because he simply wants them or whether HE NEEDS THEM DESPERATELY, would you then be in favor of a somewhat socialized version in which all, including poor and rich, received emergency medical help to a certain degree, given the gravity of his circumstances?
Professor, are the qualifications needed in your example? Would your question be the same if it was a student or middle class instead of "very, very poor"?
Not that you asked me, but to answer your question I believe we have laws that do not allow emergency rooms to turn away patients that need care. I believe that is a good law. To refuse care to a dying person because their wallet is empty is, in my opinion, despicable.
Loathsome,
I only qualified the "very, very poor" because I did not want to quibble as to who can afford it or not. But, Yes. My question would apply to ANYONE who cannot afford medical care.
If a person walks into a private hospital's emergency room (we have one in Miami, it's called Mercy Hospital), and he desperately needs to have his 104 degree fever taken care of, then does the hospital have the right to kick him out after the administrator realizes that he does not have insurance? You say that there are laws in place so that private hospitals could turn away patients who are in need of care. OK, so then who pays for the emergency room services given to this uninsured patient? The patient sees his bill of about $1000 or more, and determines that he cannot afford it. So he debates with the hospital administrators and he states that he can only pay a certain amount per month, but the administrators want more. After going back and forth, no one compromises and the patient refuses to pay anything, to which the administrators then report his fees to a collection agency. The collection agency then report this patient to a court judge who rules in favor of the hospital and then proceeds to freeze the patient's assets and take-home pay. The collection agency then takes 30% of the patient's take-home pay at will. And if you don't think this can happen, I'll give you my dad's phone number and he'll tell you about his two run-ins with this situation after he had two strokes that left him $50,000 in the hole. Furthermore, the private hospital won't take him in even if he's about to die! They literally told him "don't bother coming here should something come up."
Is this the type of privatized medical care you want? (That question is for Lumbee, but anyone can answer.)
I dont think you have to have either or. I think the law is simple. Who pays...you and i do. But not the government.
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