It never ceases to be amazing that while most Christians, including Adventists, are more hawkish when it comes to fighting foreign wars for the express purpose of killing individuals, yet fight desperately to avoid their taxes to permit health insurance and coverage to all the U.S. citizens.

Are our tax dollars more wisely spent in bombing the citizens of other countries than in protecting the health of our own?  It would seem so if we take the pulse of the opposition to national coverage.  For a so-called "Christian nation" to care less for its citizens than the "atheistic nations" of Europe is astounding.  Speaking with a relative, a native-born Netherlands citizen, she finds it unbelievable that the U.S. is the only civilized countries that does not provide health coverage for everyone.

It is often the Marie Antoinette syndrom:  "I got mine, and am not worried about you." 

What we have is medical care masquerading as healthcare and calling it reform so that prescription drugs can be available to everyone when the public has no clue that adverse reactions to Rx drugs are the leading cause of death below age 75 as supported by medical literature not reported by the evening news, thanks to the pharmaceutical sponsors.

As a people we are supposed to give the call out of Babylon,  "for by her sorceries [Greek word, pharmakeia) were all nations deceived." Rev 18:23. Every nation practicing westernized medicine is on the brink of bankruptcy because drugs do not cure and sooner or later, they cause additional harm.

Richard Ruhling, MD, MPH
Board-certified, Internal Medicine
Assist. Prof. Health Science, LLU, 1974-78
www.LeadingCauseOfDeathPrescriptionDrugs.com

PS: Classic example--my wife died Oct 5 of low platelets causing a stroke. The Physician's Desk Reference shows that the antibiotic she took a year ago can cause that condition and her hematologists found no other cause. Ellen White was right that drugs "change the form and location of the disease" (Ministry of Healing, p 126) and can often work harm later.

This comment has been edited by AT Moderator 

All I will say in response is we strongly disagree on this as "health reform" (falsly so-called) in congress. But we will let it go on here, unless of course the name Adventist is dropped from the site. I wouldn't want people to think the church is endorsing what some genuinly view as an expansion and role of the federal government.

Monte:

I really enjoy your work! I've read your books and follow your blog. On this one, however, I must respectfully disagree with you.

One can make a principled case for the proposition that large, intrusive government social programs that focus on alleviating need with no requirement for personal responsibility actually create more problems than they solve.

 There is a LOT of data that supports this. Anecdotally, I have experience on a couple of different levels working with beneficiaries of these programs and can confirm at least some of them suffer from self-inflicted maladies that no government program will heal.

The logic of your essay would not stop with health care. How can I obtain a college education when others, undoubtedly more intelligent than I, cannot afford one? Any government program designed to alleviate suffering could carry just such a moral imperative as you suggest exists for health care reform. Must we support them all?

As I read between the lines of your essay, I can't help but think: What he's really saying is that Jesus supports European-style social democracy and that if I vote against the expansion of the welfare state, I'm going to hell.

You wrote:

"If I vote to keep my taxes low or my benefits better at the expense of the one in six of my neighbors who have no health insurance ... that is an immoral act. To leave a system untouched in which one in six of our fellow citizens must suffer in order for the rest of us to keep our taxes low or hold onto privileges we like ... is sin."

I know Jesus is not a Repubican. But have I been wrong all these years in thinking that He isn't a liberal Democrat or a member of the Worker's Party either?

Dave Dildy

Mr. Sahlin, the characterization by you of those in opposition to the current “Health Care Reform” monstrosity as “idiots” and “thugs” pretty much eliminates meaningful discussion. Would you like to back up and try again?

It seems the vast majority of Americans believe that we need substantial improvement in the delivery of health care. It also appears that the majority has come to the conclusion that a takeover of health care by the government is not the answer. Unfortunately for the current leadership, the public is not quite as gullible as they think. It would be refreshing to see our representatives come up with a few common sense improvements that would result in real progress in this area. As this would require that they ignore the special interests they are beholden to, I’m not holding my breath.

You might want to reconsider using the current Adventist Health System as a model of charitable good works. This may have been true in the past but our hospitals are now just another big business with allegiance to the bottom line and the bloated salaries of administration.

If you want an example of how the Adventist Health System deals with charity care, go to http://www.wherethemoneygoes.com and type in Rodney Vega in the search box.

Monte

You are well familiar with statistics. Perhaps you are familiar with studies such as these? http://www.marketresearch.com/map/prod/2392684.html

Perhaps you will step away from your own bents and write an article on why people choose to spend more on average on beer and cigarettes than on their health care plans?

The concept is not lost on even the Rolling stones.

I went down to the Chelsea drugstore
To get your prescription filled
I was standing in line with Mr. Jimmy
And man, did he look pretty ill
We decided that we would have a soda
My favorite flavor, cherry red
I sung my song to Mr. Jimmy
Yeah, and he said one word to me, and that was "dead"
I said to him

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes well you just might find
You get what you need

So how about it? How about something on personal choice and spending patterns instead of the conservatives telling the poor to go eat cake?

Pastor Monte,

I think you've missed the mark in calling a vote for lower taxes or better benefits at the expense of my neighbor's welfare an "immoral act." The real immoral act is to not come to the direct aid of my hurting neighbor and instead expecting the government or my neighbor's employer-sponsored health plan to provide aid to my neighbor. Has Christian charity been reduced to paying higher taxes so the government can take care of my neighbor, or higher prices so my neighbor's employer can provide better benefits?

Monte,

I certainly hope that you are not implying that one is not a Christian if one does not support the current health care reform bills in the US congress.  These bills are nothing portrayed by their proponents. 

It will not cover all US citizens (close to 20 million will still be without health care insurance),

it will not lower costs, (current projections put the cost at close to $1.5T over 10 years and most people who understand health care say it will be 10 times that),

it does not improve quality (with not enough providers currently in many areas it will only exacerbate the inability of people to see a physician, nothing in the bill is designed to increase quality and in fact most likely will reduce quality), and

it will cover illegal aliens (although one can make a strong case this is in the best interest of the public, it is contrary to what Obama promised - the famous "you lie").  This is a bill written by the insurance companies' lobbyists.  It is health INSURANCE reform at best.  

Although the insurance companies did buy into the original concept, if congress does not require all US citizens to purchase health insurance they, the insurance companies, will not honor the agreement to have no pre-existing conditions and probably will not support the bill.  

The AMA sold out to congress on condition that Congress fix the constant battle every year over physician fees.  Congress took this piece out of the bill.  There has been a seperate bill passed by the house but seems to be going nowhere in the senate.  

The "public option" is likely to be run like Medicare.  It will not be fair competition as Medicare certainly cannot be matched profitably by the private sector.  Medicare is  clearly set to break the bank very soon as baby boomers enter this sector.  Many people have been helped by Medicare but it is always going to be expensive and need to be supplemented.  This almost guarantees that we will have a universal insurance in the long run.  Maybe not such a bad thing.

It is easy to ask the question "Are you happy with your health care" of people in other countries.  Most will answer yes.  The questions that needs to be asked as well are "What are your wait times for technological procedures?   What is end of life care like?  Do you feel that you can get the best and latest if you needed it?"  The answer to these will not be so universally glorious.  

End of life care is a big one.  A very high per centage of our health care dollars go to the last 10 days of life.  We, in the US, are unable to discuss this rationally.  All of us are pretty well guaranteed 100% mortality yet we do not discuss this.  Therefore, everything possible is done for .....   sometimes out of guilt on the part of family, mostly out of ignorance of this choice and all of its implications.  Other countries seem to be able to keep people comfortable and well taken care of without spending useless dollars on wasted technology and medications.

As a physician and also having been a health care administrator, I would love to be paid for all the work that I do.  The payment is likely, under these bills, to be pretty much what we get now in total dollars but the number of patients will be increased.  not a good situation.

I am in favor of all US citizens having access to health care.  I do not think health care is a right.  The minute it becomes a right, the government has huge say in how I live.  I think there are many better options that we as a country could do that would give access (paid or mostly paid) for all citizens without these added layers of bureacracy (last I read it added over 150 new government entitites).  I do think our current system needs over hauling but these bills are not going to do that.  

This does not mean I am not a Christian because if I could I would vote a great big NO to these bills.  It does not mean I am not compassionate.  I do not think anyone that knows me would say that.  It does not mean that I am unwilling to give to others, as I have spent most of my life doing for others.

As someone in a previous note said, I think you need to step back and re-evaluate your comments.  Health care is very complex. Simplistic answers, such as we will all be willing to pay more taxes to cover all US citizens, are not helpful.

 Much more could be said but I think this addresses the main points.

Yvonne E Stratton, MD, MMM

Steve:

Thanks for your kind words. I enjoy your posts very much as well. You have a knack for disagreeing in a very agreeable way!

I suppose my objection to Monte's line of thought is even more basic than I set forth in my initial post.

God loves "a cheerful giver." People don't give to government. Government takes by force. I have a hard time accepting that Jesus would vote to allow the government to use force to take property, say a coat, from Citizen A and transfer it to Citizen B, who needs it. I think it much more likely that Jesus would simply give Citizen B his own coat.

The bottom line is that we are talking about being enerous with other people's money. God may ask us to do this but He does not compel. Government compels. Is it sinful for me to choose not to allow the government to take property from someone else and redistribute it?

There is another point that I think needs to be made. This whole thing may be a boondoggle. It may not work. Costs may not be reduced. The Deficit may skyrocket. The economy could further erode as the government places yet another burden on small businesses. And the cost to our freedom could be substantial.

The pedigree of this plan is pretty clear. This is big-government liberalism straight from the Progressive playbook of the late 19th and early 20th centuries. Progressives believed in a society ruled and ordered by trained, educated experts. People, surprise!, very much like the Progressives themselves. Many of their ideas were commendable. Others less so. All of them believed in the power of the goverment to shape society for the common good. If this meant trampling on individual liberty, well you can't make an omelette.....It was progressive Lincoln Steffens who said "I have seen the future and it works" regarding the Soviet Union.

It was progressives who ignored Soviet brutalities until the wall fell because of Soviet "progress" in areas like universal health care. It is progressives who lionize Castro. And Hillary Clinton spoke like a classic progressive when a small business owner told her that her health care plan would force him out of business: "I can't be responsible for every under-capitalized small business" was her reply. Would Jesus vote for that?

