Insurance will take your life or give you death

37 comments
Insurance is life or death

At least those were the options the Oregon Health Plan gave to Barbara Wagner last year. This government-run health care plan deemed it was too expensive ($4000) and not worth tax-payer dollars to give her a drug that could extend her life . But they were happy to give her $50 to be “put down.”  No joke.  (I have a poll at the bottom of this post.  I’d love your response.)

It’s an interesting story.   Since Oregon has legalized assisted suicide, the $50 suicide was the most practical option for them. I’m sure it is not a surprise to find out that Barbara Wagner didn’t appreciate their pragmatism. But she didn’t have the money for the drugs, so she was running out of options.

“Her case is hardly unique,” said Michigan lawyer Geoffrey Fieger, who defended Dr. Jack Kevorkian’s crusade to legalize physician-assisted deaths. “In the rest of the country insurance companies are making these decisions and are not paying for suicide,” Fieger told ABCNews.com. “Involuntary choices are foisted on people all the time by virtue of denials.”

Now, of course, suicide of any kind is wrong. Our life was given to us by God and we have no right to take it anymore than we do to take anyone else’s life. But that’s a topic for another time. The point here is that this situation is hardly unique.

The headline is that this is a government run health care plan. And here they are rationing care and making life and death decisions for private citizens.

The untold story is that when the government denied her this treatment but did offer to kill her instead, it was one of those big, greedy pharmaceutical companies that stepped up and donated the drugs to her for free.

The real story is that these decisions have to be made every day, whether you are on a government run health care plan or you have private insurance. It highlights a number of important issues.

First, it reminds us of the need to have choices in health care insurance. We need to make multiple insurance options cheap enough for even the poorest to be able to make a choice. One of the reasons I’m against a public option is because it doesn’t seem like it is going to do this. It will offer a single, government run plan that the less-affluent in this country will basically be forced to have. And because such an option is unfairly competitive (subsidized by your tax dollars), it could end up pushing private insurance options out of the mix and therefore destroying any other choices for everyone else as well.

Second, and more important to this conversation, we have to face the reality that a dollar value is placed on human life all the time. It is unavoidable.

Dollars are not just profit. The cost is equal to all of the resources it takes to accomplish something. It takes experts, equipment, labor, time. It all costs money. Yes, health care should be above profits. But it is not above money. It costs money just to get it done.

And it doesn’t matter if you’re the government or a private company, you have limited resources. We can all imagine the scenario where endless amounts of dollars could be spent on end of life care trying to extend human life as much as possible. What happens when we run out of money? What happens when an insurance company simply, and honestly, can’t afford to pay the thousands of dollars for the 5% chance of extending your life 6 months?

It’s not as simple as just saying, “well we need a government program that will cover it then. See, that’s why we need nationalized, universal health care.” That misses the point. The government only has so much money too (and they’ve been out of it for a long time now). And since we do have limited resources, do we not have a moral responsibility to use them as wisely as possible? If we could send another person to college, save the environment, fix one person’s disability, save one baby seal or give the money to extend somebody’s life 1 month (maybe), who should get the money?

It seems we have a lot of people in this country that would just say – “give the money to all of them!” But they are living in a fantasy world. In the real world, decisions like this must be made every day. So the question is not if decisions like this will be made. The question is who should make them.  And if we are talking about federal dollars, it is your own money being decided upon.

In this case, an insurance company (here it was the government plan) can only give what it has. Barbara had every legal right to make the choices available to her. We all had the right to pitch in and help her out if we were so moved. And the big pharmaceutical company had the right to give her the drugs for free (as they did).

Is Barbara Wagner’s situation tragic? Of course. And there are many more just like it. Was it unfair for her? Probably so. But was there a more fair, realistic option? Aside from the government communicating with her more delicately? I don’t know. Can we do better to help situations like this? I would think so. So we should. But ultimately, aside from trying to cut costs, we will need more money. So how do we get more money and do it morally in order to help the situation?

We could ask for it through charity. This is certainly fair and effective. And Americans are the most charitable people in the world. But what if that is not enough?

The other option is that we take it from people. And this is what the government does. They’re called taxes. So the question is what is a fair tax? What right does the government have to take money from one person and give it to another person like Barbara?  Can they take as much as they want? Even if it is, for example, to prolong her life for one month and it costs $100,000? Where is the limit?  When does somebody else’s pursuit of health care begin to infringe on another’s right to live their life freely?  And who should decide that point?

As Catholics, there is an obligation to personally love and care for people – the suffering, the dying – the best we are able until natural death. But there is no moral obligation to take money from other people in order to do it. In fact, taking money that isn’t yours from other people is immoral itself. But of course, this line is blurred in our civil tax laws that a majority have forced onto everyone. So what is the answer?

I’m not pretending there is a simple answer here. I’m just pointing out the difficult questions involved on both sides. Would love to know what you think in the poll and comment section below.

What moral right does the government have to take money from one person (against their will) and give it to another for health care?

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37 comments Add comment

pinko August 11, 2009 at 12:50 pm

Matt, I don’t get it – you try to demonize a nationalized insurance program by saying a similar one tried to kill this woman but then spend the rest of the article saying there’s nothing they reasonably could have done to save her. The ‘rationing of care’ is something that is happening all the time, all around the country, every day, on private health care plans. Secondly, here are some details you skipped:
1)A lifelong smoker, she was diagnosed with lung cancer in 2005 and quit. The state-run Oregon Health Plan generously paid for thousands of dollars worth of chemotherapy, radiation, a special bed and a wheelchair, according to Wagner.
2) Her oncologist prescribed the drug Tarceva to slow its growth, giving her another FOUR to SIX months to live. (emphasis mine)
3)the drug does not meet the “five-year, 5 percent rule” — that is, a 5 percent survival rate after five years.
4) The median survival among patients who took was 6.7 months compared to 4.7 months for those on placebo
5)The state also regularly evaluates and updates approvals for cancer treatments. “We look as exhaustively as we can with good peer review evidence,” she said.

