I sat listening to the President last night deliver what I believe to be a long overdue speech on health care and the direction he wants a proposed bill to go. My wife and I have talked about this some and I told her almost from the get-go that he was making a mistake not to hand Congress at least the skeleton of an actual bill to work from, instead allowing that bickering bunch to cobble something together on their own. People need direction and Congress has demonstrated they are incapable of rising above party ideology to get anything significant accomplished. But anyway, I thought Obama delivered the speech well and did a good job of explaining why health care reform is needed.
First of all, I’ll reveal my biases, both past and present. I’ve grown up Republican. I’ve never voted for a Democrat for President and can’t think of one I would have supported in the elections that have occurred in my lifetime. My default switch is set toward finding a way for private entities and the free market to solve problems. In my experience, when the government takes over something, it tends to get mired down in red tape and bureaucracy, is terribly inefficient and doesn’t deliver the same quality of service as a private entity does. On the other hand, health care seems to be in a totally different category than other things for me. I have a hard time believing that if someone posed the question “Is health care a right or a privilege” to Jesus, that He’d come down on the side of “privilege” and expect people who can’t afford decent insurance coverage to just go bankrupt or throw themselves on the mercy of a (hopefully) charitable doctor or hospital. So to that end, I believe universal health care coverage is a worthwhile and noble goal. I’m just not sure how to get there. The systems in Britain and Canada don’t impress me because as with all things that are free (or at least are perceived to be free since there’s no transaction at the point of service), supply can’t keep up with demand and rationing begins either in the form of long waits or some treatments simply being unavailable.
So when President Obama talked last night I found myself agreeing with him on a lot of what he said. Those of us who have health insurance are still seeing it increase by way too much each year. There are the headaches with “gotcha” clauses in the coverage. People get dropped over technicalities when it appears the insurance is about to have to cover some expensive treatments. A person changes jobs and their new health plan won’t cover them because of a preexisting condition that the previous employers plan was covering. Coverage is expensive even when the employer pays most of the cost, so people who don’t make enough money can’t afford coverage. Others work for employers that don’t offer coverage at all. The self employed find it extremely expensive to pay for a good health plan. It’s a tough situation. And I thought he did a good job of compromising and being pragmatic as to how to achieve what he laid out as his ultimate goals, drawing from ideas originating on both sides of the political aisle.
But in the end, we have to look at cost. Almost $1 trillion over the next 10 years. And such estimates are notoriously low when it comes to major government spending programs. Even assuming that Obama’s figures are right on the money, can we actually pay for this simply with cutting out waste, fraud and abuse and increasing efficiencies in the current health care system? No tax increases? Really? Not sure I believe that. And if the projections for the next ten years of cost are accurate, how do we avoid the bloat and explosion of growth in costs that inevitably seem to follow government programs that have been around for a while? Because such programs are also notoriously hard to get rid of once they’re in place and people are dependent on them.
I’m all for insuring everyone in a manner they can afford and gives them good coverage. I do think that Christ would have us figure out a way to help “the least of these” in such a manner if it’s within our power to do so. But the question is, is it really within our budget and capabilities to pull it off without demand vastly outstripping supply, the quality of care overall going down and the costs shooting through the roof?
What do you think?