So, your question could be rephrased: Would Jesus vote to severely curtail individual liberties, hamstring the economy, and turn over substantial amounts of our freedoms to government bureaucrats in order to provide health insurance to everyone?

Does changing the question change the answer? I think it does. Does it feel unfair to state the question that way? Perhaps it was but it was no more or less unfair than the way that you or Monte stated it. And perhaps that's why trying to pin this or that policy to the cross is so problematic and, ultimately, so unhelpful.

The social welfare plan of the OT involved society creating opportunities for self help. It did not involve the government confiscating property and redistributing it. Perhaps that should tell us something. It should certainly give one pause before one describes a conservative political philosophy as "sinful."

Even the most strident libertarian would agree that some government spending is necessary. How much and in what degree is a matter of policy and Constitutional law (Whether this thing is Constituiontal is another matter entirely. Perhaps we should just ignore the Constitution for the common good. Wait a moment....seems like I've heard something about that somewhere before.....)

Well. I see that I've written a tome! If you've managed to read all my drivel, thanks for your patience.

Dave Dildy

Dave, it's a pleasure to discuss this with you.  Again, you pose interesting, important questions that warrant consideration and contemplation. 

One of the biggest issues is simply - Is the reform this administration is pushing not only a not a step forward, but actually a gargantuan mistake that will set us back financially and ruin healthcare?

I've spent a significant amount of time reading not only the bills themselves, but also the positive and negative commentaries regarding the proposals.  The most vocal opponents commonly decry the cost - yet curiously are the same lawmakers and commentators that voted for and supported the pre-emptive war on Iraq that has cost us well beyond the amount that has been proposed in the healthcare bill.  The same people that threw tea parties sat on their hands while the previous administration spent us out of a budget surplus and tripled the national debt that was declining when they took over the reins.  Before they left, they secured another trillion dollars for their wall street buddies - and - silence from the now suddenly fiscally responsible budget hawks. 

Spendthrift mutes-turned-vocal misers are one of the reasons I view the financial criticisms with skepticism. 

Another frequent criticism references the loss of individual rights because of government involvement in healthcare.  Again, when individual rights were being trampled by the prior administration, there was a deafening silence from the now-deafening chorus - suspension of habeus corpus, warrantless wiretaps, stop-loss policies in the military, and so on were met with applause, rather than protest. 

And now, universal healthcare brings about protest about the loss of individual rights?  I just don't see it, and framed in the context of the prior 8 years, frankly, it baffles me.

I think the manner in which the Obama administration is approaching healthcare reform has its pros and cons, and deserves debate.  What is not debatable is that reform is badly needed, and that the prior administration, as well as the prior republican administrations that led the country during my lifetime did nothing to pursue any changes or reforms or improvements whatsoever.  I'll be interested to see how the work that is currently being done turns out.  What I'm not really interested in seeing is faux-protest and Rush Limbaugh-fueled unrighteous indignation. 

Frankly, it would be difficult to argue that reform is not well overdue - our nation has muddled through decades of a substandard system that, inspite of its successes, has failed too many people. 

The recent economic meltdown is only exacerbating and magnifying the problems with the current system.  As people lose jobs and the attached health insurance, chronic problems go untreated, preventative medicine goes unutilized, and important maintenance prescriptions go unfilled.  ER's are already experiencing an increase in visitors, as the ER becomes the only accessible healthcare for the uninsured.  And the uninsured, whose issues have gone untreated, get sicker and sicker, need more treatment, and their physical health plummets along with their financial health.  Hospitals, whose ERs are monumental money-pits, are finding their biggest financial hole getting wider and deeper.  As hospitals shift costs to make up for their losses, the amount billed to insurance will increase, meaning our premiums will be escalating very soon. 

I'm excited to see how it all pans out.  I really hope that we don't see things stay as they are - in my opinion, that would be the biggest failure of all. 

Excellent comments, Dave.  I'd be interested in what Statefarmsteve would think of a 10% flat tax for everyone except the clergy, as was the law for the Israelites. Leviticus 19:15 and Exodus 21:2 and 3 admonished the Israelites not to pervert justice by favoring the poor over the rich.  The Torah also admonishes Israel not to become a debtor nation. There is nothing remotely Biblical about our present tax structure, much less the even higher tax rates which Statefarmsteve seems to want. Nearly 50% of Americans pay no income taxes - and now we should pay for their medical care, no questions asked? Many who have posted here haven't the foggiest notion of what produces wealth, and couldn't care less about the laws of supply and demand. They would never dream of running their households or raising their children the way they want the government to run and to treat the dependents it creates.  Imagine spending 40 cents of every dollar you earn on interest payments, with interest rates at 3.5%. If the government had to pay the 15% tax rates that prevailed during the Carter administration, all the revenues taken in by the Treasury Department would be inadequate to pay that debt.  Nevertheless, Monte Sahlin and others here feel it is a moral imperative for everyone to have equal access to deck chairs on the Titanic.

Interestingly, for the soak-the-rich aficionados, federal income tax revenues actually increased following the Bush tax cuts, and the tax payments of the wealthy, as a percentage of total federal income tax revenues, went up. Unfortunately, the Republicans wasted this important teaching opportunity by irresponsible pork barrel spending, dwarfed only by the audacious profligacy of the present Congress and President.

Medical care is not ubiquitous. It is a limited resource, produced through hard work, keen intelligence, and self-sacrifice that few have or would endure. Universalizing it will dramatically decrease access to it, and adversely impact its quality. The brightest and the best will turn to careers that offer more freedom, creativity, and financial rewards, while tens of millions flood a system with woefully inadequate resources to meet the increased demand.  Covetousness, masquerading as compassion for others, does not thereby become a virtue.

Ardor for universal health care is really all about egalitarian wealth redistribution, not concern for the poor.  9.1 million of the uninsured live in families earning over $75,000 per year, according to latest figures from the census bureau.  Some 12 -14 million are eligible for S-CHIP or Medicare, and just have not enrolled. Another 11 million are legal and illegal immigrants.  Several million are simply temporarily uninsured due to being between jobs.  85% of the uninsured report themselves to be in good or excellent health.  

Do we need medical care reform? Absolutely! Is a government plan which preserves and perpetuates the power and wealth of the AMA, AARP, public employee unions, pharmaceutical industry, and the insurance industry the answer? Hardly!  As Dr. Ben Carson has stated, what we need is less government, more competition, and more personal responsibility in medical care.  Eliminate the anti-trust exemption for insurance companies; allow them to compete across state lines; eliminate employer tax deductions for employee health insurance; let consumers choose the type of health coverage they need and want; make insurance plans portable; eliminate ridiculous state requirements that insurance policies cover things like massage therapy, acupuncture, marriage counseling, podiatry, optometry, dentistry, etc., that drive up the cost of insurance for everyone.

Someone recently said to me, "Universal health care is upon us; the debate is over; the question is, 'how can church health care institutions be at the forefront of insuring that the health care needs of the uninsured are met?'" My response was, "Why, if universal health coverage is legally mandated, do we need church health care institutions?" Perhaps as policemen?  Perhaps it's time to re-read Romans.  Paying taxes is not charity; legal  and economic servitude is not Biblical servanthood or love. Christians who would transform the world by making charity and love the law of the land seek nothing less than to eradicate God from the world, a process that seems to be working very effectively in Europe.

It was not my intention to characterize everyone who opposes the current proposals for health care reform as "idiots" or "thugs," and I don't believe that I did so. Those words, perhaps too strong, refer to specific behaviors that many, perhaps most of those opposed to the current health care reform proposals are clearly not guilty of. My intention in referring to certain outlandish behavior and comments was to get beyond that kind of thing and focus on more basic issues.

Here is the moral bottom line as I see it: Is a desire to keep government from a "takeover" a legitimate reason to deny my neighbor something as basic as health care?

Adventistdad, I agree with you. No, Christian charity is not simply about voting for taxes to meet human needs. That is why I volunteer with an Adventist-sponsored charity in my city that mobilizes volunteer health professionals specifically to provide basic care (medical, dental and optical) for those who do not have coverage. If enough Christians across the country were to have become involved in this approach over the last two or three decades, the current legislative proposals might be unnecessary. That did not happen and now we are faced with having to make a decision about legislation that attempts to both improve the effectiveness of the health care system, reduce costs and extend coverage to all. This creates a moral dilemma. I have to choose between paying less in taxes or extending health care to the one in six of my neighbors that do not have access. What is the truly Christlike choice?

Hi, Nathan.  If you wonder how I'd feel about a flat tax, simply ask me.  I don't think I've ever shrunk from engaging you in conversation.  I'm a fan of a flat tax.  I'm a bigger fan of income tax being replaced with a consumption tax.

I'm not a fan of quoting the Old Testament and the Torah to garner support for any one position on contemporary law.  Such quotes are selectively self serving, and require one to pretend that obviously retarded things like the death penalty for Sabbath-breaking didn't exist.  If you want to revert back to a society ruled by Old Testament law and the Torah, then move to a Muslim theocracy - it's the closest thing you'll get to it here on earth today.  For all the downside of Burkhas and death penalties for adultery and severed hands for stealing, you at least get to practice the one fun Old Testament-approved law of plural marriage. 

Did the federal treasury increase its intake during the Bush years, as Nathan asserts?  If so, was it because of Bush Tax Cuts, as he implies?  The increases came largely from corporate taxes and non-withheld individual income taxes (largely bonuses and stock sales).  Corporations were supposedly roaring along from 2004 to 2006.  Executives were being bonused beyond belief for their dynamic performance, and were cashing in on stock options as the prices hit ridiculous targets.  Of course, these corporate incomes were being restated by 2007, and executives were being fired, fined, and jailed.  Those who purchased that soaring stock that triggered those huge executive options bonuses, by 2008 were watching their 401(k)s and portfolios evaporate.  Also, from 2004-2006 the US was experiencing a housing boom - people were flipping homes, generating huge income from nothing.  Every bag boy and janitor had a mortgage brokers' license, and was making a hundred thousand dollars a year from home flippers.  Now, bag boys are back to being just bag boys, and people that were flipping houses are losing their homes to forclosure.  The Bush boom and the resulting increase in federal revenues was a mirage - not a tax cut-fueled nirvana. 

However, now that you've pointed out that Monte seeks to eradicate God from the world, I will certainly approach his columns with more caution.  And now that I understand that God fled from Europe when universal healthcare arrived there (I'm assuming he's gone from Canada, too, then) I'll reconsider my support for universal healthcare.  Scary, scary stuff indeed. 