Now, I’m not saying I think she should die, and definitely if I knew her I’d want to have the drug. But she COULDN’T AFFORD INSURANCE – and the state helped her as much as they could and then eventually made a decision that a giant number of private health insurance plans would have. You ask “When does somebody else’s pursuit of health care begin to infringe on another’s right to live their life freely?” but who’s life is being infringed on? Is this really all a tax debate? You think you’ll notice the difference in your taxes that it takes to give this woman that initial shot at beating lung cancer? And if you do, you’re willing to argue that it’s not worth your financial freedom to do so? Or even not you, but the 30 people that already polled that no, the government shouldn’t spend ANY money to provide someone health care (sorry to be the one to alert you guys, but the government already spends trillions of dollars on health care… you all want to take that away? wow.) Not to even mention that this health care bill is meant to lower the expected cost of government spending on health care in the foreseeable future…

Honestly, I don’t get it. This overwhelming fear of socialism, despite the fact that you all love roads and firemen and police. The second you can’t see how it directly would benefit you personally, then it’s evil. I just… yeah, I don’t get it.

Nic August 11, 2009 at 1:18 pm

I know it’s not common for Catholics to read the Bible, but Matt, you may want to double-check on Jesus’ attitude towards the poor and less fortunate in our society.

I’m British and while the NHS is far from perfect, at least everyone has the right to some level of healthcare.

We have national bodies who set standards on “how much is too much”, and sadly, “which drugs are cost effective” (this agency is oddly called “NICE”).

Seriously thoug, I read your blog and appreciate a lot of the stuff you do online as a Catholic; I just think your a bit off-base on this one.

Matthew Warner August 11, 2009 at 1:59 pm

Thanks Nic! I appreciate that and your thoughts as well. Can you be more specific on what I need to double-check in regard to Jesus? I’d like to correct it if I got something wrong. Thanks!

Peter August 12, 2009 at 9:17 am

Matthew,

You got nothing wrong about Jesus. Jesus was not a socialist. Nowhere did He endorse the concept of the state taking away your possessions and giving them to someone else. The Left always cites Matthew 25 as the basis for socialism. It isn’t. It’s the basis for compassion and Christian charity. And no, compassion cannot be mandated, any more than volunteerism can be forced. There is nothing compassionate about the state robbing me and giving it to someone else. That’s called legalized theft.

Matthew Warner August 11, 2009 at 1:56 pm

Pinko – wow – i think you need to reread my post without whatever bias you are reading it with.

Yes, I pointed out that Oregon offered to kill her for $50. Which seems pretty bad to me. But I didn’t demonize them.

And overall, I admit that their problem they faced is one we ultimately face all the time, even with private insurance.

I skipped those details you list because they are ultimately unimportant to the overall point I’m making. And if I did include them, they simply support what I was saying – that their program had to make a common, tough decision. So I’m not sure what you’re getting at.

I also didn’t say one thing about socialism.

I also didn’t argue that helping pay for this woman’s care was “not worth my financial freedom.” I just asked the question. So why all your accusations?

I also never said that helping her was evil.

And now you’re accusing every person who says the government has no moral right to take money from people and give it to somebody else…what…selfish? Suggesting that they are only concerned with something if it “benefits them personally”?

Perhaps you should open your mind a bit that it’s possible to be a loving, giving, charitable person who does amazing good in this world without also believing the best way to do that is by believing some institution has the right to take as much property from one and give it to another. Just maybe.

I don’t know who those 30 people are. But I’m willing to bet many of them give more to charity and to helping people than the average American. I could be wrong. But I’m basing that on people I know – which is certainly the case. So I would urge you to be more careful and sensitive about the generalizations and conclusions you jump to about people who may see the world quite differently than you do and don’t answer a poll question the same way you answer it.

Katie August 11, 2009 at 2:15 pm

Pinko: I’m glad you pointed out some more facts in this story. It’s an incredibly complicated issue with many, many parts. I’m one of the people who voted to say that the government has no moral right to take money away from its citizens to pay for health care–but I think it’s more appropriate to say that, philosophically, it’s not the role of government to provide health care at all. Do I know how much money the government already spends on health care? Sadly, yes. Do I think it’s reasonable for the government to suddenly and completely stop funding its health care components? Absolutely not. I don’t think that will ever happen and I’m not convinced it should, from a practical standpoint. But again, philosophically, I don’t see providing health care as a role of the government–any government.

I’d also like to point out that loving “roads and firemen and police” has little to do with questioning the role government should play in a society’s health care. I don’t know anyone who would suggest that developing and maintaining infrastructure, or financing police and fire staffs, is not the proper role of a government at some level (be it federal, state, etc.)–no matter their political perspective. It’s unfair to suggest that people who appreciate infrastructure and civil order are somehow hypocritical if they have, what you call, an “overwhelming fear” of socialized medicine.

pinko August 11, 2009 at 3:19 pm

Firstly, Matt: You didn’t use the word evil but you have a little graphic of the grim reaper up there. And you didn’t mention the word socialism in the above post either but you know exactly what I’m talking about. There’s no reason to play the victim here. Re-reading, without my ‘bias’, “Since Oregon has legalized assisted suicide, the $50 suicide was the most practical option for them.” still reads like you’re blaming Oregon’s health program for trying to kill a defenseless woman.

I will stand by my own words, though: yes, I think it’s selfish for people to say government shouldn’t take money from them and give it to someone else. Because those people benefit from the government all the time in everything they do. But I just asked the question, exactly like you did: is this honestly all about fear of having to pay more taxes? I don’t understand why you wold never question a giant military budget to fight terrorists but you hate the idea of the government fighting, in this example, cancer. It’s weird to me, especially on a Catholic website. Call me wrong, warn me about my generalizations, whatever, it doesn’t change this: I don’t get it.

