The Latin re-ligio means to relink; to reconnect. Hence, the purpose of religion is to restore people to relationship with one another and to the Devine. As we then read the scriptures, there are several “macro-stories” centered around themes of bondage followed by liberation, exile and the journey of return, and sin and guilt followed by forgiveness. These become the stories we hear from childhood that encourage us to reflect and contemplate the message of our hearts. As Jesus upset the established order of the day with his message of unconditional love, those in positions of power could not stand the implied threats, and killed Him. The contract of the human head won over the contract of the human heart and the message of Jesus.
Social reform, as contemplated by humans, is a battle between those that have vs. those that don’t. The outcome of reform is a change in who wins and looses. Everyone does not win. The resources of supply are reallocated and consumed differently, until the supply is expanded, replaced, or depleted. In health care, we are referring to the supply of caregivers and the facilities in which those caregivers function.
The goal of expanding health benefits to all is fundamentally a supply and demand question. Cost is secondary though very important in determining marginal demand. The household demand for health care will continue to rise by most projections, regardless of the outcome of current social reform efforts. Without personal responsibility for buying the service, however, demand will become "tragic" as defined by the inability of any system to find a solution. While every system has opportunity for improving efficiency and expanding benefits by reducing waste, the path is completely independent of the agenda for typical social reform with its focus on defining a new model of rationing.
The central issue of religion is unconditional acceptance for the human condition. If our policy wonks had religion, the primary focus would be on structures to better meet "real" demand. This would lead to a focus on educating more people as caregivers. We would be looking at ways of redistributing caregivers to medically underserved areas through incentive structures. And we would be focusing delivery system performance on best practices with education to the average citizen as well as incentives to the delivery system. The concept of social reform Jesus preached was not a new model of winners’ and losers’. Everyone was a winner! Meeting the unmet needs of all will require a very different contract with the American people, starting with a focus on our legal system structures that impede delivery of best practice services, and ending with assuring an adequately qualified workforce. Then and only then, can America stand together and stand strong. Thoughts?
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2 comments:
I agree with you and I would love that it would be that simple. However I've dealt with many a people who's expectations for health care for all mean they get it for free at someone else's expense. They look at the rich and money's ability to pay for an extended life with expensve care. Hate is born of this and politicians are all too quick to make promises to this constituency. In this model there's still no personal responsibility on behalf of the consumer as politicians try to make the argument that health is a right.
I however, believe health is a choice. I don't have the right to fill my body with crud to weight 500 pounds then demand the right to bariatric surgery only to repeat the cycle. There's no protection for those of us not killing our bodies. Making health care a right takes away consequences. I can choose to eat my way to 500 pounds, if you have insurance the rest of you are protected against me entering the cycle above as my surgery will and should be denied until I can show the commitment needed to keep the weight off if I do one day end up with an approval for the surgery.
Jesus came with the same message. He was clear what would happen to those that followed him and to those that choose another path. Christianity was not a right, it was a choice and sometimes that choice got you killed. Jesus knew that without commitment you couldn't have faith and therefore would fail to acheive the afterlife he prepared for you.
This is why I believe health care reform should not come as a gift. Humans are flawed and the gift will be squandered without consequences of choice.
Eliminate the barriers preventing doctors to charge what they see as fair and let the people choose. Make health insurance become what it really is and that is risk insurance against a catostrophic illness/injury. If the policy makers succeed in making health a right, then other "basics" will follow. Can you imagine what would happen to farming in this county if eating is considered a right. What about marriage if procreation was considered a right?
As you suggest, health care is at risk for being the next "tragedy of the commons". When the buyer of service is detached in a fundamental way from the service provider, exploitation of the service results. This is the tragedy of entitlements. Because of the unpredictable, often unavoidable, and very costly nature of catastrophic health care services, we need the social solutions insurance provides. Today, the delivery system is out of balance and in need of a correction because basic services are out of reach for many Citizens. The solution, however, is not more comprehensive insurance. Rather, it is less government and employer intervention and a return to more personal responsibility and accountability. This will force providers to lower price, bringing the system back into balance. Thanks for your thoughtful input.
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