Last month, NEJM had some interesting statistics regarding the % of patients who use the largest % of the health care $. It's not unlike the penal system, a few costing the many a lot. For more than 20 years, it has been said that ~30% of the medicare $ is spent in the last year of a person's life. For what? Agressive medical intervention actually traumatizes  some patients who should be left to die in peace. Fact is, people die. Whether they die with dignity, peacefully, is a decision usually made by family members.

Medical economists recognize that tens of billions of $ could be saved annually simply be implementing responsible end of life care. Few people are willing to make the decisions necessary to make those changes.

Unsophisticated/ uneducated/ dysfunctional/ individuals are deciding that hundreds of thousands of $ must be spent on their loved one, an 80 year old with liver cancer, for example. It's not their money, of course. If it was coming out of their inheritance, perhaps, almost certainly, most would decide differently. When taxpayers are picking up the bill, why not spend everything possible? No personal loss is involved.

Some medical ethicists advance a duty to die paradigm, which advocates  termination of lives which are a drain on society. Why not? Emotional issues, theological issues, psychological issues? The ability of medical science to keep people balancing on a thin edge  between life and death, does not mean that the technology should be used.

While active, involuntary euthanasia might find few supporters, certainly rational individuals can see that allowing people to die a natural death is within the realm of not only faith but common sense.

Note the conflict in this family and estimate the cost to society should the son prevail: 

http://www.nejm.org/clinical-decisions/20090129/

" Follow the Money — Controlling Expenditures by Improving Care for Patients Needing Costly Services --> Thomas Bodenheimer, M.D., M.P.H., and Rachel Berry-Millett, B.A.

-->In the United States today, 10% of patients account for 70% of total health care expenditures. Many patients who require high-cost care are people with multiple chronic conditions, many medications, frequent hospitalizations, and limitations on their ability to perform basic daily functions due to physical, mental, or psychosocial challenges. Some well-researched programs have been shown to reduce costs for these patients with complex health care needs, but major payment reform would be needed to spread these programs throughout the United States.

In 2002, Medicare beneficiaries with five or more chronic conditions accounted for 76% of Medicare expenditures. Health care spending for people with five or more chronic conditions is 17 times as high as that for people with no chronic conditions (see graph).1 Because Medicare expenditures will soon become unsustainable, we urgently need to find a way to reduce the cost of care for this rapidly growing group. "

 http://content.nejm.org/content/vol361/issue16/index.dtl

NEJM 10 15 09

Maybe the US Congress should look at Howard County, MD for a model of how to do health care.  Both the county executive and the president of Howard Community Hospital have spoken to the Rotary Club I belong to about this county's unique approach to medical care.

All residents of Howard County who do not have medical insurance are covered by the hospital.  They can come to the emergency room and receive free care for whatever they need for their health.  How is this paid for.   Howard C Hospital is part of Johns Hopkins Health Care and they charge a slightly higher premium  to every patient that pays at the hospital.  This creates a surplus that pays for those without insurance.  The insurance companies have agreed to this and everyone is "happy."

No government bureaucracy, no wasting of tax payers dollars.  We were told that Howard County is unique in this kind of service that they provide.

David Newman

Editor, Adventist Today

As I recall, the cost of the war was discussed. None of the war's supporters, including myself, envisioned the mess that Iraq has become.

This brings up an interesting point: Conservativism recognizes the limitations imposed by experience and reality. William F. Buckley pointed out that the Iraq war was a fundamentally unconservative enterprise in that we were attempting to install a democratic government on a population with no tradition of democracy. As has been seen, this is a problematic exercise. 

Similarly, the current health care plans are fundamentally unconservative enterprises. Experience teaches that government programs are almost universally less efficient and carry more unintended consequence than free market alternatives.

To answer your question more directly: Wars are sometimes absolutely necessary, regardless of the cost. They are a legitimate function of government. I and some others have honest questions as to whether health care reform as it is currently envisioned: (1) is necessary; (2) will work; and (3) will not cripple our economy as has occurred in Europe as a result of similar efforts.   

Dave Dildy

Hi David - First, I'd have to believe that Howard County is the envy of many.  To have access to a Hopkins-affiliated institution on any level is truly a blessing, indeed. 

If the arrangement enjoyed there is unique in any way, it would largely be due to the level of cooperation enjoyed between the county, the hospital, and the insurance companies.  It wouldn't surprise me if such harmony is the result of the proximity to DC, and the likelihood that lawmakers and their staffers and their family members reside there.  It would not serve either healthcare facilities or insurance companies to wage war so close to where it could negatively affect such people.  (ATM fees were largely lower or non-existent in the DC area, too, in an effort to keep such things under the radar of lawmakers.) 

All hospitals engage in cost-shifting.  A single tylenol costs $10.  An IV drip of salt water costs hundreds.  Perhaps if other hospitals and insurance providers and governments could find a spirit of cooperation similar to that found in Howard County, services and payments could be exchanged in a more reasonable manner. 

Monte:

If the goal is simply to provide coverage for everyone, why not give uninsured people tax credits to purchase insurance? That would be simple and would cover everyone.

However, this is about a whole lot more than just covering everyone. There is also the matter of controlling costs. Assuming that covering everyone is a moral imperative, controlling costs is not. Rather, it's a matter of public policy. I'm not an expert in this field. I know people who are and they assure me that our current system is not sustainable. So, reforms must be made to keep costs under control. Again, not a moral imperative but definitely a policy issue that must be dealt with. But how to do it?

It is clear to me that the current plans under consideration tilt left. For example, Tort Reform, which would certainly help drive down costs, is off the table entirely because of Democratic dependence upon trial lawyers. Is this a moral imperative? No, it's a political calculation tilting in favor of a liberal constituency.

I do support reform. I would like to see everyone covered. But I cannot support either monstrosity that is before congress because they are about so much more than either controlling costs or covering everyone. It's about government picking winners and losers and controlling peoples' lives. It's also about creating a government program that politicians can use as an election issue: "They want to take away your [name the program] but I will protect it."

I am very leery of giving politicians this much power over our lives.

Dave Dildy

One of the issues raised was about medical equality and charity towards all.  Regarding charity it is interesting to note that it is the fiscal conservatives - those that oppose higher taxers and oppose larger government that are more charitable.  Here's one link as an example.  http://www.realclearpolitics.com/articles/2008/03/conservatives_more_liberal_giv.html

Even though our current system needs reform it currently does take care of the poor through the ER and volunteer or low cost organizations or offices.  Taking away the opportunity for citizens to participate willingly in charity makes our hearts smaller. 

The mainstream media would have us believe that no conservative low cost healthcare alternatives have been offered.  Actually, they have been offered - but in a democratically controlled congress Republican bills have been largely ignored and denied. 

Here's a post re: the house Republican bill from Nov. 5.

Washington, DC - U.S. Congressman Mike Pence, Chairman of the House Republican Conference, released the following statement today after the Congressional Budget Office reported that the House Republican health care plan will reduce health care premiums by up to 10 percent and lower federal budget deficits by $68 billion over the next ten years:

"Across the country the American people are calling on Washington to pass responsible reform that will lower health care costs.  Yesterday, House Republicans answered that call by putting forward common-sense health care legislation that reduces the deficit, lowers premiums, and ensures coverage for those with pre-existing conditions.  As a result of the House Republican bill, the non-partisan Congressional Budget Office now confirms that families will see their health care premiums reduced by up to 10 percent and hard-working taxpayers can expect deficits to decrease by $68 billion over the next decade.

"The House Republican health care bill proves that we can lower health care costs, without launching a government takeover of health care.  The Pelosi plan for more spending, higher taxes, bloated bureaucracies and federal mandates is not the prescription for health care reform that the American people expect.  House Republicans will continue to stand in opposition to the Pelosi government takeover of health care, and stand in support of real reform that lowers health care costs for our families and small businesses." 

Why is saving money instead of spending money not a priority for Congress?   Hmmmm.......That's another issue.

Hi David.  Indeed, the cost of the war was discussed.  Lawrence Lindsay disagreed with Cheney's lowball estimate, and he was fired for it.  The CBO estimate was over a trillion dollars, and Cheney poo-pooed at such a preposterous number.  Now, the most recent CBO estimate is $2.4 trillion.  Erg.

I agree that wars are sometimes necessary.  Was that the case here?

In the case of Medicare/Medicaid efficiency versus private enterprise, the Medi's run a 4% administrative cost compared to a 35% administrative cost for private enterprise.  Payment from the Medi's to providers is unquestionably more timely and less burdensome than that from private insurance providers.  So it runs more efficiently with regards to both money and time than free enterprise. 

There is no current form of healthcare yet.  It is being debated as we speak.  The questions you and others have are very, very legitimate, though most believe that healthcare reform is necessary.  The Obama plan may not work.  It may be too costly.  But there has been plenty of time for input from republicans, particularly if you go back 25 years or so, the majority for which they controlled the power in the country, yet did nothing regarding healthcare reform.  If the current outcome is less than desireable to them, perhaps they will accept some of the responsibility for not having addressed the issue when they had the opportunity, no, the obligation to have done it when they ruled the roost.  If the current administration's ideas conflict with their ideas, perhaps they bear some responsibility for their own ideas remaining mere ideas, rather than becoming bills and laws and statutes.   

We also live in a society where if something doesn't work, we can vote for someone who we believe will fix it.  If the current administration messes up healthcare like the prior one messed up Iraq, we'll get the chance to vote someone else into office very, very shortly.  There's no need to worry too much.  The system is designed to handle failure of our leaders.  In the meantime, what will be, will be.   

lwenzel - US Rep Mike Pence has been in Congress since 2001, and for the first 6 years, or his first three terms, the Republicans enjoyed a healthy majority in the House.  For 4 of his first six years, his party controlled the House, the Senate, and the White House.  His plan could have zipped through the legislative process and become law.  How was his healthcare reform bill received when he submitted it for consideration in the years from 2001-2007?

If he didn't submit it for all those years that he and his party were in power, then isn't he at least partly responsible for sitting on his hands for the better part of a decade?  Or is it really the fault of current House Democrats that his ideas never germinated?

