September 19th, 2011
Freethought San Marcos: The Republicans’ callousness about health care

Freethought San Marcos: A column
by LAMAR W. HANKINS

Now that the Republican nomination for president is in full swing, we once again return to the topic of health care, especially the role of government in assuring that all Americans have access to that life necessity.

Living adequately in a modern society requires many things–transportation, housing, food, income, security from crime, education, water, fire protection, fuel for home needs and vehicles, and information about what is going on in our community, state, and nation.  Few people disagree with this list, but when health care is added to it, some people become uncomfortable–some almost apoplectic.

The government at all levels helps provide everything on the list, as does the private sector.  We have a mixed economy.  Usually, government and the private sector cooperate in providing needed goods and services.  Sometimes the government takes the lead role; sometimes it is the private sector leading.  Few, if any, vital services are provided exclusively by the private sector.

I may buy natural gas from a private company, but the transmission of that natural gas to my home requires the assistance of government to assure that it is done with sufficient care that no one is put at risk.  The public highways and streets are used by the gas company to provide the service.  Public rights of way are used for the natural gas lines.  The government inspects the company’s installation and maintenance of the company’s gas lines to insure that they are safe and citizens are protected.  It is a cooperative endeavor that benefits all of us.  

Neither the government nor the company is perfect, however.  Mistakes are made by both on occasion, but the system works about as well as any human enterprise can be expected to work.  When there is a failure, the causes are determined and actions are taken to correct the deficiencies in the system.  If the failures are too great, changes in leadership occur in either the government, the private company, or both.

Few goods and services are provided in our society without this sort of cooperation, coordination, and connectedness between the private sector and government.  In fact, I am unable to think of a single 100% private-sector activity; that is, an activity that does not use some resource of the government or the public to carry out its purpose.  If you come up with one, please share it.

This system works, more or less, for all of the needs of modern life.  But when we start discussing health care, people who believe strongly in self-sufficiency and rugged individualism posit the notion that health care needs must be entirely the responsibility of the individual.  This happened at one of the recent Republican presidential nomination debates, as described by The Washington Post’s Eugene Robinson:

“The lowest point of the evening — and perhaps of the political season — came when moderator Wolf Blitzer asked Ron Paul a hypothetical question about a young man who elects not to purchase health insurance. The man has a medical crisis, goes into a coma and needs expensive care. ‘Who pays?’ Blitzer asked.  ‘That’s what freedom is all about, taking your own risks,’ Paul answered. … Blitzer interrupted: ‘But Congressman, are you saying that society should just let him die?’  There were enthusiastic shouts of ‘Yeah!’ from the crowd.”

Paul then mentioned that the churches would take care of such people.  Most listeners and watchers to that debate probably missed the irony in this exchange between Paul and Blitzer.  Jay Bookman, a columnist and blogger for the Atlanta Journal-Constitution, explained in 2008 what Paul has ignored and Blitzer likely did not know:

“Kent Snyder, 49, served as Paul’s 2008 campaign manager but died of complications from pneumonia two weeks after Paul withdrew from the ‘08 race. … However, Snyder did not have health insurance. According to his mother, he had a pre-existing condition that made it financially impossible to buy it on his own. (Interestingly, Snyder is credited with raising $19.5 million for the Paul campaign in the fourth quarter of 2007 alone, but none of that money was apparently used to buy insurance for campaign staffers.)”

“Because we treat health care as a de facto right in this country, Snyder did get at least some health care, racking up $400,000 in unpaid medical bills before he died. A fundraising effort after his death — the charity approach advocated by Paul — produced only $35,000 toward paying off those bills.”

“That’s not an unusual story. … [Patients such as Snyder don’t] come close to having the resources to pay off their bills. But somebody paid them. You did, and I did, and we paid Kent Snyder’s bill as well. It’s a convoluted, extremely irrational, unnecessarily expensive and inefficient system, and the only two approaches that show any promise of rationalizing it are the individual mandate or single-payer.”

When Bookman writes that “we paid Kent Snyder’s bill,” what he means is that Snyder’s bill was absorbed into the rate structure that all of us who have health insurance support.  We pay for all the Snyders by increased premiums and increased co-pays. 

What such situations point out to me is that many people in our political system are driven by an ideology that ignores the reality of our lives.  Nowhere is this more apparent than in the health care debate.  The indisputable facts are that the US is alone among the advanced societies in failing to assure that health care is available to all its citizens.  Access to health care is controlled mostly by health insurance corporations and pharmaceutical giants so that these companies can rake off large profits at the expense of 50 million Americans who do not have insurance, as well as at the expense of every policy-holder.

One of those Americans without health insurance is a friend of mine who has had to take out crushing loans that could leave him penniless to pay for two essential surgeries and other medical procedures as a result of accidental injuries he sustained doing a good deed for another person.  He can’t afford health insurance in the present system.  Where are the churches that Ron Paul touts as the solution?  Where is the compassion?

For the same amount of money we spend in this country for health care and health insurance, we could cover those 50 million uninsured and an equal number of poorly insured with one simple reform–a single-payer system.  What we would miss out on is paying millions of dollars to health insurance and pharmaceutical companies to enrich their stock-holders and executives for a service that adds nothing to the nation’s well-being and could be provided better by a single-payer system.  They have rigged our system with appeals to the kind of libertarian arguments made by Paul and others, while 45,000 Americans die needlessly each year because they can’t afford health insurance.

The US health care system ranks 37th in the world in its quality of care and its efficiency according to the World Health Organization.  It is this way only because too many people have bought the lie that we have a free enterprise system, which is falsely seen by them as the greatest idea in the world, more important even than all the world’s religions.  But we don’t have a free enterprise system.  We have a cooperative enterprise system, and that system does not serve the people well when it comes to health care.

It is the government’s responsibility, acting on behalf of the people, to make our society work for the people’s benefit when any system becomes dysfunctional. When that dysfunctionality results in the unnecessary deaths of tens of thousands of Americans each year, that responsibility becomes an imperative. 

I am not advocating that government pay everyone’s health care bill.  I am advocating that government help create a health care system that everyone can afford to participate in.  That’s not socialism, as some falsely charge; it’s American democracy.

For nearly 100 million Americans with no health insurance or inadequate coverage, having meaningful health insurance reform will do more than almost anything else to assure that the promises of the Constitution are fulfilled. It is past time for us to have a government of, by, and for the people, not of, by, and for the giant corporations who now control access to the health care system.  When ideology prevents our system of government from working as was intended by the founders, its adherents are ideologues, not patriots.

© Lamar W. Hankins, Freethought San Marcos