Friday, September 04, 2009

Socialized Healthcare 2: Discussions in Facebook

Today, at least 7 of my friends in facebook posted this in their status:

“No one should die because they cannot afford health care, and no one should go broke because they get sick.” If you agree, please post this as your status for the rest of the day.

I replied on their respective status with this comment:

“Malabo yan (that’s vague). A poor or middle class person who needs xx million pesos of medical treatment for his/her cancer so he won't die nor go broke, where to get the money? From taxes, where else. Should we kill those living and working in high taxation just to save the dying? Where is the limit or demarcation line between personal vs. government responsibility in health care?”

I think the above requested quote is an offshot of the hot debate in the US healthcare bill.

Then I got the following replies or counter-comments:

(1) Noysky - I construe the message as it is. Who wants to see a poor person die because he has no medical insurance coverage? I am sure you don’t want to see (my 2 kids, one has special needs) in bahay ampunan (adoption house) because we used up all our savings to pay for my medical bills. Whether health care is a personal or government responsibility, I don’t know. I also don't know the demarcation line between them... hehehe Please educate me, professor O+!”

(2) …We should have a health system patterned after UK.That way...patronage politics does not enter into the health care equation. It also avoids future pension and health care headwinds and provides additional incentive in paying of taxes.

(3) Health service is a human right.

To which I made these respective comments:

On (1): Not only poor people but rich people die. Cancer, Alzheimers, HIV, stroke, etc. do not choose their victims. It’s just that the rich can probably prolong their lives. Instead of dying within 6 months of a stage 4 cancer, they may live for 1 or 2 year/s. For people with special health needs (like those with physical and mental disability), I would concede that government should come in to help and provide subsidized health care. Governments should not over-tax parents and over-regulate private healthcare enterprises. Over-taxing the income of parents reduces their disposable income. Over-regulating private hospitals, clinics, pharma and health insurance companies, result in reduced competition and high operating costs that those enterprises will pass on to their patients.

On (2): Health socialism often results in health rationing. Demand will always exceed supply. A person suffering a headache will most likely demand lots of diagnostic tests to ensure that he does not have cancer or tumor or whatever disease. Anyway diagnostic tests and physiciian visits are free. With health rationing, health bureaucrats will determine who needs prompt health care, who should wait 6 months.

On (3): Not all the time. People who drink 7 nights a week, smoke 2 packs or more a day for many years, over-eat fatty food and have sedentary lifestyle, get into frequent fights and rumbles, live promiscuous lifestyle, etc., then when their intestines or lungs get mutilated, they run to the State and demand that "quality healthcare is their right."

Health socialism – like education socialism, housing socialism, or socialism in general where the rich will be over-taxed and the poor will be subsidized, regardless of the circumstances of their poverty – will always remain a populist and emotional issue. Understandably so because once a family member gets sick, especially chronically sick, the rest of the family will be restless and worried. Not only about their health condition but also about the financial drain that sickness will bring.

With health socialism, the most common target of attack are the big companies – pharmaceutical and health insurance companies, hospitals and clinics, diagnostic and lab test centers – and the rich physicians and other health professionals. Governments are seldom seen as a contributor to expensive health care. For instance, people often lambast the multinational pharmas for expensive medicines but they turn a blind eye on high and multiple government taxation of medicines. People attack the private health maintenance organizations (HMOs) for their expensive health premium but turn a blind eye on government multiple regulations and taxation of such companies.

Government does not have the monopoly of providing quality health care to the citizens. There are hundreds of voluntary organizations that provide free health services to the poor: civic groups like Rotary, Lions, Masons; religious groups like CFC and Christian groups. Such groups, professional associations and individuals do it with zero taxes, zero bureaucracies, zero politics.

Nonetheless, I thank facebook for allowing, even encouraging, this kind of spontaneous and unscripted exchanges among people. Information technology is really wonderful. Bureaucratism is not.

I wrote this last February 24, 2009

Soaring Healthcare Cost in the US

I read today this news report,

Health care costs to top $8,000 per person

It's from a recent report by the Department of Health and Human Services, and I'm wondering how the US government will respond to the following figures, among others:

* health care costs will average $8,160 this year for every man, woman and child, an increase of $356 per person from last year.

* number of uninsured has risen to about 48 million, according to a new estimate by the Kaiser Family Foundation.

* health costs will reach $13,100 per person in 2018, accounting for $1 out of every $5 spent in the economy.

Since the Obama administration has promised lots of welfare program for the citizens of America, the soaring health care costs should be a very burdensome issue that his government will face.

But is health care entirely government responsibility? I have always believed that only for a few public health issues like epidemics and diseases of babies and toddlers, health care should be personal and parental responsibility.

So when the latter is accepted as public policy, then government should get out over-regulating health insurance, and allow competition among private health insurance companies to provide different services at different terms and prices for different sets of people. Yes, no need to put lots of tax money for health care, and no need to impose high taxes to finance public health care. Because responsible people will take care of their body and avoid alcohol/tobacco/drugs abuse, live sedentary and cough potato lifestyle, and so on. And people will be able to choose which kind of various health insurance packages will fit them given their health condition and personal or household budget.

All of us are going to die anyway. If health care will remain a "government responsibility", then some people will insist that their medically-hopeless condition, or very expensive-to-treat diseases, should be shouldered by the government and the taxpayers at large will foot the bill. This is health socialism and it is counter-productive to society over the long-run.

* See also Socialized Healthcare 1: More Government = Less Health Care, March 29, 2006

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