Actually, Monte, 53 billion dollars a year is spent by the government on health care for the 1 in 6 of your neighbors whom you say has no access to basic health care.  Why do you use this 1 in 6 figure to perpetuate the myth that the poor are uninsured?  Are you contending that these are all "needy" poor? Patently false premises do not constitute a very secure foundation for a bottom line. The only poor who are uninsured are non-citizens.  They are maybe 3% of the population.  And even they are not denied basic health care.  Most metropolitan areas have multiple community clinics staffed by volunteers, and open to all in need.  And of course there are emergency departments with state-of-the-art medical care for all comers.  

The poor in all countries have worse health care. They take less personal responsibility for healthy living, and they are less likely to prioritize preventative care.

If your burden truly was for the poor rather than for wealth leveling, you would point out that virtually everyone in this country, who has access to food, shelter, clothing, running water and plumbing, is in the top 10% of the world's population when it comes to health care, regardless of access to physician and hospital care. So why do you focus on the speck that is in the eye of the health care system in this country rather than the beam that is in the eye of Third World health care?  It seems to me that a truly missional, post-American concern for the poor would argue that, in the context of history and the larger world, it is absurd to characterize any group in America as being in material poverty or in want of basic health care.  You would be lobbying for this country to use its enormous resources to level the health care playing field between itself and the rest of the world.

This is not to say there is no poverty.  We do indeed have a poverty crisis.  But it is a poverty of values, and a poverty of the habits of industry, frugality, self-restraint, and spirituality that are enervated by command and control economies enabled by political rhetoric and Left wing educators. 

Do you believe, Monte, that the Constitution places any restraints upon government?  Do you believe that the will of the American people should constrain politicians in Washington? If the government can take over health care, the mortagage industry, and auto companies, what limitations do you propose on its powers. Have you learned nothing from communism and fascism? 

I do not believe that the "do-gooders" are ill-intentioned atheists.  They are, and always have been benevolent in their goals.  Communists and socialists have never opposed charity. In fact, they think, despite abundant evidence to the contrary, that their collectivist elixirs will, through social evolution, create new hearts and minds, bending over generations and time, like flowers to the sun, to serve the collective good. 

Pro-choice advocates have not intended to destroy nearly 50 million human lives over the past 35 years; NGOs and U.N. organizations never intended that bans on DDT spraying and religious sex education in Africa - conditions of financial assistance - would result in tens of millions of unnecessary deaths. These were simply the laws of unintended consequences at work. But progressives never seem to believe in either the laws of economics, human nature or unintended consequences.

So, in response to your "bottom line", even with its false premises, YES, if the choice is between government takeover, with elimination of material want, and limited government protecting freedoms which create the possibility and inevitability of some poverty and the need for charity,  I will choose freedom.  Who said, "Those who would trade freedom for security deserve neither."? He might have added, "They will get neither."   

Hello David,

I can tell you are doing your best, as are many of the bloggers, to digest the implications of the massive legislation before our congress.  I did note this quote of yours, however, that got me to thinking:

The social welfare plan of the OT involved society creating opportunities for self help. It did not involve the government confiscating property and redistributing it. Perhaps that should tell us something. It should certainly give one pause before one describes a conservative political philosophy as "sinful."

It reminded me of Deuteronomy 15:1-18 and the whole "Sabbatical Year" remission of debts.   Talk about a radical redistribution of wealth!  Deut. 31:10 mentions it again.  But read as much of OT Judahite/Israelite history as I can, I can not find a real solid example of the "haves" ever imposing this on themselves, or of a king imposing it on himself or the rest of the upper-class.  

Yes, it's true that the rule applied to fellow Israelites, not to the "foreigners", but in principle this amounted to a massive "reset" on property ownership and indebtedness.  

This is one of the OT's "opportunities for self help" in that it allowed bankruptcy every seven years for those who were indebted. With all that WAS imposed by the kings that was hurtful, (cf. Solomon) I fantasize that enforcing this would have been a wonderful, life-giving, regulation that could well (in God's hands) have kept Assyria and Babylon away from their invasions.

Now how this applies to the proposed health legislation ....

Ole Olesen

Richard L. Noel, DMD

I am astounded that the SDA church claims to care for the health of the people in this world.  First of all, we have become people who seek to make money from this and have totally forgotten how Jesus worked.  HE ACTUALLY HEALED PEOPLE AND LED THEM INTO A RELATIONSHIP WITH GOD.

Secondly, we have for generations tried to teach "Jesus' methods" as if they were some psychological formula.  Jesus did not teach it that way at all.  Even with the woman at the well, He demonstrated the power of God to her in a way that she recognized it and wanted to know more.  In luke 10, his instructions were "heal the sick" vs. 9, and then tell them the Kingdom of God has come upon you.

Ruhling7, 

You are correct that the concept of modern drugs curing disease is a dangerous deception.  Still, there is another deception at work that is far more powerful and is actively destroying our nation: the advance of "liberal" political objectives that offer us the illusion of social benefits like universal health care because the hidden cost is the active destruction of our liberties.  Advancing that agenda requires that the government take from the people an ever-increasing levy of taxes.  That toll removes the prosperity that allows the people to be charitable.  The eventual result will not be the delivery of improved health care but the utter destruction of both our economy and our liberties.

At this time of Thanksgiving it would be good for us to remember the lesson that the Pilgrims learned in the first years of the Massachusetts Bay Colony.  The started out with a social agenda.  Their first government structure was communist where no one owned anything and the community owned everything.  The result was that no one was motivated to produce or work.  They nearly starved to death because no one was growing much food.  People froze to death because not enough people had grown cotton to spin into fabric or harvested enough beavers and other animals for their skins to protect them from the winter weather.  But when they let each person own land and pursue their own interests, productivity improved, prosperity followed and the pilgrims even began including the Indians in their acts of charity.  The lesson: give people freedom and individual responsibility and the nation prospers.  But when you enforce community responsibility for everyone, no one prospers and people start dying because of shortages. 

Hey Ole,

Very good point regarding the Sabbatical year in the theocracy of Israel. However, I don't think that Bill Gates or Warren Buffet would vote for it.  Even though it would be good for our country.  We have a massive wealth imbalance nowadays.  Its seems that we are turning more and more into a "banana republic" as each day passes.  If our country followed the biblical laws of health as outlined in the Bible we would save billions of dollars.  And if we turned out churches into centers for health and healing, that would change whole communities that would save massive amounts of money as well.  I'm puzzled why SDAs are not getting into this issue in a more political way and speaking out to the public at large more when the issue is so relevant.

Hi Ole:

That's a good point! I had not thought of that when I made my comments. I was thinking more of things like the laws forbidding gleaning a field twice and requiring that the corners and edges remain ungleaned so as to leave food for the poor.

I suppose that I always thought of the sabbath year and jubilee year requirements as stabilizing factors. If followed, and apparently they weren't, they would have prevented any family from being permanently crushed by debt or the loss of their ancestral land.

Of course, debt forgiveness every seven years and returning ancestral lands every fifty years are very different things from seizing wealth and transferring it on a yearly basis, which is what modern tax policies do.

I agree that it is a shame that these things were not followed. Had they been, Israel would have been a very different place.

Happy Thanksgiving to you and yours! 

 Dave Dildy

When the idea of private property is discussed, Malcom Gladwell in his book "The Outliers" explain why the Chinese, and most other Oriental cultures are today recognized as top students (out of proportion at Harvard for their population numbers), as well as musicians:  they have a long history of hard work.  Their motto is "get up before dawn to achieve success."

Centuries, perhaps millennia ago, individual farms were recognized as producing more than tenant farmers.  Their main product is rice, which is very labor intensive and many varieties which must be planted and protected daily, harvested and then another crop planted on their terraced hills.  This long time attitude of hard work has paid off in their phenomenal academic success as recognized by all teachers and companies who hire them.

 Perseverance is the key.  The desire to own a piece of land or some valuable entity is the driving force to attaining success.  There will always be enough workers who do not wish to do the hard work in order to become an owner, but those who do will usually be greatly rewarded.

Monte, 

Thanks for being willing to stand up and truly speak the truth. As someone who works at a very high level of management in this whole arena I live everyday what you are trying to open our eyes to. We must begin to recognize that our responsibility to the poor and those in need around us is and should be a priority in our life on this earth. It has nothing to do with Republican or Democrat but rather following the example of Jesus the Son of God!

The heated opposition to raising taxes for health reform is quite a contrast to the "ho-hum" reaction to taxes for bridges to nowhere and the many pork barrel projects almost monthly enacted.

Why is so little attention given to  the major expenditures of our tax monies for payment to nearly all the foreign countries which would easily support healthcare for all our citizens?  Nary  a word is heard on these "subsidies" to foreign countries but the opposition to health reform has resulted in one of the lengthiest proposals in Congress.  Where are our priorities?

"At this time of Thanksgiving it would be good for us to remember the lesson that the Pilgrims learned in the first years of the Massachusetts Bay Colony.  The started out with a social agenda.  Their first government structure was communist where no one owned anything and the community owned everything.  The result was that no one was motivated to produce or work.  They nearly starved to death because no one was growing much food.  People froze to death because not enough people had grown cotton to spin into fabric or harvested enough beavers and other animals for their skins to protect them from the winter weather."

You are so right, brother or whoever you are. I wonder whether Monte would be more comfortable in a truly socialistic environment. The ideas he has expressed under a guise of Christianity are highly questionable.

What I'm about to say applies to anyone who espouses his philosophy -- check what percentage of your assets are you now devoting to the welfare of those less fortunate? It is my view that we have individual responsibilities to succor the sick and aged. To say we have a moral responsibility to require the government to increase our taxes so the legislators have more money to play with is not supportable. 

Truth Seeker

I'm having a hard time seeing Monte dressed up as a goose-stepping, Heil Hitlering, Lenin-worshiping Socialist.  To paint him as such is akin to the mock ups of Obama defaced to look like Adolf Hitler.

Universal Healthcare is as far from Nazi Germany as our current system is from an anarchistic, Lord of the Flies, survival-of-the-fittest social system.  Canada and many European countries have enjoyed universal healthcare for years, and yet they weren't our enemies during the cold war, lumped in with the USSR, China, and Cuba.

The idea that Universal Healthcare = Socialism = Communism = Nazi Germany is a complete farce dreamed up by Radical Right Wing Conservatives.  We have never done battle in the name of freedom with nations because they provide their citizens with healthcare.  In fact, those very nations have proven to be our best allies in times of trouble. 