To Katie: yeah, I understand where you’re coming from (despite what Matt will tell you otherwise, I don’t think you are selfish :) ) I just honestly don’t see the difference at all. Like, if your house catches on fire, a government organization is there to do it’s best to make sure you’re okay and your stuff is okay. But if someone is injured in that fire, well, they’re on their own. It’s just completely against everything I know – granted I’m a democrat and a lot of you guys are republican and there’s just a philosophic difference there, but – I just wish someone could explain to me WHY health care is different? AND big thanks for responding saying you were one of the voters, I appreciate it. I really don’t think you are a selfish person.

Matthew Warner August 11, 2009 at 3:38 pm

Pinko – I think you’re missing the subtlety of the question. I didn’t ask “should” the government take money and give it to somebody? I didn’t ask “do we as individuals have a moral responsibility to care for people that need it.?” I think the poll response would have been very different in each of those cases.

I didn’t even ask “should we GIVE money to the government to take care of other people.”

I asked does government have a moral right to take from one person against their will and give to another? That’s a very different question. And certainly answering “no” does not make somebody selfish.

Nic August 11, 2009 at 3:47 pm

Matt, I guess we’re at different ends of the political spectrum and this may affect our interpretation or “overall view” of the gospels.

Certainly, searching http://www.drbo.org (great resource!) for “poor” doesn’t back up my arguments, but I always remember that Jesus spent a lot of time with the poor, said stuff about “the eye of the needle”, telling the wealthy man to give up all his gold, and blessed are the meek and the poor etc.

While having the state “take” your cash, instead of relying on your Christian generousity may seem wrong to you, I put it to you that not enough people in our society are a generous as we need to maintain a health system on charity alone.

Once again, thanks for all your good work.

Michael Ejercito August 13, 2009 at 10:45 am

Certainly, searching http://www.drbo.org (great resource!) for “poor” doesn’t back up my arguments, but I always remember that Jesus spent a lot of time with the poor, said stuff about “the eye of the needle”, telling the wealthy man to give up all his gold, and blessed are the meek and the poor etc.
If the Oregon Health Plan administered the kind of health care that Jesus administered, it would go like this:

“We hereby decree you healed. If you die, you just did not have enough faith.”

Matthew Warner August 11, 2009 at 4:03 pm

Nic – you may be right about not having enough charitable people. I don’t know. I don’t think we’ve tried it as well as we could have. But either way, it’s also not my place to judge if a person is being charitable “enough.” That’s between them and God.

There is no doubt Jesus’ teachings are filled with helping the poor. In fact, he says it is one in the same as helping/loving HIM (“whatever you do for the least of my brethren you do for me”).

But Jesus never once tells anyone to take from another and give to somebody else. And he never says that if people aren’t charitable enough on their own that we are to force them to be charitable (which of course destroys charity in the process). In fact, God made commandments about NOT coveting your neighbors stuff.

Thanks for your thoughts and honesty!

Artie Catalano August 11, 2009 at 8:47 pm

Matthew the more I think about it, I almost want Obama’s health care reform to pass because it will be the end of his political career.

Any reasoned look at what is being proposed will lead to the conclusion that the long term effects of the program will be to increase costs (something bureaucracy does exceedingly well), increase taxes, lead to greater deficits, lead to health care rationing, drive private insurance out of the market, promote euthanasia, lead to more nanny state interventions in people’s lives, promote greater dependency on government, stifle the development of new medical treatments (just when we’re getting to the point that we might start seriously extending the human life), and basically kill a lot of people, both here in the U.S. and in other countries, which have been relying on American innovation since their own socialized medical systems put the squeeze on domestic innovation.

The package as a whole would be a disaster.

As far as the political Jesus is concerned. Scripture teaches a both/and not an either/or in regards to the poor. (if you don’t work, you don’t eat and clothing those when they are naked and giving drink when another is thirsty)

Nic, it is all about being Christ to one another (speaking love with truth). One without the other cannot coexist and that is the problem I have with the rubber wing right and the party of death left.

If anybody has traveled outside the United States to a country where the poor are actually poor you will see quite a contrast to the poor in our own country. This is not to say that there are not legitimate poor people in this country, but most of the people that are on the streets in the United States made poor decisions (sorry if this sounds insensitive but I have a cousin that *CHOSE* to live this life style).

If you actually go out and talk to some of the poor people you will find that some of them chose to be homeless.

Nic, I also have a co-worker who is from England, and he moved out of his country and moved to the United States, because he despises having to pay for people who *CHOOSE* not to work.

Believe it or not, the system can and will be abused.

Aaron August 13, 2009 at 4:09 am

The only problem with that theory is that FDR also began many programs that increased costs, taxes, and deficits, led people to dependency on the state, stifled innovation, etc.–and extended a Depression for several years. And he was reelected three times and is still seen as a hero by most of the people who grew up then. I’m not sure Obama’s failures will be counted as failures–at least not while he’s still in office.

monique August 11, 2009 at 11:28 pm

For me one of the most important sections in this blog post was the paragraph that reads,

“It seems we have a lot of people in this country that would just say – “give the money to all of them!” But they are living in a fantasy world. In the real world, decisions like this must be made every day. So the question is not if decisions like this will be made. The question is who should make them. And if we are talking about federal dollars, it is your own money being decided upon.”

