Black Shards Press – Electronic Gumbo is Our Specialty

The Health Care Debate We’re Not Having

20.08.2009 (2:58 pm) – Filed under: Health,Medicine,Politics ::

imageI was privy to an an email Michael Merritt recently received from a self-described liberal who called him an idiot for writing about the hypocrisy of the left’s attacks on John Mackey, CEO of Whole Foods.  In the exchange that followed, that hypocrisy was demonstrated at its most fundamental level by Michael’s accuser.  Free speech and individual thought are, in the minds of liberals, their birthright alone and must be denied to anyone who doesn’t think and speech in like fashion.

That was John Mackey’s crime.  Mackey is the president of a company that manufactures products deemed acceptable to the true believers on the left.  At least they were acceptable until Mackey wrote this gem of an editorial for the Wall Street Journal, which included this pithy truth that incensed many of his leftist customers:

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America.

Indeed, this is the core of the matter and what should be the center of the health care debate.  Unfortunately, the discussion is centered elsewhere, the unfortunate and incorrect assumption that health care is a God-given right having been tacitly accepted by leaders of both parties.

Presumedly this acceptance, made evident by Republicans having provided their own version of an expanded government health care program, was made semi-consciously, the reflexive act of politicians shying away from a controversial principle and the necessity to uphold it, for political reasons.

Nevertheless, this is the health care debate that we should be having.  The question should be, “Should the government offer any sort of health care benefit?”, not “What kind of health care program should we implement, how much should it cost, and who will it cover?”  These are interesting questions; however, until the former is answered, resoundingly, as an affirmative they are also irrelevant.

Medicare, Medicaid, and the Veteran’s Administration are all examples of the federal government’s ability to run health care programs.  Not surprisingly, all are dysfunctional in significant ways that range from Medicare’s effective insolvency to the VA’s unacceptable levels of care to our nation’s military personnel.

Michael’s accuser claimed that neither he nor the right in general were interested in having a serious debate about health care.  But the fact of the matter is that no serious debate about the subject can be had using the status quo as a starting point.  The programs already in existence distort the health care market such that no determination can be made as to its effectiveness.  Moreover, the assumption that these bloated, wasteful programs must continue to exist and grow must not go unchallenged in any serious debate.

Instead, the tacit assumptions about past liberal programs must be unmade, the debate re-opened, and the unasked questions brought to the forefront of the debate.  John Mackey says that there is no right to health care in this country.  Harsh as his statement may sound, it is correct.  As such, the health care debate should start there.  It must, if it is to be a legitimate discussion. 

How can such a heartless principle be correct?  Simple.  When the Constitution was signed there were no health care facilities we would give the name to available.  If one wanted medical care the doctor was summoned and, upon the hope of receiving further assistance, paid for his services.  That is the essence of the medical system: services needed are rendered for payment.  There is no difference between medicine and any other service industry.  Even liberals do not expect to be served free burgers at McDonalds, should they deign to dine there, or to have their clothing dry-cleaned at no charge, or to drive a new car off the Honda lot gratis.  Why should medical services rendered by the best and brightest among us (for this is what we expect and demand, rightfully, of our physicians) be subject to their particular regulatory whim?

The only answer is in the left’s inexplicable assumption of health care as a fundamental right, inherent to every American – its supply unlimited and its cost negligible, like that of air or water.  But this is an incorrect reading of things.  Rather than being a natural part of the public commons, medicine is a service provided by highly trained people who deserve to be compensated for their skill.  This compensation of physicians is the first and foremost obligation of the medical marketplace.  In fact, the only legitimate government interference in this area is to establish and enforce rules to ensure that doctors have adequate skills.

When the government interferes with pricing, as it does with regard to Medicare patients, the market is distorted and the costs, far from disappearing as Medicare adherents suggest, are largely shifted onto other patients.  When costs are actually reduced, it is often because care is not provided, or is delayed, or inferior care is delivered in place of what could have been obtained at the actual market price.

What is needed is not another in a long line of cost-shifting strategies but rather a comprehensive look at the field of medicine, who it is meant to serve, what we expect from it, how much we are really willing to pay for it, and who should benefit.  Just as importantly this review must be zero-based.  There can be no sacred cows, like Medicare, left unexamined because of a collective failure of political courage.

Thus far I have heard no important voice on the left make such an assertion (and precious few on the right, for that matter).  I’ll know that liberals are serious about health care reform when I do.

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