If you are one who bought into this ridiculous notion, and are equating universal healthcare with socialism, take a quick look at the countries around the globe that provide universal healthcare, and examine their political systems.  Are they all Socialist regimes?  Do their citizens suffer from oppression that has robbed them of their human rights and basic freedoms?  By this justification, should we prepare to engage Canada, England, France, the Netherlands, Switzerland, Sweden, and many other nations in a war to free their citizens from unjust tyranny?

If you want to argue the merits of Healthcare, universal or not, based on the difficulty of bearing the cost, on the questions of how our society which values the individual's right to smoke, drink, and be overweight would deal with a collective responsibility for healthcare, or on the logistics of providing healthcare to everyone, including illegal aliens, or any other real issues, then put your ideas forth.

But it really is just plain silly to expect people to engage in the fallacy that adopting Universal Healthcare will make our nation a communist, socialist state.

If one is Truly Seeking the Truth, I'd hope they'd begin by telling the truth about others.  Monte is neither advocating socialism, nor naziism, nor communism.  Asking if he'd be comfortable in a socialist society is insulting and pointless.  Such a dishonest question doesn't deserve an honest answer.  Perhaps the ideas he has expressed "under the guise of Christianity" bewilder you because you embrace such an extremist point of view to the debate over Universal Healthcare.  There are pros and cons to the idea of Universal Healthcare, but one of the cons is certainly not the metamorphasis of the USA into the USSR. 

Dave, the moral issue for me is about providing health care of some quality to all, regardless of their ability to pay. The problem with a tax credit for this purpose, is that the majority of the working poor do not pay sufficient income taxes for a tax credit to actually yield enough for them to purchase health insurance. If the credit could be applied against payroll taxes, instead of income taxes, it might work. But, those in Congress who have usually advocated a tax credit have also insisted on making no cuts in payroll taxes, while cutting every other tax in sight. And, to be fair to them, if tax credits for health insurance were applied to payroll taxes, it would just "rob Peter to pay Paul," since the payroll taxes fund Medicare, SSI and Social Security.

There are some other moral issues involved, I think, such as insurance companies being allowed to engage in recisions, exclude prior illnesses, etc. The private sector has, to a large extent, behaved in an immoral fashion in the area of health insurance and that has fueled the demand for government options.

I agree that cost-containment is largely a policy issue. I have mixed reactions to the various alternatives put forward. None of them seem to me, at a strictly cost-accounting level, to achieve the cost containment of a single-payer system which Canada and all European nations have. Whether it is "socialist" or not, the aversion that most Americans have to the Canadian/Swedish/German/UK type of system seems to me irrational and very costly.

Monte, I'm not very comfortable with the notion that corporations have a duty or capacity to act morally.  They have a duty to act legally. They have a duty to act responsibly with their shareholders' investments, and produce quality products at a competitive price.  But somehow, I have a hard time seeing a starry crown in store for G.E., or any other company that practices corporate social responsibility. It may be good business to do so, but if not, I have no interest in investing in such a company.  I think I'm perfectly capable of choosing the objects of my benevolence with the profits I expect companies that I invest in to earn.  

Are you really suggesting that the government can be trusted to act morally?  The Obama Administration has been negotiating with the AMA, Big Pharma, the health insurance industry, labor unions and AARP to cut deals with them so that they will sign on to Obamacare.  Why do you single out the "private sector"? Do you have any problem with the trial lawyers, AARP, the NEA, Big Labor, SEIU, Hollywood, ACORN, politicians - or is it just those who actually produce wealth whose morality concerns you?  The reality is that the government regulates business for the benefit of business and for the benefit of the politicians. We hardly have any free market left in this country.  It was Tim Geitner and Chris Dodd who approved the multi-million dollar bonuses for AIG execs and failed banks.  Read Michelle Malkin's "Culture of Corruption" if you want to see just how moral our political leaders are.

Speaking of governmental morality, do you not have a problem with the bribe of $300,000,000 promised to Senator Mary Landrieux's home state (a bribe she proudly advertises), where she faces a tough re-election battle, in order to get her to vote for cloture and keep the health care debate alive in the Senate?  Do you not have a problem with the lack of candor and openness that accompanies this administration?  Do you not have a problem with an administration that calls dissenters and protesters idiots and thugs? (Oh, sorry, I forgot, that wasn't the administration, was it?)  Actually, what Obama said was, "We don't need to hear from them; we've already heard enough from them; now it's time for them to shut up and get out of the way."  So much for bipartisanship...

Statefarmsteve observed that he has a hard time seeing Monte as a goose-stepping Nazi.  So do I.  But anyone with a knowledge of history knows that FDR was once an admirer of Benito Mussolini.  Fascism did not always have a bad reputation.  In fact, I believe it was Orson Wells who coined the term "liberal Fascism" as a term of praise.  Anyone who doubts the parallels between the agenda of the American Left - which includes far more than simply universal healthcare - and fascism should read "Liberal Fascism" by Jonah Goldberg.

The more one's political positions are grounded in the authority of religious writings, or other absolutist ideologies, the greater the risk of totalitarianism and tyranny. Whether you call them social justice, compassion, communism, or fascism, they end up wearing the jackboot of despotism.  You see, Statefarmsteve, it's not just the idea that Monte favors socialized medicine that worries some of us.  It's that the politicians who are pushing it think Chavez, Noriega, Castro, and Zalaya are really cool people, and that Ahmandinejad is simply misunderstood; it's that Obama chose as one of his czars an outspoken communist (Van Jones), and as his Director of Communications a woman who said that Mao Tse Tung was one of her two favorite political philosophers; they view Ted Kennedy as a hero; they favor federally funded abortion on demand; they want to silence Fox News and conservative talk radio; they want to introduce card check.  And they are not interested in open honest debate, bipartisanship, or transparency.

The health care bills presently being considered are unmitigated disasters - certainly far worse than doing nothing.  Viewed in the larger context of the ambitions of the Left, they are simply more signs of the end times.

It is my understanding that the Administration has exaggerated the number of those persons who do not have Medical insurance because of financial problems. In any case it is obvious that some are falling thru the cracks

It is evident to some of us that adding millions to the public dole, and that is what it would likely be, will result in a serious Doctor shortage. How do you, Monte, or anyone who subscribes to his socialistic philosophy suggest that we provide enough general practitioners or family doctors to fill the void?

Truth Seeker

Am I to assume, Truthwave, that you know what is in the bill that passed in the House? - for starters, one hundred eleven new federal bureaucracies to regulate every detail of your health care. And you think that's better than what we have now?  Are you really sure you want to argue that, because people don't behave responsibly, the Government should take money from those who are responsible to protect the uninsured from the adverse consequences of their irresponsibility? Even the most absurdly optimistic economic projections do not suggest that universal health care will save money.  

My daughter will soon have spent a  total of 14 years beyond high school, accumulating enormous debt to become a neonatologist.  Will someone please explain to me why anyone has a right to define as a public right that which she has worked so hard for, and to further demand that she has a moral obligation to provide her services at a government dictated fee?  What careers do you think the brightest and best students will choose when medical care becomes a universal right?  As Walter Williams would say, if you guessed law and business, go to the head of the class. 

Markham:  Talk to a large cross section of business owners and to the people working for those businesses.  If you do, I'm confident that you will hear a lot of frustration and anger at the skyrocketing costs and lower coverages!  Many businesses are offering insurance coverage but putting more and more of the costs on the employees, or even worse not even offering medical insurance.

The public dole is already being used to pay for those who don't have insurance, and that could be reduced if everyone was compelled to pay some type of premium, and by making preventive medicine the watchword, instead dealing with the very expensive costs associated with diseases that have left untreated till they reach an emergency room and hospitalization stage of treatment. 

Nathan: If those agencies root out the greed and corruption of the trial lawyers, insurance companies, and drug companies, and the exorbitant fees that medical specialists charge, that would be a good thing. We just can't afford to have health cost continuing to skyrocket when everything else is deflating.  In addition we have an aging population, with 70 million baby boomers being added the national medical burden as we speak.  We have to do something to reform our health care system, and yes, Obama's plan is not perfect, but at least he is trying to do something.  We cannot keep doing what we have been doing, that is futile.

Regarding your daughter and the high costs of medical school, that needs to be changed as well.  The cost to get the education to become a doctor should not be exorbitant either.  It seems that the they both feed each other.  Medical callings should be looked at much in the same way that going into the pastoral ministry and other humanitarian calling.  Its not a place for mercenaries but missionaries.

Thank you, Monte, for your willingness to take the moral highroad to support America's need to improve its health care delivery system.  And thanks to AT for publishing it! 

Puzzling, isn't it, that so many of us who profess Christianity find it impossible to speak out against the cost of life, limb and treasury expended in war, yet, when it comes to supporting the decision to improve health care, many stand mute or they join in the chorus with all those who, in monotone unison, sing repetitiously and with mean-spirited-vigor the old worn-out stanzas...

Perhaps it's time those who occupy prominent positions in Adventist pulpits follow Christ's lead, and along with Monte, address the prevailing mean-spirited hypocrisy. 

--Bud      

Bud:

My opinion about the proposals currently before Congress is that they are bad on several different levels. I have made no secret about my opinion on this board.

My understanding is that this board exists for the free expression of ideas. Your statement that those who oppose these monstrosities "join in the chorus with all those who, in monotone unison, sing repetitiously and with mean-spirited-vigor the old worn-out stanzas" is not really discussing ideas. It's really an attack on me, and others like me, who think  that these proposals will cause more harm than they cure.  If that is what you want to contribute to this discussion, why even bother?

It would be be a more meaningful, and very welcome, addition to the discussion to respectfully demonstrate that I am wrong rather than calling me "mean-spirited" and a "hypocrite" because I do not share your views. 

Dave Dildy

Nathan - 111 committees, commissions, and offices to administer something the size of a national healthcare program seems to be an appropriately-sized beauracracy, and in any case is a smidgen compared to the Bush-created Department of Homeland Security with its thousands of offices, committees, and commissions, hundreds of thousands of employees, hundreds of thousands of square feet of office space, hundreds of thousands of employees, and its 5-tier alert system.  When DHS was created, nobody on the Republican side of the isle made a peep.  When DHS predictably spiralled downward in terms of efficiency, performance, job satisfaction, and public perception, while eating up ever more and more dollars and resources, still no tea party.  In fact, they praised Bush for the exact types of things they are now criticizing Obama for. 