The idea that under the current health care reform plan, as I understand it, the federal government will be making these decisions scares me considering the grossly anti-life stance of the current administration. I don’t want my tax dollars used to help pay for abortions and euthanasia. If the government didn’t take so much of our money in taxes we would have more money left for charitable giving. I do a lot of volunteer work for a pro-life healthcare organization, http://www.divinemercycare.com. I help raise money that is used to serve under/un-insured patients but Divine Mercy Care stays constantly faithful to the teachings of the Catholic Church. I would much rather be able to donate money to organizations like DMC than lose that money to the federal goverment to use however they see fit.

pinko August 12, 2009 at 8:40 am

Yeah, I see what the question says – but I still don’t get the difference between the moral right of a government to take your money to fight terrorism, which has killed around 3500 U.S. citizens in 10 years vs. using your money to fight cancer, which kills over 500,000 EVERY year.

I understand the concerns – your taxes might go up a bit, you might have to wait longer at the doctor, the government might not match your ethics in all cases (which would make you feel personally guilty since you gave them money… even though, again, this never comes up when talking about, say, bombing a city while trying to rout out insurgents) – but in my mind they’re nowhere near the level of the benefits. Virtually every industrialized nation in the world besides US has universal health care. Health care is cheaper per capita in all those countries, and the quality of care, measured by many different factors, is by and large better. Yes, we have the best doctors and the best stuff – but none of that is going to change just because poor people have access to insurance.

And as for those poor, Artie, I’m not sure what city you live in but it must be a utopia. In the rest of the country, a full 3rd of homeless people are schizophrenic. And the health insurance is not actually about the homeless anyway so much as it is the working poor. Just because other nations have “real” poor, as you’re calling it, doesn’t mean in the least that we should want to help our own poor.

Another concern I hear is that companies will stop buying insurance when a govt option is provided – but a) that makes a company with better insurance have “benefits” just like what they’re called now, b) I promise you the employees at, say, an auto factory would prefer taking gov’t sponsored insurance as opposed to losing their jobs entirely (which has been happening all the time), and c) small business such as Phil’s (i think that’s who said it) will be able to thrive – thus giving them more money to donate to charities!

I guess it all just comes down to a general mistrust of the government for all of you guys? Am I wrong in saying that? And why, then, do you trust them to make decisions about invading other countries using your money? My thought is: living in a country as great as the U.S., I’m more than willing to pay the taxes that they ask of me. Even when there’s a war I disagree with, I don’t consider stopping my taxes. And when they propose something that seems like it can do an extreme amount of good in exchange for slightly more of my taxes, then I’m all for it.

Matthew Warner August 12, 2009 at 9:08 am

Pinko – that’s the great thing about our country (that doesn’t exist to the same degree in those other countries)…right now somebody like you can choose to give as much money as you want to support whatever cause you want. And judging by your position, I’m guessing you send in extra amounts of taxes to the government every year. Nobody is denying you that right.

I’m just asking that you let those of us who don’t believe that is the best way to spend our money helping people do the same.

We could have asked the same question about say “taking money to fight a war.” Maybe we’ll do that some other time. Good idea!

Zeke August 12, 2009 at 11:12 am

Government has NO rights at all here in America, moral or otherwise.

pinko August 12, 2009 at 11:56 am

But low taxes is not some inherently American concept. It’s basically an 80’s concept. Look at every year before Reagan’s sweeping tax cut to see what those rates were like. And something that everyone seems to be all the sudden interested in – the debt – started growing insanely rapidly right around the time when Reagan cut those taxes, for some reason. Somehow Reagan = America in a lot of people’s mind, and Reagan cut taxes drastically, so a lot of people think it’s American to not want to pay taxes. Then of course Clinton did really great things with the deficit, and then ol’ Bush came and started handing out tax cuts again (which republicans always argue stimulates the economy, until now when they don’t have a leg to stand on). Now Obama is spending money and trying to just get rid of Bush’s stupid tax cuts and everyone is acting like he jumped the tax rate up to, well, to it’s pre Reagan level (he’s not, by a margin of over 10%.)

It’s not a matter of if you believe it’s the best way or not. What if your buddy decides it’s not the best way for the government to have any of his money? He can just stop paying taxes altogether?

So just to clarify: what do you think is acceptable to tax for? And what do you think is an acceptable rate for that tax? How much is it worth to you to be an American citizen, is 35% the magic number? Is the (imagined) tax hike just a deal-breaker, or do you, like katie, just fundamentally believe that the government should stay out of healthcare for its citizens. And if it’s the latter – this is for everyone, btw – Why?

Ending on a less exhausting note, I really like the site re-design, nice work. It looks like the limits have been taken off the comment postings, too, which is awesome because I ramble…

Nic August 12, 2009 at 12:44 pm

I must say that this is an interesting insight into how right-wing (as I view it) Catholics (and other Christians) think. I may not agree with your views, but at least I understand your position better.

As Neil Kinnock said warning of an impending right-wing government in the UK, “I warn you not to be ordinary. I warn you not to be young. I warn you not to fall ill. I warn you not to get old.” Because if the state does not look after the disadvantaged, then few will.

You may not like taxation and view it as a violation of choice, but without it, as a society we are un-Christian. Think of it as the lesser of two evils.

I could move to the US and (I think!) make a better life for myself. Except that I’ve had cancer, and without the UK’s NHS, I can’t get healthcare. Which means your free-market in talent is broken. Think on that, free-marketeers!

Michael Ejercito August 12, 2009 at 3:09 pm

Did Jesus actually help the poor?

When He healed people, what methods did He use?

ClaudiaGo August 12, 2009 at 3:43 pm

Where did we get the notion that Health Care Insurance has to cover every possible treatment available, regardless of cost and probability of success, and dare I say, regardless of an individual’s responsibility to care for themselves? Why does it have to be universal? It is one thing to cover basic medical care, plus some level of catastrophic care insurance (which is available in every county clinic for routine care, and medical facility that has to legally treat emergencies-which taxpayers and insurance premium payers are already paying for!) and it is another thing to buy into this idea that everyone should have infinite choices and access to whatever they desire or is available. Being Christian requires us to be compassionate and to comfort those who are sick and dying; it does not require us to provide every desired, and even less extraordinary means, to prolong life, just because doctors and medical technology can do it.

