Monday, August 10, 2009

A question about "healthcare reform"

This is not a Philly-specific question, although Philly is a world center of healthcare delivery and education.

I was viewing a comment stream on a Facebook page called SBABG (Small Business Against Big Government), and I saw this contribution:
I have a newborn baby Becky[name changed]... went to the NICU on her first day of life. She was diagnosed with 22q11.2 DiGeorge Syndrome. She has life threatening heart disease: Tetralogy of Fallot, Pulmonary Atresia, MAPCAs and more. The cost of her healthcare may bankrupt us, even with the BEST healthcare coverage possible. We are extremely fiscally conservative, but still can suffer from problems like this. I am against the Obamacare plan, but we certainly need reform.
I think I know what answers I'm going to get, but it is safe to assume that this individual is a believer in a significant role for government in managing the healthcare industry? Otherwise, what would he mean by "but we certainly need reform"?

What are the responses of my readers, to this person's statement? How would "reform" help him out?

If I may be a bit indelicate, think of how we work through the wrenching problem of a pet who has a serious health condition. Say that the pet will live if it receives a $20,000 treatment, but if it does not receive that treatment it will certainly die. Depending on the economic situation of the owner of the pet, and the nature of the owner's relationship with the pet, there's a spectrum of likelihood that the owner will spend the money for the treatment, ranging all the way from "Of course! How could you even think of not doing the procedure??" to "Sorry, [pet name here], there's nothing we can do." Wealth alone wouldn't be the indicator-- two people who both have a sizeable savings account might have very different ideas of the importance of the pet's survival, relative to other possible uses of the money. (Example: "daughter's wedding next year, or another several years with the cat?")

Now-- the huge difference here, is that we can be sure this man's baby daughter is at the very very top of his personal financial priorities. But why does the bald fact of his daughter needing exorbitantly expensive care to remain alive, lead to the conclusion "we certainly need reform"? Is "reform" a code word for "more generous health insurance policies for people like me"? What kind of "reform" will make it good business for an insurer to fork over $[x] million dollars for one little girl, if it isn't good business now?

The guy could be facing bankruptcy in a few years for a variety of reasons. He may have reached his insurer's maximum payout amount, or the coinsurance costs may be bleeding him dry. What can he do? Well... if we really believe in the market, then our answer is-- "sell your daughter". Ok, I said that for shock effect, but I kind of mean it. Go out into the world, and convince individuals and organizations (churches, businesses, whatever) to contribute to the treatments that Becky(TM) needs to have a shot at making it to adulthood. Right? ('Cause, otherwise, you're getting those contributions anyway, via taxes, but without asking for them.) When all these people and groups are approached for contributions for Becky, and for Jimmy, and for Bobby, are they going to give equally to all three? Who knows? It'll be a complex decision, but a decision will be made. And the wider you cast your net, the more "votes" you can count. The market will decide whether to provide the resources you lack, for the purpose that you wish to use the resources for.

I feel I'm going to ramble if I go further. What do people think? I think we need to develop more sensible ways of talking about these emotional hot-button things. Just because we are very emotional about our own children, doesn't mean we should justify taking money from "society" by force.

Sunday, August 2, 2009

A Tree That Grows For Ages, Hurting No One

As I gear up for my second post on this blog, I'd like to share one of my favorite lines from any song, of any kind, that I have ever heard:
My longing:
Not to be a god or hero, but to change
Into a tree that grows for ages, hurting no one
(It is from a song called "She's All Heart", written by Terry Taylor of the band Daniel Amos.)

I have a root, that anchors me to the ground. That root is my wife. I've known my wife closely for going on nine years now, and I've never once heard her express a desire to leave the Philadelphia area. Ergo, I am rooted in Philadelphia. I am a voluntaryist, but I have no real desire to bring the light of voluntaryism to any place other than the Philadelphia region. I wish that everyone, all over the world, understood and lived out the principles of voluntaryism, but until everyone in the Philadelphia region can live free from the fear of government force being initiated against them, I leave the project of bringing "the light" to other places in the world, to the people who live in those places:
Why do you see the speck in your neighbor’s eye, but do not notice the log in your own eye? Or how can you say to your neighbor, “Let me take the speck out of your eye”, while the log is in your own eye? You hypocrite, first take the log out of your own eye, and then you will see clearly to take the speck out of your neighbour’s eye. (Matthew 7:3-5)
When you see faulty reasoning being acted on, constantly, and everywhere you turn, it is very tempting to attack the faulty reasoning, to attempt to correct it. The instinct to reach outside of yourself, outside of the place where you live, is almost overwhelming. We want to take our sound reasoning, that is in our heads, and spread it. But the attitude of the passage above (a quote from Jesus, if you're not sure what Matthew is) is one in which we are extremely slow to point out faults in others, and very quick to examine ourselves for faults. If you adopt this stance, you will be always watching, always listening, and very occasionally speaking.

A lot of smart people have thought about how society can be made better. I've heard about strategies and tactics for undermining the State. I've heard about how evil the State is, how much violence it does, how badly it distorts the truth, etc. But here's a problem, with thinking that way: the people of the Philadelphia region are extremely divided. The State has exacerbated this over the years, but the fact is that people fear those who are different from them. We are divided by wealth levels, race, religion, and many other things. We need to meet each other, find out about each other, and forge deep and strong bonds with each other, which will allow us to weather together the storms that naturally buffet those who stand for the truth.