I'd also like to congratulate your daughter on her accomplishment.  I do find it odd that in one sentence, you'd acknowledge that she has borrowed a lot of tax dollars and tax-subsidized loans, yet in the very next sentence ask if the society that funded her education should have any say in their investment.  The knowledge she gained in school and the expense of her residency was largely funded by federal taxes which fund research and residency programs.   

I also find it interesting that she chose neonatology - a specialty that is largely dependent on federal tax dollars for its existence.  According to the Kaiser Family Institute, more than 41% of live births are paid for out of tax dollars, and a larger percentage of those tax payer-funded babies require the services of a neonatologist due to low birth weight.  As things stand, in California in particular, Neonatal ICU's have been shuttered at an alarming rate because they don't turn profits for hospitals.  Preemies and babies just don't always pay their bills.  The finest work of neonatologists that saves the life of a preemie can create an immense financial drain on society with a lifetime of brain, eye, and orthopedic surgeries, hyperalimentation, vents, tracheostomies, shunts, gastronstomy and jejunostomy tubes, and other medical procedures that quickly exceed insurance limits and overwhelm a family's finances, creating a money pit that society ends up filling somehow. 

Having said all of this, please understand I don't mean it as a knock on the amazing things your daughter has accomplished or will do in the future.  I also believe that regardless of the direction things go with healthcare reform, your daughter will be exceedingly well compensated for her education, talent, and hard work.  Perhaps she'll only be able to afford a 5 series BMW, an E-class Mercedes, or a Lexus ES, but it's more likely that she'll be able to afford the absolute top of the line of any of those automakers.  She'll still live in a gated community and her kids and your grandkids will go to private school.  She'll still live a life that is the envy of her less talented, less highly-compensated peers, and it will be well deserved.  I wish her the best in her future career. 

It seems that it's not possible to discuss the need for meaningful health care reform without it being partisan.  Hopefully nobody will strike a match here as there are many strawmen littering the landscape of this discussion.  Since politicians of all stripes and parties have succeeded in creating a total mess over the last 50 years, I for one am not willing to trust any of them to being able to resist selling out to whatever their pet special interest is.

I'm intrigued by the $400-$500 billion in savings that are available to the government in Medicare waste.  I have to wonder why we aren't taking advantage of those enormous savings right now.

All posters, please give your answer and the morals involved, in answering this person's desparate call for help.

 http://www.nytimes.com/2009/11/29/opinion/29kristof.html?ref=opinion&pagewante

On checking, this site is not available.  Here is a brief summary:

John Brodniak was a foreman at an Oregon sawmill when he suddenly blacked out.  After rounds of CT scans, MRIs and other tests, it was discovered that he had a cavernous hemangioma of his left parietal lobe.

He began having trouble walking, and would sometimes collapse, and suffered mental problems.  He has blinding , incapcitating headaches with vomiting.

He is unable to work, so lost his job, and health insurance.  His wife had insurance for herself and children from a previous marriage through her job.  But she couldn't add John because of his preexisting condition.

Without insurance, he has been unable to get surgery.  When his wife rushes him to the ER, there is not much they can do and he was told not to come back until he has insurance.

His wife had to quit her job to devote to caring for him.  They can no longer pay their rent, and the doctors warn him that pressure from the growth could lead a major blood vessel to burst, killing him.  He says "I am a time bomb."

He has been able to qualify for the Oregon Medicaid program, but hasn't been able to find a doctor who will accept him for surgery, apparently because the payments are so low.  Doctors tell him that his condition is operable--but that they can't accept him without conventional insurance.

 "The mill won't let me go back to work until a doctor gives me a note saying I can go back, but they won't."

______________________________________________________

For those who refuse to believe that there are thousands who will die this year for lack of health insurance, how can it be denied that John is the only one?

What is the Christian's answer to the many, like John, who have truly fallen between the cracks?

Assuming that John is not a fraudulent, lying, political tool of the radical left, his situation is incontrivertibly a tragic failure of our system. 

Unfortunately, John isn't alone.  He's one of tens of thousands who face death every year because of a lack of insurance and an uninsurable condition.  His family is not the only one that suffers because of the gaps that inevitably exist in a profit-driven system of healthcare.  His parents and wife and loved ones are among the hundreds of thousands of Americans who die inside as they watch their loved ones racked by pain, eaten by disease, wasting away, suffering without the dignity and healing and relief brought about by proper care. 

If there is a fix out there, and I believe there is one, it's time to give it a try.  The time is past for lip service, the time is past for rancor.  The present administration may be wrong in their action, but at least they're not wrong in their inaction.  Those fully responsible for the inactivity of the past deserve a voice and consideration, but if they use their voice and that consideration to attempt to destroy crucial momentum and honest efforts by those that finally got the ball rolling - the very same ball that sat immobile and ignored for years and years and years - they should be run out of Washington DC on a rail, showered with rotten tomatoes and verbal abuse. 

The inactivity of the past was immoral.  To continue to do nothing is immoral.  It's immoral because real people are hurting, and we have the real power, the real tools, and the real ability help them.  If it means we have fewer bombs and fewer aircraft carriers, then so be it.  To embrace the status quo is akin to walking past the victim of a robbery and assault on the side of the road, averting our eyes and hurrying our steps to avoid the inconvenience and expense of assisting the needy. 

I might be able to swallow the "wait till we come up with a better plan" argument if the same people making that argument had at least tried to do so when they were very recently, and for a very long time, in charge of the country.  However, their past performance, which is the best indicator of future behavior, has not been promising.  I don't say this as a criticism or to be mean, just as an observation that may or may not be wrong. 

There's my answer, and I apologize if it was too long-winded or too accusatory in nature.  It's my opinion, not meant as fact, and certainly not meant as a judgement on another's opinion, given with the full understanding that many reasonable, good people feel differently, and I'm okay with that. 

Hello Elaine:

As a Christian, my response is that local churches could assist John in  his plight. As a Christian, I do not believe that it is my right to use the power of the government and take property from other people to assist those in need. As a Christian, I believe that God calls on me and my community of faith to help others. I do not understand that call as a mandate to ask government to force other people to help.

This is a tragic story and it's obviously having the effect that Kristoff hoped for when he wrote it. We are a country of 300 million people. It sounds callous but the reality is that bad things will happen to people. Stories such as this cannot be the deciding factor in passing legislation that will dramatically reshape every area of our economy. Particularly when there exist methods for helping people like John that will not hand government such tremendous power over our lives.

What stories will be written about those who die because of rationed care? What about the stories about those who die because they cannot receive the specialized help they need under the new regime?  What stories will be written about those who are laid off because their companies can no longer afford to pay the burdens imposed by either of the plans currently before congress?

There are better, less intrusive ways to provide full coverage and lower costs than are currently being considered.  The reason those less intrusive plans are off the table is that they do not cater to the interests of Democratic supporters (trial lawyers and labor unions) and because the Democrats hope to  create this benefit, make people dependent upon it, and then run as its protectors for perpetuity. Where are the stories about these things?

This is not a zero sum game:  There are ways to help people like John and control costs that won't  put politicians in control of our lives. The idea that if  we don't support these bills, we're mean-spirited  or we don't care about people may  be what the DNC and the Times wants people to believe, but it is not the truth.

Dave Dildy

Had you read the complete story in the NYTimes by Nicholas Kristof,  you would know that the church had assisted John.  He lives in a small town, and the church is small and raising the amount of money for surgery was an impossibility. 

It is easy to pass along such patients to churches, but does anyone calculate the money necessary to ensure healthcare for all those who are not now able to afford insurance?  Simple answers are usually simply not explained as to how this would work.  Please explain how such a plan would cover the uninsured now in our country if all the churches provided coverage.  How much would each member be able to contribute to such a plan?  How would it be distributed to those in need?  Who would administer the plan?  How many would be employed in administering the program, and how much would the employees be paid?  Unless a plan could be presented, it is only merely words, and they are no better than saying to John:  "I will pray for you recovery, good luck."

This would not obviate taxes for all those others who are presently insured under Medicare and Medicaid, but would only be more out of each individual's pocket--at least those who are church members.  What about those millions who are not affiliated with a church?  Are they unworthy?

Hansen, I read the article from the NYTimes.  Surely, you aren't implying that a brain hemangioma is caused by diet?  Or that many other serious illnesses are due to personal choices.  While some are, should they be set aside to die?  Such compassion is unbecoming one who claims to be a Christian.  Even medical personnel do not do a wallet check or blame a patient needing treatment that it's all his fault.  Remember, that is what the people asked Jesus about the lame man:  "Did he or his parents sin?"  And Jesus said, "Neither."

From Dave Dildy:

There are better, less intrusive ways to provide full coverage and lower costs than are currently being considered.  The reason those less intrusive plans are off the table is that they do not cater to the interests of Democratic supporters (trial lawyers and labor unions) and because the Democrats hope to  create this benefit, make people dependent upon it, and then run as its protectors for perpetuity.

Dave, I am a registered independent, who has voted republican more than democrat, but did go Obama during the last election cycle.  I'm not a liberal left winger, and I don't have a vested interest in either party's political machine.  You mentioned earlier that you are disappointed by the partisan nature of the healthcare debate, and more recently mentioned that there is a less than savory motive behind the democratic plan.  The statement you made that most piqued my interest was that "there are better, less intrusive ways" but that a democratic conspiracy to control Americans is the primary reason the better way is not the one at the forefront of the debate.

For the last 30 years or so that I've been a member of American society, Republicans have controlled the immense power of the White House bully pulpit approximately 2/3 of the time.  They've controlled the Senate approximately 1/2 of the time.  They've controlled the House just over 1/3 of the time.  They've controlled both the senate and the house 1/3 of the time.  And for 4 years, very recently, they enjoyed the rare trifecta - a republican majority in both houses of the legislature and had a republican in the White House.  Yet, no improvement on healthcare.  They stymied the democratic plan in 1993 using the same arguments they are using today - yet in the 16 years since (many of which they were in control of some or all lawmaking branches of government)  they've not introduced or proposed even a single, solitary piece of significant healthcare reform legislation at all, much less one that is better and less intrusive. 

The current Republican Senate Minority leader is Mitch McConnell.  It's his job to make sure that his party effectively blockades the current proposals.  He's been in office since the 80's, and not produced any healthcare reform legislation.  You'd think, as a direct beneficiary of FDR's work in the fight against polio, Senator McConnell would be more open to the idea of expanding healthcare to those less fortunate. 