I have decent Health Care insurance for myself and family because of the decisions and efforts I have made to secure them. I am well aware that these are not guaranteed, but I do my best to make sure that the decisions we make and the way we conduct our lives and careers give us the best shot to assure that we have coverage. I also take personal responsibility for how I care for myself, and I think it would be wrong for me to expect others to pay for the consequences of bad lifestyle choices that result in the need for extraordinary and expensive medical choices. If my means won’t secure these treatments, so be it.

And even though I might not “deserve” a condition or illness that would require measures beyond my means? I expect that at some time I may find myself, or a loved one, in a critical decision situation where my/their insurance and personal means will not cover any further treatments to prolong, or guarantee a quality of life. And I pray to God that I will have the grace and the selflessness to see the larger picture, and accept that my time has come.

And in response to comparing using our tax dollars for the military and for the police, firemen, etc. to that of using it for universal health care – these are civic services, not individual services, and are also enummerated in our constitution as duties for our government in order to preserve our sovereignty and enforce our civil laws. Nowhere is it written that the federal governement has an obligation and duty to provide health care to its citizens, nor has the federal government shown a great aptitude in the past to provide these services (Medicaid/Medicare). All of these types of nanny state services have arisen from the misguided acts of the Roosevelt administration, for which there was no constitutional justification, and has resulted in the current generation assuming that there is no limit to what the government is obligated to provide for its citizenry, consequences be d****ed.

Matthew Warner August 12, 2009 at 4:02 pm

Pinko –

There is no magic number. It’s a complex, real world challenge. And there isn’t a clear-cut, pat answer for any of us. So there is room to disagree as Americans.

Right now people are upset because they don’t want their money being given to a government institution to decide how it is spent – particularly on things they have no part of. They don’t trust, nor see the necessity of, having some government thousands of miles away deciding such things and spending it on things they don’t support or believe in.

It is precisely the reason for the American Revolution. Americans didn’t want some institution thousands of miles away making decisions with their money that they didn’t feel were in their interest (Taxation without representation).

Additionally, the federal tax rate when America was founded was ZERO. And they’ve only gone up and up and increased the scope of the federal govt more and more with no sign of stopping. Originally, this stuff was designed to have been handled at the State or Local level.

So I strongly disagree when you say…

“But low taxes is not some inherently American concept.”

It couldn’t be more American. The idea of a federal government that is limited and only does the bare minimum that it must do is uniquely American. The rest is left to the states.

So yes, I totally agree with Katie that this is a philosophical distinction. And I also firmly believe that it is this philosophical distinction that has made our country uniquely great, as well. And it is there to secure our freedoms long term.

What is the great need to have the federal government provide health care? Should this not be handled at the state level? Let each state do what is best for their unique situation and better represent their own people.

And if the national government program is going to be as great as you seem to think it is going to be, why have such programs not worked as well on a state level? And if they ARE working, why not let each State adopt what they see fit and learn from it?

If each state took on this responsibility in their own way, you’d have 50 American approaches and each could learn from the other. And each person would have more of a voice in their local government. It is also more efficient this way. When a local government’s own resources are at stake (instead of just getting a check from the federal government) there is less fraud and increased efficiency. We have to let Americans own it. A huge bureaucratic program thousands of miles away breeds corruption, fraud, and unhealthy dependency.

We’ve lost local and state government in all of this. And you don’t have a lot of national senators (from either side) clamoring for it because they all want more secure jobs. They want more money. They want more power. They want a bigger fed gov. Our government was never ever supposed to be this way – and not just arbitrarily, but for a specific purpose.

These current plans are taking us in the wrong direction. And in the end I don’t think they’ll be better and that they’ll actually make it worse.

And thank you for the site compliments! I appreciate that. I was beginning to wonder if anyone noticed. :-) I like this poll feature too. I want to do that more and get more interaction from people that aren’t inspired to actually comment. It’s fun.

Nic – I really appreciate your honesty. I agree that I think a big part of all of this misunderstanding is that each side thinks the other is just crazy….because from their point of view, they just don’t “get it” (as Casey said). And I think that’s an honest, sincere feeling. But I really think many people come at these things from VERY different points of view and truly don’t understand why and the heck the other side believes the way they do…to the point that they think they are evil or crazy or stupid or bigoted or whatever. I really do appreciate your points of view and thank you for sharing them on the blog here. It’s a step towards a better understanding.

If either of you or anyone else are interested, I wrote a post awhile back explaining a little bit more of why I feel the way I do about the role of government. It might give you a better idea on where I (and others like me) are coming from in what we believe. It has a video in it that is worth watching. I hope you’ll take the time to watch the whole thing and comment if you get the chance.

If you have anything similar, I would enjoy checking it out as well to better understand your world view.

Here’s the link: http://www.fallibleblogma.com/index.php/the-freedom-to-freely-practice/

Andreas August 12, 2009 at 6:47 pm

Tee hee, when (philosophical) worlds collide…

The thing I find interesting that no argument (not enough money, will impede my career, I am not willing to, it’s my choice) would pass in the case of abortion.

But when it comes to life and death of *born* people in the case of health care, it seems that suddenly money is very important. Technicalities (“the government takes” vs. “I give”) are suddenly very important. Personal choices are very important. And you don’t want to be responsible for other people’s choices, and you don’t want other people to make choices for you or force their view on you. This strikes me as, well, hypocritical.

I just bring it up because of Pinko’s repeatedly made (and pretty much ignored) point about spending hundreds of billions on a war, on the military or other pet projects without a conservative outrage.

But now, that the money would actually be used to help people – it’s all wrong and must be opposed. I think this is what I don’t get about conservatives.

