May 30, 2024

The Case for Universal Healthcare

The U.S. healthcare system is broken.  No one seriously disputes that any longer.  The current national discussion is all about how far to nationalize healthcare.  This presupposes both the existence of a problem and that the free market cannot fix it.  But do we know the latter assumption is true?  How long has it been since the healthcare market was even reasonably free of the twin tyrannies of government regulation and health insurance providers?

There seem to be two groups who are advocates of universal healthcare: those whose liberal ideals make the idea of healthcare as a right feel like a good idea and those whose conception of their moral obligations to others make universal health care take priority over individual rights.

The first group I dismiss out of hand.  Feelings, no matter how well intended, are no reason to get out of one’s chair and walk from here to there, let alone allow the president to spend $1.5 trillion to make universal coverage a reality without offsetting economic justification.  Indeed, taxes will be raised to offset some of the cost; the rest is, like so many of Washington’s grand plans, “unfunded”.

Defending the proposal, Barack Obama says that the massive spending effort will “make families healthier and companies more competitive, but over the long term, it will also help us bring down our deficit”, but the first of his claims is supposition, the second is highly improbably, and the third is a politician’s pipe dream.

Do we have a moral or ethical obligation to pay for healthcare for those who can’t afford it for themselves and/or their children?  Many Christians believe so.

I had a discussion this very evening with a friend who fits more-or-less into the second group, those who believe universal healthcare coverage is required of us on a moral basis.

My test case was this:  Assume two neighboring families, one of which has 2 working parents making perhaps $125K/year in total and whose personal/employer medical insurance contributions are around $12K/year.  The second family lives off of welfare and charity and performs no work of any kind.  Should the children of both families be entitled to the same healthcare as a matter of law?

The Bible teaches that we are not to oppress widow and orphans, an instruction that many Christians extend to children with parents as well. 

My friend used this teaching to say, “Yes, to deny the children of the non-working family healthcare is blaming the children for their parents’ non-action.”  And hence, not providing the same level of healthcare to their children is anti-Biblical, anti-Christian, and simply immoral.

The parents, he went on to say, were entitled to nothing unless they were disabled and unable to work, which made sense to me.

My position is that it is the parents’ responsibility to provide all kinds of care for their children, including healthcare.  If they are unwilling to do so, is that society’s problem?  More specifically, is it a Christian’s obligation to provide charitable relief to the children?  And how does that change if the parents are utterly unable to provide for their offspring?

Taking the last two questions first, yes, Christians are obligated to provide charity for those in need.  That’s not optional.  But ultimately it’s up to the individual to decide to whom and to what extent their giving extends.  I don’t believe there’s any Christian obligation to support a government-based solution to what is essentially a local problem.

For instance, if a parent of one of the kids in my bible study class came to me crying and said, “Little Susie needs an operation or she’s going to die!”, I’d almost certainly whip out my checkbook and give.  What, exactly?  Hard to say until you’re faced with it.  Depends on the situation and, in truth, who is involved.  But the obligation is there nonetheless.

Returning the question of whose problem it is, the economic reality is that society will suffer if poor children don’t get the care they need to thrive.

Whether that is better or worse than the result of a welfare state in which disincentives for working and caring for one’s own children are created is highly debatable, however.  The U.S. currently provides hundreds of billions of dollars in government aid to poor families with little in the way of results to show for it beyond a continuing cycle of poverty.  The unyielding nature of a market-based system may seem harsh, but if it produces better results for most citizens, doesn’t it make sense to go that way and let private charity handle the remaining hard-luck cases?

(The fly in the ointment in this free market scenario is those people who underachieve and/or simply do not attempt to provide for their children, then refuse charity out of damn fool pride.  A government program is somehow acceptable to people I know who fit this description.  I suppose because it can be looked upon as a right of citizenship and therefore acceptable.  But it’s difficult to see this sort of edge case as a deciding factor.)

Regarding the free markets issue, here’s a sample case.  My wife recently had her gall bladder taken out.  The procedure took about 90 minutes and our insurer was billed over $10K for the procedure.  Without questioning the expertise of the staff or the quality of the facility involved, this seems exorbitant for what is now a routine procedure with no overnight stay or follow-up care.  Could a free market for medical services really be any less efficient?  And couldn’t we afford to simply pay cash for many medical scenarios if the direct doctor-patient relationship were restored?

Suffice to say that my friend and I had to agree to disagree.  What say you?


Marc is a software developer, writer, and part-time political know-it-all who currently resides in Texas in the good ol' U.S.A.

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2 thoughts on “The Case for Universal Healthcare

  1. Free market system? This has not existed for many, many generations.

    What constitutes requirements for a doctor? Would you rather have the worst of today of the best of 100 years ago? What caused this marvelous transformation? It is simply one single thing – EDUCATION.

    What is our obligation to human society? None that I can see. Our obligation is to ourselves and to achieve the best that we can be. How is this to be done? It is simply one single thing – EDUCATION.

    The above author refers time and time again to $. This reflects the values of this age. An age spawned in a Capitalist Venture that has the basis of Greed as it’s fundamental precept. This is a failed experiment but we have not come to understand that yet as we are patting ourselves on the back for defeating and even worst experiment – Communism. Greed is the most base of human traits. Economic reality indeed!

    I submit that it is a better system that educates everyone to the fullest extent of their capabilities. This will supply the system with the health care professionals required.

  2. Will the best and brightest become physicians if we continue to create economic disincentives for them to do so? No.

    Money has been the motivating force for humanity for centuries because it is a distillation of other forms of power. Before that there was land, animals, grain, etc. Currency use is central to society in whatever form. Take it away and the basis for society goes with it. That’s the true lesson of the Soviet Union.

    I agree that education is important. I’ve written at some length about the need to help children reach their potential. This means not establishing a goal of meeting a least-common-denominator standard but rather making goals and achievements personal for each student to the extent possible. At the very least the best students should be grouped apart from under-achievers starting at a very early age.

    But no amount of education will direct people to difficult, demanding professions that are not profitable economically and personally.

    That’s why there is a shortage of American-born engineers. The profession demanded more work to enter and advance in than others and offered less in the way of direct rewards. Business then made the problem worse by importing labor from foreign countries rather than pay market wages at home. Now the problem is worse than ever.

    There are three motivators when it comes to work: money, satisfaction, and charity. Satisfaction is the least powerful of these. I wouldn’t count on altruism either when the chips are down. We do what we have to so that there’s food on the table. After that we can talk about what makes us warm and fuzzy inside.

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