Before you embrace the partisan rhetoric that there is a better way - I'd encourage you to consider where the arguments are coming from.  Have the "better way" advocates been promoting this "better way" in years' past?  If not, why not?  Have they not been in power, in a position to pass their "better way"?  If they have been in power, and they have this "better way", have they been remiss in their duty to serve the American people?  Why on earth would one trust them to suddenly accomplish this "better way" if they haven't passed or even introduced legislation that includes this "better way"? 

Hello Elaine:

You are right. I did not read the article carefully. I had actually skimmed it before you posted it. Sorry about that.

I am not suggesting church support as a substitute for health insurance. You offered an anecdotal example of a horrible case. I suggested an anecdotal response similarly based upon an individual case.

The plans before Congress are not simply about full coverage. They also involve cutting costs through regulation. That's where most of the problem lies. To suggest that those who oppose these gargantuan bills somehow don't care about people like John or are churlish is grossly unfair. This is about much more than universal coverage.

What about my questions? What of the "blowback" from the proposed plans? What about the risk of unintended consequences? What about the Constitutionality of all this? You are talking about shifting a huge amount of power over our lives to the government. I am extremely uncomfortable about this.

It's fine to say "Oh this is horrible, we have to do something about this." But one need only look at the mortgage industry to see that government intervention can often make things far, far worse.

Dave Dildy

Aren't there always some "blowbacks" and unintended consequences to almost any bill in Congress?  Equal numbers may suffer disadvantages while others experience advantages.

 What about the constitutionality?  Please give some reasons you must have in mind.

Which of the many new programs enacted by the government in the past 50 years have not turned over power to the government?  All businesses and even individuals are governed by many orders. 

Currently, in the private health insurance plans we are governed by their policies; policies that are structured specifically to make a profit.  Otherwise, why would any be in the business?  They are able to deny coverage for any preexisting condition which they choose; they are able to deny coverage for a patient  who they deem may be too costly; and often the premiums are too costly for many millions of families to afford. Should these families not be granted insurance at a more reasonable cost?

A major savings could have been obtained if Medicare had been given permission to negotiate with the pharmaceutical industry for better prices.  This was specifically not granted (guess who lobbied successfully for that rule!).

The government will also have the charge of establishing costs for any public option that is offered.  Do you disagree that there should be no government options, period?  Is it not competitive (the Bible of capitalism) for public insurance to be available if the private companies are unable to compete?  Is it the place of government to prevent competition? 

Quite a few states are almost exclusively covered by only one private insurance.  Is that being truly competitive?  Presently, the government plans (Medicare and Medicaid) are priced differently by the states.  Should there be one price only for the entire U.S.?  Should the government subsidize the private Medicare companies that directly compete with Medicare?  Is that not the government attempting to divert Medicare dollars into a competitive plan?

There will always be regulations and rationing.  As a Medicare patient for 20 years, I have experienced rationing:  long waits for elective surgery; major necessities:  hearing aids and eyeglasses are not covered at all; there are others.  Of interest:  Medicare covers E.D. drugs but the government will not cover either birth control meds or abortions.  IOW, the government will pay for mens' "needs" but women's medical care is less important.  Quite a paradox.

Hi Steve:

I've always found your posts to be "fair and balanced" if I might use that term. :)

I agree that the Republicans have not been a model of responsible governance. Unfortunately, both parties tend to cater to their constituencies when they get elected, often at the expense of the country as a whole.

I also agree that the Rs didn't do much to advance this issue when they had power. I don't think, however, that this means that we should just roll over and accept whatever the D's propose on the grounds "that at least it's something."  (I do think that the scope of the problem is exaggerated, probably, which effects the urgency of dealing with it. But that's just my feeling which isn't worth much.)

Republicans trying to damage Obama politically in this? I am shocked! Shocked!  :) This entire thing is political. Recall when Bush tried to reform Social Security? The Ds howled and twisted his proposal into something that it was not. He tried to fix a looming problem and got blasted. Sound familiar? Politics is a bloodsport in which each side tries to wring the utmost advantage out of the other. This is another reason that I  object to attempts to nail this issue to the Cross.

I don't think that this is a Democratic "conspiracy" per se. I do think that Democrats favor the expansion of government, which will in turn make people more dependent upon government.  This will in turn allow Democrats to run for reelection as protectors of those programs. It has happened before....

I enjoy discussing this with you. Have a good evening.

Dave Dildy

Hello Elaine:

Thanks for your thoughtful reply. Your posts always make me think. Which makes my head hurt but I can't in all fairness blame you for that.

You are quite correct that almost all bills have unintended consequences. This is an excellent reason for government to do as little as possible to minimize these unanticipated effects.

You are also correct that the general trend has been toward more regulation. To the extent that these regulations are repealed or minimized the economy tends to perform better. (Example: The mortgage crisis has many villains. But this mess started when the government forced banks to lend to unqualified applicants. There were many subsequent bad actors -- lenders, investors, home buyers -- but this mess started when the government forced the market to act against basic economic principles in the interests of "helping." ) Note: I am not an anarchist or a libertarian.  My general preference is against regulation though I acknowledge that some regulation is necessary.

I don't know about equal numbers suffering advantages and disadvantages from these bills either. I suspect that the people adversely affected by the current bills will vastly outnumber those who benefit. And is it really government's role to pick who is disadvantaged and who is not? Who gave the government that authority? Which leads me to:  

The constitutionality of this effort:

Where does the Constitution vest Congress with the power to force a person to purchase health insurance?

Where does the Constitution vest the government with the power to set rates for medical services?

Where does the Constitution provide the government to establish bureaucracies that will have the power to determine who gets treatment and who does not?

Those are just a few questions but they'll do for now.

I'm a bit baffled by your comments on competition and the public option. Government  would prevent competition by not competing?

Competition is generally preferrable.  The problem with the public option is that it's not really competition -- it's a trojan horse for a single payer plan.  Competition is good if it's governed by the market. There is no way that private insurers, who must make a profit to survive, can compete with government, which does not. If a public option is passed, it will eventually lead to single payer as private insurers are squeezed out of the market.

I agree with you that limiting insurance sales to only certain states is a bad thing. But who imposed that limitation? The government! I also agree with Charles Krauthammer that simply removing this regulation would do a lot to decrease costs and make insurance more affordable.

Your last point about the paradox of male vs. female care made me smile ruefully.  Is it really a good idea to give the government that made that decision control over 1/7 of the economy?

Dave Dildy

The government is intrusive into nearly all of society today.  Those who dislike it in some areas, praise it in others, i.e. do citizens have input or a vote into war?  Or the funding for military activies?  Did the citizen have any voice in the TARP program that we funded to the tune of $700+ billion dollars?  Did we have any vote in government support for the auto industries which had for years ignored the efficient foreign cars?  There are numerous examples where we, the taxpayers, must pay for these tremendous bills, but we had no vote in either approving or rejecting.

That healthcare is so very controversial is somewhat of a puzzle when these other expenditures were enacted without a citizen vote.  It seems that because the idea of universal healthcare is seen as directly aiding citizens that it is so controversial.  Or, is there another reason that cannot be identified?

It appears to me, to be a priority of values with the American people.  This has also been an idea perceived by European countries who have long had universal healthcare coverage.  As a new idea for the U.S., it goes against the grain of our country's founding as being strong, independent, and needing no assistance from the government to care for ourselves.  Of course, it a fallacy, as without the many government supports, no citizen could be certain that his home, property, education, and many other "rights" could be assured.  Even the "cash for clunkers" and the $8k given to new home buyers is a program begun to help those who have been very adversely affected by the recession. 

One of the greatest reasons for personal bankruptcy has been identified as huge medical bills:  bills far beyond the average person's ability to pay, even with insurance.  It is not unusual for the health insurance to refuse to cover care beyond a definite amount, and if the charges are high, the insurance may be dropped by the company, leaving the patient with no means to pay the bills already incurred, but now without insurance.  All the print media has covered many such cases, and it is not at all rare.

What suggestions do  you have since  you are opposed to single-payer insurance?  The present system is not working, and there must be some changes.  There must be more than simply saying "no" to any plan.  What are the ideas that should be given consideration?

 T

Some people see government as an agent to level the playing field and, when that does not lead to "fairness," to create equal outcomes by the use of its power to tax and redistribute income.

I think that view both unconstitutional and unwise. Concentrating power in the government stifles economic growth, leads to inefficiency, and robs people of their freedom. I think history shows that minimal government action and regulation is best.

There are some things, however, such as fighting a war, that only government can do. One may disagree with the decision to enter this or that conflict but it's hard to argue with the proposition that fighing wars is a legitimate function of government. I am not sure that government forcing me to purchase health insurance is such a legitimate function. I'm not sure why we're talking about people having a direct vote on policy. We don't live in a democracy but in a democratic republic. I certainly do not advocate a move toward more referenda. Our system is structured brilliantly. There is no one reason that this issue is so controversial. For myself, health care is an important issue because the plans under consideration involve a massive transfer of power over our lives to the government. This, and not a churlish urge not to help those in need, concerns me.

There are instances where some government involvement is necessary and health care seems to me to be one of those areas. I don't think it's fair to say that our current system doesn't work. We provide the best health care in the world. The problems are inefficiency and lack of care for everyone. The question for policy makers should be: How do we fix those problems? That can be done without a government takeover of health care. If we have a public option, a government takeover is where we're headed.

Several people have asked me what I would propose as an alternative. Well, I cannot claim to be an expert but Charles Krauthammer's proposals seem logical to me. He suggests that we: (1) enact tort reform; (2) tax employer-provided plans and use the money to provide vouchers for the uninsured; and (3) allow insurance companies to trade across state lines. These measures would have the effect of enhancing efficiency by eliminating the need to practice defensive medicine, providing universal coverage, and lowering costs through increased competition.

Additionally, these, or some other similar less intrusive measure, have the benefit of being incremental. If something does not work, we can adjust it without having government seizing control of 1/7 of our economy.

Dave Dildy

In response to the sad story that Elaine refererenced, it seems there is more to the story.

http://michellemalkin.com/2009/11/30/a-doctors-message-for-nick-kristof/

While the U.S. may provide the best healthcare system in the world, it is not available to everyone. 