I have been following this blog for a while and I enjoy the discussions. This one really surprises me, I am with pinko on this. I understand your stance on abortion and on other issues. But this? Your money seems to be more important than your fellow man. The “charity will take care of it” has not really worked, ever. It helps, but it will not take care of the problem in a structured way.

And when it comes to “there has to be a better way than Obama’s plan”, well, I haven’t seen it. The Republicans had eight years to start fixing it… nothing.

Michael Ejercito August 12, 2009 at 7:46 pm

People claim that abortion is immoral.
But when it comes to life and death of *born* people in the case of health care, it seems that suddenly money is very important.
Refusing to pay for someone else’s health care is not the same as killing them.

To go back to the abortion issue, refusing to fund prenatal care is not the same as an abortion, though they both affect the unborn.
Your money seems to be more important than your fellow man.
Money did not do the Holocaust or the Rape of Nanking.

Money did not rob and murder Matthew Shepard, nor kidnap and rape Elizabeth Shoaf.

Fellow man did this.

Just recently, a girl in Los Angeles was murdered. She was really into helping the homeless.

The suspect who was charged was a homeless ex-con who was homeless because he would rather do drugs than work.

If you look at all the evil fellow man does, you will understand why we prefer to keep our money to ourselves.

Andreas August 14, 2009 at 10:13 am

-“But when it comes to life and death of *born* people in the case of health -care, it seems that suddenly money is very important.
–Refusing to pay for someone else’s health care is not the same as killing –them.”
Well… I would say that is sophistry. That’s like standing next to a pool with a drowning kid and saying: “well, I don’t kill it, the pool does, tough luck”. My point is: you seem to be extremely concerned about the suffering of unborn life, but that seems to change drastically once the person is born. If you happen to be poor, well tough luck. Chronic disease, no health care, constant pain, well, not my problem. I find that hard to reconcile, especially if you claim to be a Christian.
Jesus helped those who needed help, not those who *deserved* it.

I find the “I won’t support a plan that won’t work” excuse very dishonest: even if the plan isn’t perfect, it would surely help to mitigate suffering. That should be reason enough to do it in a society that cares.

And Michael, I really don’t get the “Money didn’t kill the Jews” thing. What is your point? Your fellow man doesn’t care enough? That would be exactly my point. If you rely on people’s charity and voluntary generosity it will get you exactly nowhere in the issue of a functioning health care system that covers every citizen – we need some legislation here. People are selfish. Unless you make them pay, they won’t. I guess if all people who call themselves Christians in this country would actually follow Jesus’ example, it might work. But it seems praying is easier than actually doing something. I’d rather go with a less than perfect system than what we have now.

Michael Ejercito August 14, 2009 at 11:19 am

Ah, I see. You think poor people are all just unfortunate victims of circumstance.

Have you ever heard of Charlie Samuel?

http://www.latimes.com/news/local/la-me-lily-burk28-2009jul28,0,123041.story

Why would you want to pay for the health care of someone who would rather do drugs than work, as Charlie Samuel did? Why would you want to pay for the health care of a paroled rapist? The fact is, not every poor person deserves charity. If a man who raped a girl is paroled out of prison and gets cancer, let him die of cancer!

By the way, Jesus healed people by declaring them to be healed, not by drugging them or hospitalizing them.

Matthew Warner August 12, 2009 at 7:53 pm

Andreas – why would I support something that I don’t think is going to help people? What’s not to get about that?

As for abortion, I’m not asking the government to spend any money on it. So I’m not sure what’s so “interesting” about that. I just want our laws to recognize the natural human right to live (i.e. to not be killed) of all humans – including the ones in the womb.

I’m not ignoring the war topic. I think it’s an interesting topic. But there are only so many side tangents we can go on in a blog post comment section before the conversation becomes too confusing and a waste of time. There are some big fundamental differences between health care and defense of our nation (constitutionally, personally, obligatorily and otherwise). I’ll try and have a blog post on it soon for more discussion.

And Andreas, you’re smarter than comments like this “Your money seems to be more important than your fellow man.” If you’ve read half of the comments and the post then you know the question is WHO gets to spend MY money and how it is spent.

Again, there are lots of ways to cut costs, help with pre-existing conditions, and insure more Americans WITHOUT a public option. SO don’t pretend that the only options are “Obama’s plan” or “do nothing.” And don’t pretend that just because somebody opposes a public option that they “care more about money than their fellow man.”

pinko August 13, 2009 at 6:26 am

A few points-
Claudia: You say “medical facility that has to legally treat emergencies-which taxpayers and insurance premium payers are already paying for!” but I think this is often misunderstood. A good example is someone whose kidneys have failed and need dialysis. In our current system, someone without insurance is told to wait until they start feeling awful – until there’s so much toxin in their body that they are literally dying – and then come to the emergency room for emergency dialysis. This is was more common than you’d like to imagine – ask any intern/resident at any of those county hospitals that you mention.

“Being Christian requires us to be compassionate and to comfort those who are sick and dying; it does not require us to provide every desired, and even less extraordinary means, to prolong life, just because doctors and medical technology can do it.”
I just think being Christian- or a good person of any faith/non-faith- means you WANT to do those things. No one is required to do anything.

Matt: “Taxation without representation” – this is by no means taxation without representation. You have a representative. Several in fact. THAT is what makes America great. It turns out that more of the country, right now, have chosen a person to represent them who is in favor of universal health care. And if enough of you got upset with the way things were going, you could change the balance of those representatives. Thankfully I don’t see that happening any time soon because the Republican party is one big screamin’, sleepin’ around, quittin’ mess right now.

