Center for Ethics and Leadership

Saturday, October 3, 2009

Some Thoughts on Health Care Reform

Two of the more fiercely debated issues in health care reform concern the public option and federal coverage of abortion. I have been trying to figure out the pros and cons of a public option for a while now, and I am sorry that the Senate rejected it, but glad that the House holds on to it. It seems that a public option if properly structured would go a long way toward reaching a goal of universal coverage. Those opposed to it say it would put the insurance companies out of business and lead to government-run health care.

I wondered about this. After all, Medicare already represents a large portion of the health care economy and also has been modified to allow for private insurers to sell supplemental products. I have worried about American corporations dropping their health insurance benefit and most of the population moving to a public option, but not for fear of "socialized medicine." That exodus, if it occurred, would require an enormous increase in taxes and also relieve American corporations of a tremendous operating cost that grows more severe each year. Now, that tax increase, the cynic in me argues, would not be borne by the corporations but by ordinary taxpayers. In other words, there would be a windfall to the corporations and their shareholders. Would there be a transfer of wealth upward?

I went Googling and found an editorial from last June from the Salt Lake City Tribune that helps. The following is a close paraphrase of what was written.

A good deal depends on how the public option is designed. If eligilibility is limited to such persons as the self-employed or small employers and premiums follow the current Medicare schedule, about 32 million would drop private insurers, not a serious shift. If private insurers's rates were used, only 10 million people would switch from private plans. A public option open to all at current Medicare rates would lead to 131 million people leaving private insurers. The editorial claimed that this transfer would decimate private insurers, but did not address the ways in which the last design would affect the provision of health care in the U.S. Would that be the cost restriction the health care sector so sorely needs?

As for coverage of abortion, The New York Times strongly editorialized in favor of abortion coverage on October 1. Said the Times, "In a rational system of medical care, there would be virtually no restrictions on financing abortions." Not so. In a rational system of medical care we might have a more genuine debate about the difference between rights that prohibit government interference in personal freedoms, and rights that obligate government support. The first are called negative rights (the government may not) and the second positive rights (the government should). One's freedom of speech does not require a government-bought megaphone.

The negative right of freedom of reproductive choice is well established in American jurisprudence. Even the very conservative justice and Catholic, Chief Justice John Roberts, said during his confirmation hearings that he considered Roe v. Wade to be stare decisis (settled law). At issue is whether the positive right to federally funded abortion exists. Contra the Times, the plans put forward do not "constitute an improper government intrusion in Americans' private lives."


  • thanks for share your article, it has been so helpful.. I enjoyed to look at your beautiful blog

    By Anonymous myasthenia gravis, At October 3, 2009 12:22 PM  

  • I saw a bumper sticker yesterday: Health Care Yes, Health Insurance No. There is something to be said for separating the issue of health care from the idea of universal insurance coverage.

    I liken insurance to an auto expense. Note that insurance is an expense. There is no sector of our society that receives a rebate or tax credit for their insurance premiums, although there are executive that receive cars and transportation services as part of their compensation package. If you want a car you are required in most states to pay for car insurance.

    I agree the system is broken, I also agree that in one of the wealthiest nations in the worlds, some minimum level of care should be made available to all people. I do not however believe that services that cost money need be made available to all at no charge. I am inconvenienced by my insurance payments, any by the required co-payments. I have to make a choice about the prescriptions I fill and where I fill them, part of being a responsible consumer is making choices and allocating resources, my own resources more than the resources of others. There is a place for insurance companies, and there is a place for public health, there is also a place for tort reform and for that matter for limits on end-if-life billing excesses.

    The politicians have a job, and that job is to find a plan that solves some of our problems and responsibly services the electorate. As with social security, I'm sure if they had to live with the plan that they create for everyone else, it would probably be OK.

    By Blogger kobe2, At October 12, 2009 3:32 PM  

  • Abortion?? That should not even be an option in todays society. How can someone possibly live with the fact they killed something in them. That is so horrible. They shouldnt even talk about that anymore, it should just be illegal and no arguments. No matter what you are killing God's creation. that baby could be something special. No matter what the circumstance is, no one should abort their kid. There is a very good reason why it happened. There is always a good reason for things in life.

    By Anonymous Liz Fortuner, At October 26, 2009 6:17 AM  

  • Health care definitely needs to be addressed today. Unfortunately, most of the "solutions" require major government oversight. I think that most of us can agree that our legislators (on both sides of the aisle) are motivated by two major concerns: 1. Getting elected and 2. Getting re-elected. Decisions are made based on who provides them with the most support to accomplish those two goals. Those supporters have agendas that they expect rewarded for that support. Until we come up with a better election process where outside influence is negated and our elected officials are voting with their conscience, large issues like health care are best off left to the private sector.

    By Anonymous Claude, At November 1, 2009 9:45 AM  

  • Liz,

    Did you know that the state of Illinois permits labour induced abortions of babies 6 months old AND they are left to die once born prematurely.

    One baby took 8 hours to die.

    What a great health care system !!

    By Anonymous Avnish, At November 18, 2009 2:04 PM  

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