"The United States places last among 19 countries in deaths that could have been prevented by access to timely and effective healthcare, a new study finds."

If the United States had performed as well as the top three countries out of the 19 industrialized countries in the study, there would be about 101,000 fewer U.S. deaths in the per year, the researchers estimate.

The top performers: France, Japan, and Australia.

Healthcare expenditures (percent of GDP)

United States 13.4%

Canada          10.0 

The U.S. has a higher infant mortality rate (10.4%) than  10 other industrialized nations.

The death rate of  1-4 year-olds (per 200,000 per year):

U.S. 101.5%, decreasing to 53.3 for Finland

Life expectancy (years):

Japan              76.2 men      82.5 women

U.S.                 71.6              78.6 (tenth place)

The reality is that the various goods and services that fall under the rubric of "health care" are scarce goods and services, just like all other goods and services.  We have been kicked out of the garden of Eden and there is scarcity.  As a result, goods and services have to be rationed.

In a market economy, most goods and services are rationed via the market system, i.e., the market establishes a price at which a seller will freely sell and a buyer will buy, and no government intervention is necessary.  The alternative to market rationing is government rationing.  Since the government typically sets a price that is too low (often zero, i.e., "free"), demand almost always exceeds supply and the system is brought back into equilibrium by making would-be buyers or conusmers wait in long lines to get the good or service (hence the long lines in the former Soviet Union for things such as bread or toilet paper).

What we have currently in the U.S. for health care is a hybrid system in which, for the great mass of consumers of health care (5/6ths of us) health care at the point of delivery seems free or almost free, because we or our employer have previously purchased insurance.  Because there is no incentive to economize, there is chronic over-demand, which results in an upward spiraling cost of insurance.  (Insurance companies try to re-introduce rationing to this system, but not effectively, and for their efforts they are hated by both the consumer and the provider of the goods and services).  This has resulted in Americans spending about 17% of GDP on health care, which is about double what is spent by most other advanced societies, which spend about 8-10% of GDP.  I believe that our health care is the best in the world, but it certainly isn't twice as good as everyone else's, yet we spend twice as much.

Logically, what needs to happen is that we need to move immediately back toward market rationing, which means greatly reducing the role of insurance, or toward government rationing, which means single payer, government-controlled health care, and long waits for non-emergency procedures (even though some of these procedures are life-preserving and their delay will cause some people to die who might have lived).

Naturally enough, the current "reform" bill does neither of these things, but instead forces some uninsured to buy insurance on pain of fines or imprisonment.  Obviously, this is only pouring gasoline on the fire, because our current problems are caused by 85% of us already having insurance and thus not having sufficient incentive to economize, and insurance companies being unable to impose sufficient economy on the buyers and sellers.  This will cause the cost of insurance to increase by 40% to 50% and put further strain on the already vastly over-demanded health-care delivery system.  (This is exactly what a similar program did in Massachusetts.)  This bill will further "break" the already arguably "broken" health care delivery system; it is designed to make people want a single-payer system, whereas currently the will for single-payer does not exist in this country.

All of this is simply an argument about economics and policy, and for Monte to frame it as a question of morality is most unhelpful and needlessly divisive.  I do wish the Left would refrain from infusing its enthusiasms with faux moral urgency. 

"Logically, what needs to happen is that we need to move immediately back toward market rationing, which means greatly reducing the role of insurance, or toward government rationing, which means single payer, government-controlled health care, and long waits for non-emergency procedures."

Because the average insurance beneficiary is exempt from being affected by the costs of treatment, he cannot be a conscious consumer.  Imagine, going into a store and no prices were posted, how would our choices be made? Would we not gravitate toward the better and more expensive model?

The government single-payer system is presently used by Medicare, Medicaid and the VA system.  Extending it to the public who is not now able to afford the expensive private premiums, is one that too many in Congress are dead set against, because they are beholden to the insurance companies who have lined their pockets.  Why are leaders of either parties so adamantly opposed to government option, if not because of this? 

All the industrialized nations have universal coverage, France being considered the best.  Only the U.S. has both the highest costs per person for healthcare and one of the lowest outcomes.  Why is that?

Elaine, your second paragraph makes my point very concisely.  The way the present system is structured, there's no way a consumer could make economical choices even if, for some reason, he wanted to.  But that is only because the present system is geared to insurance.  In cases that are traditionally uninsured, like elective plastic surgery and laser vision correction, the prices are posted up front, everyone knows what it costs, and doctors do compete on price.  And prices for these services have fallen as a result of the open information and competition.  The same could be true across the health care system.

As to why the Senate is rejecting the public option, it is too obviously a transition mechanism to a government-run, single payer system, and, as I said, there is not currently the political will for single-payer socialized medicine. 

David, we are in agreement on nearly every point!

One day, I will not predict when, the U.S. will have a single-payer healthcare system.  Because it is now seen as too radical to change the present system, it will be incrementally changed, as the public begins to experience the small changes that will emerge  when a bill is finally passed.

Ask any Medicare patient if he is dissatisfied.  No, it does not cover all the costs, and there will probably be some cutbacks.  Even for the next three years we will pay a slightly larger premium and there will be no increases in Social Security. 

As the new program, regardless of how the benefits and costs become, there will be a recognition that the government is not the ogre it has been presented in a public-option plan.

Consider university education:  the U.S. currently provides higher education in 2,500 four-year colleges, and roughly a quarter are public.  These state-subsidized public institutions do not seem to threaten the viability of private colleges (think of the rush to be admitted to some of the top ones).  Rather, the two sectors appear to complement each other, both offering excellent education.  These less expensive state schools force private schools to grant generous financial aid if they wish to stay competitive on cost, while the research-intensive private schools impel the public ones to support faculty research in order to be taken seriously as academic institutions.  Doesn't the public benefit from the presence of both types of colleges?  Perhaps a public-private insurance system too, would benefit the public.

Elaine, sorry if I've been unclear.  We don't agree on the big picture because I want to return to a market system and you (I think) would probably prefer a single payer system.

There's no question that, at this point, returning to a market system would be much more wrenching and dislocating than going to a socialized single payer system.  But in the long run it will be far healthier for society.  Socialist Europe is close to being in a demographic death spiral, in part because it has lost its Christian faith, and in part because cradle-to-grave welfare, including socialized, medicine, has removed everyone's adult responsibilities.  People live their lives in an extended adolescence, don't get married, and don't have children.  Europe is not a model to be emulated.

I would love to hear those who are sanguine about the integrity, altruism, and trustworthiness, of politicians offer some historical examples to justify their optimism.  I would also like to know why proponents of Obamacare are unwilling to address alternatives which create incentives to efficient use of resources and personal responsibility: removal of governmental favors for insurance companies, such as anti-trust exemption; repeal of laws prohibiting insurance companies from effectively competing with one another across state borders; repeal of laws that prevent consumers from shopping for the type of coverage they want and need; tort reform; elimination of tax exemption for employer provided insurance plans.

Tremendous cost savings could be realized through these measures.  Why not try some of them?  

Elaine, you love to make specious comparisons between the U.S. and other countries, as if the statistics you cite are gospel.  A quick Google search will demonstrate, to anyone who is interested, that there are compelling alternative perspectives.  The U.S. also spends more on groceries, eating out, cars, flat screen T.V.s, sporting events, and other entertainment than the rest of the world.  We are wealthier!   Mississippians spend far less on health care than New Yorkers.  Does that mean we should adopt Mississippi's health care delivery system? On a purchasing price parity basis, France, Germany, and Japan all have lower standards of living than Mississippi.  Is that what you want for the entire country?  Citizens of other countries may well be very happy with their markets and consumer outlets.  That's all they know.  I'm not sure Americans would be happy to trade our supermarkets, Wallmarts, and Costcos for what they have in Europe.

"Researchers estimate..." is code for a politically motivated study.  Many of Elaine's statistics come from the WHO, a highly politicized branch of the U.N. that does everything possible to make the U.S. and Israel appear in a negative light.  As Climategate is demonstrating, research is worthless without looking at the raw date and methodology, particular when it comes from a biased source. 

PLEASE - can you at least acknowledge the reality that extending the health care that insured Americans receive to the uninsured will increase demand for health care; that holding down costs, which would normally rise in the face of increased demand will produce less - not more - health care resources; and that rationing and reduced quality are the inevitable result?  If you won't acknowledge these basic laws of economics and human nature, intelligent dialogue is impossible.

Finally, will someone please explain how anything that is a limited resource, producible only through personal effort and sacrifice, can be deemed a basic or universal right.  This reasoing makes involuntary servitude a moral and legal duty How does it differ from the Marxist formulation - "From each according to his ability. to each according to his need."? Redistribution of resources, in furtherance of a totally non-Biblical egalitarian ideal, has nothing to do with advancing the Kingdom of God.  It does not produce surrendered hearts and minds, but only a feeling of entitlement on the part of the recipients, and a feeling of resentment on the part of those who must subsidize and support them. 

I believe had the SDA church accepted the advice of Sr White signing a pledge to dispense with meat the health message would have had more impact on the world.  She wrote the church could not make meat a test when the leaders still ate meat.

I have my own blog and here are two studies about Isaiah 22 and making it a test.

http://imssdarm.wordpress.com/category/vegetarianism/

Regards,

Sabbath Sermons

How many employees, even of Adventist organizations, know each and every entity that holds their pension funds?  Many are likely in mutal funds, and they change regularly, depending on the manager and his criteria.

How is it possible in today's world with huge pension funds (CALPERS)being the largest) for anyone as a shareholder to be accountable for such decisions?  Do you know each and every stock held by the SDA pension fund or where it invests its money?

Monte,

I've agreed with many of your positions in the past, but there are many reasons why those who have read the current "health reform" proposals don't like them.  The goal of this and all social justice programs may be laudable, just ask Karl Marx, but your proposal that social justice systems would be supported by Jesus is more than a bit over the line.  I would hope that this is not the future Adventist position.  I know many people who have lived under such "just" systems and they come here for the freedoms that this nation has historically offered.I see nowhere in the gospelsthat the way we are to do good in the world is to promote social engineering schemes that propose to equalize outcomes at the expense of freedoms.  There ismuch wrongwith health care, even Adventist health care, but this is the kind of cure for what ails it that bleeding was a number of years ago.  Doing something, however ill advised,  quickly isn't often the best cure, even if it does make us appear more compassionate.