“The federal tax rate when America was founded was ZERO”
“Originally, this stuff was designed to have been handled at the State or Local level.”
The tax rate was zero, and state/local was the way to go in a time where everyone rode horses. There were no cars, no planes, no internet, no phones. Things have changed a little bit. The government didn’t need taxes back then because a) everybody was a farmer b) there weren’t that many people c) they were stealing all their resources from the natives. Notice when taxes go way up, historically speaking – it’s when the war happens. All the sudden, we lived in a world that was not sheltered from everything not in walking distance.

“why have such programs not worked as well on a state level? And if they ARE working, why not let each State adopt what they see fit and learn from it?”
This is sort of the whole reason for a national plan. A national plan is a completely unified system, costs will go way down (since there are way more buyers), people can travel from state to state with no problem. Again, you think of ‘state’ the way they were before planes were invented. If, like, Louisiana has for example a hurricane problem, the people in Rhode Island don’t get to go ‘Hey I’m not sending my tax dollars to help with the recovery… I’m not really interested in Louisiana.’

“each person would have more of a voice in their local government”
Each person does have a voice in their local government. And a lot of community’s are very politically active – take Austin for example. Education issues, environment issues, development issues – I heard people talking about that stuff every day. I think, again, you have to think about how things have changed – is what’s good for Austin the same as what’s good for Dallas? Not necessarily. Is what’s good for the people on the rich west side of Austin the same as what’s good for the people on the poor east side of Austin? Not at all. So where’s the line? It’s complex, like you said before. And so for something as vitally important as health care, I think the national govt has every right, in fact i think a responsibility, to take some action.

“There are some big fundamental differences between health care and defense of our nation (constitutionally, personally, obligatorily and otherwise)”
I still don’t see the difference between defending our nation from a, say, terrorist-driven anthrax attack that hurts 15, and a free-radical driven cancer attack that hurts millions. So I’d love to hear what that difference is in your minds.

Michael Ejercito August 13, 2009 at 10:38 am

This is sort of the whole reason for a national plan. A national plan is a completely unified system, costs will go way down (since there are way more buyers), people can travel from state to state with no problem.
So a health care plan needs three hundred million to work?

How does Canada’s health care plan work with a population less than California’s population?

As a matter of fact, Massachussetts already has universal health care. How is this possible, if universal health care is impossible for states to do?

Matthew Warner August 13, 2009 at 8:38 am

Pinko – doh, yeah, I forgot they rode on horses! That changes everything. Oh, and I’ve never thought about how we need the federal government to steal resources on our behalf now since we don’t have the natives to steal them from anymore. Seriously?

And yes, I know we have elected representatives, but if my money is being taken against my will and spent on things I don’t believe in…then I’m not being “represented.” Plain and simple. Same concept. And the point was that you were trying to say low taxes is an American concept that was born in the 80’s…which is hugely incorrect. Low taxes, or NO taxes, was an inherently American concept from day one of the Republic.

Each of our states are about the size of many of these other countries around the world (that also have cars and the internet) that everyone keeps pointing to as examples of gov provided health care. So you still haven’t answered the reason why we can’t get that to work on the State level (except for the whole not riding horses thing anymore which I admit…is very compelling)? And if it hasn’t worked on the state level, why will it work at a much bigger and bureaucratic National level?

I’m all for taking down barriers so health insurance companies can compete across state lines and drive down costs. Nobody is against that AT ALL. But no need for the public option though to do that – not on a national or State level.

Michael Ejercito August 13, 2009 at 10:40 am

Has you ever heard of Los Angeles County King-Drew Medical Center?

It was run by the Los Angeles County government .

That is an example of public health care.

Michael Ejercito August 13, 2009 at 10:43 am

At least those were the options the Oregon Health Plan gave to Barbara Wagner last year. This government-run health care plan deemed it was too expensive ($4000) and not worth tax-payer dollars to give her a drug that could extend her life . But they were happy to give her $50 to be “put down.” No joke. (I have a poll at the bottom of this post. I’d love your response.)
But, but this is socialized medicine! It is supposed to give free health care for all, like a buffet or something.

I know it’s not common for Catholics to read the Bible, but Matt, you may want to double-check on Jesus’ attitude towards the poor and less fortunate in our society.
If the Oregon Health Plan administered the kind of health care that Jesus administered, it would go like this:

“We hereby decree you healed. If you die, you just did not have enough faith.”

pinko August 13, 2009 at 11:56 am

Matt, again, I don’t know why you’re incredulous – my point was – very valid, by the way – that when the country was formed they lived in a little bubble, cut off from the rest of the world by a giant ocean, in small communities. You know I wasn’t saying horses changes things, I was saying that planes and the internet and a world war DID change things. They didn’t provide for national health care in the constitution for an extremely obvious reason – there wasn’t very good health care back then at all. Now we’re at a point where a doctor can make a discovery in Germany that literally cures a disease, and the next day the whole world knows about it. Louis Pasteur wasn’t proving that germs cause disease until the mid 1800’s! We live in a different world. Saying the forefathers wouldn’t have wanted it that way is just silly and even if it were based on any truth, it’d be a little irrelevant at this point. You’re trying to rally for something that you or your parents or probably even your grandparents never experienced, because you read about it in a history book and it matched your idea about not wanting to give your money away. I wouldn’t be like- I’m racist. America was founded by racist people. We had to amend the constitution to even call black people ‘people.’ So it’s very American to be a racist.

And still, you’re not describing ‘taxation without representation.’ That’s when someone (The British) takes your money, but doesn’t let anyone come and state your case that you don’t want them to use the money that way. What you are describing is “being in the minority.” It sucks, I know, I had to do it for the last 8 years.

I don’t know any of the states that you’re saying have universal health care, I’ve never lived in one. I assume it probably does work. And if it’s really great, the states are more than welcome to keep their state plan when the national plan goes into effect. If it’s not working, it’s almost assuredly because it’s not well funded- a lot of states have trouble even keeping their school systems running well. I just don’t get what you think is gonna happen when a person gets sick in, like Dallas – you think they’re gonna have to call someone in Washington D.C. to ask if there’s coverage? It will work because: the US will be able to say, hey there all you drug companies and private hospitals and private practices- you can go ahead and do this procedure or cover this drug because you know exactly what we cover and what we don’t. It’s right there on your wall because half of your patients use the same policy. Also, you don’t need to order that MRI in Dallas anymore because we have the results from the one he got in Houston last month. (I can tell you with certainty doctors spend a whole lot of their time trying to coax medical history from their patients). Also the government plan won’t be trying to turn a profit, for example Aetna was the first one that popped in my head, googled it, they’re making in the hundreds of millions of dollars in profit every quarter. Now they have to do that by moving the bottom line, and that leads to all these claims of dropped coverage or denying pre-existing conditions, which is why people hate health insurance companies in the first place. If YOUR provider is awesome, then fine, you can keep it. In fact, if a poor person hears from you the coverage is awesome, they can take their subsidy and maybe spend a little extra, which they can now afford, to buy into your provider. What’s wrong with that?

So then, what about it won’t work? I’m starting to think you’re afraid that the government sucks just because they botched nearly everything in the last 8 years. Well, that was YOUR guy. He’s gone now.

“Each of our states are about the size of many of these other countries”
Where are you pulling your facts? I’ve got some bad news for you….

Andreas August 14, 2009 at 10:01 am

Matthew… just one quick question, which might clear up a lot for me: would you call yourself a libertarian, from a political point of view?

Matthew Warner August 14, 2009 at 11:44 am

Andreas you said

I find the “I won’t support a plan that won’t work” excuse very dishonest

I disagree. I’m not against reform. I’m against many aspects of these particular bills. First, I don’t think these plans will actually help AT ALL in the long run overall. So to me, it would be immoral to support them. You obviously disagree. But it’s not dishonest.

Second, this is a democratic process. There are good parts of these bills and there are bad parts. This uproar against the current bills (of which pluralities, if not majorities in this country are now against) is probably going to help make the bill better in the end when they finally settle on something. I hope. Then once we’ve worked out a lot of the garbage, then maybe we’ll have something we say..”hey, it’s better than doing nothing and it’s the best we can do now, so let’s support it.” As it currently is, I don’t believe it is better than doing nothing.

Third, we can’t afford it. It is immoral to promise things you can’t afford even if they have a good intention. We are robbing our kids and grandkids. We have to do better than that.

And no, I don’t consider myself a libertarian. I consider myself a “constitutional republican” in the original sense of the words. I believe that what has made America unique is that its founders recognized that real liberty is protected not by having the right people running a powerful government, but by having as limited government as possible and leaving the rest to the localities and people. They knew that no matter what technologies were available, or how globally connected we were, that people are people. And that throughout history all governments have ended in some kind of tyranny.

All of the things Pinko listed can be attained without a federally run “public option.” It can help regulate electronic records, but without controlling them. It can set compliance standards that globalize and make efforts more efficient, but it can do so without being the one enacting the efforts. It can make laws that enable competition across state lines and drives down costs for everyone, but without being one of the competitors. It can enact tort reform to reduce medical expenses without being the one suing or being sued.

There is just no need to give the fed government that kind of power on these issues. They all have us convinced that it’s either THIS plan where they get all the power or NOTHING and more people suffer. It’s a lie. It wont’ help. And we also can’t afford it. Even the CBO says these bills will not accomplish the goals we want.

And there is no country in the world with “good” nationalized health care that is as big or even half as big as the US. They are all much closer in size to many of our states. If we can’t get it to work even on a State level here, then why would we do it at a national level? It makes no sense. You can say it’s because the state don’t have funding for it. Neither does the fed gov!!! The states can tax just like the fed gov can. The point is that it doesn’t work.

The government is the worst “giant corporation” in the world in terms of corruption, efficiency, and bureaucracy. This is a proven fact. And anyone who thinks they aren’t driven by profits is in another fantasy world. The level that special interest groups are affecting these bills is atrocious! And they stand to make or lose billions of dollars depending on what happens. This is why we don’t give this power to the government in the first place. This is why the country was set up so that health care and any other such issues were left to the state and local governments. Roads, education, police, fire depts, etc. are all handled on lower levels because there is no need or place for the federal gov to be involved. And they each require unique solutions depending on the local culture and needs. And having the decisions and special interest lobbying occurring on as local of a level as possible reduces waste and corruption.

Nobody has made the case for needing a public option. Obama and crew can’t explain these 1000+ page plans to anyone. People are confused. That doesn’t bode well when the proposal is asking to put us into record debts and deficits.

Defense of our nation is slightly different. It is constitutional. And I’m not sure it can be practically accomplished without the federal government having at least most of the control. So, in my view, that’s something we give up to them. Not great, but necessary. We can debate all day long on whether certain efforts are good or bad, but the point is that it is constitutionally proper that it is handled by the fed government.

Zeke August 14, 2009 at 12:27 pm

I was a libertarian until I realized that they are also “party politics”. Then I became a “constitutional republican” which is the alternative to the “democracy” that congress operates by.

President John Adams said, “All the perplexities, confusion and distress in America arise, not from defects in the Constitution or confederation, not from want of honor or virtue, so much as from downright ignorance of the nature of coin, credit and circulation.”

Money is a science that very few people have investigated. If we use “Gods money”, all sorts of seemingly unrelated problems will simply vanish! That’s why Judge Roger Sherman insisted on Article 1 section 10 of the Constitution, which says, “No State shall… make any thing but gold and silver coin a tender in payment of debts…”

Artie Catalano August 15, 2009 at 6:33 pm

Zeke great points!

I thought this video was very interesting!

http://www.wimp.com/thegovernment/

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