No one should die, but everyone will anyway
There is a viral Facebook status update going around today:
No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.
Let’s ignore the grammatical problems with this position and examine it on the merits.
“No one should die because [he or she] cannot afford health care.” By that reasoning, no one should die because he or she cannot afford nutritious food, clean water, adequate housing, or a safe neighborhood either. Anyone who thinks that U.S. citizenship is ever going to guarantee the supply of all those other necessities is as loony as the people talking about death panels today. Also, I might agree that no one should die because he or she can’t afford a $500 treatment that would extend his or her life by another 50 years. But what about a $5,000,000 treatment that would extend his or her life by another six months? Is it reasonable for any of us to expect someone else to subsidize that sort of extravagance?
“No one should go broke because [he or she gets] sick.” You certainly hate to see someone recover from an illness or injury only to have his or her life in shambles anyway as a result of the financial stress. But we also have to avoid moral hazards. Some say addiction is an illness. Are we ready to say that no one should go broke because he is addicted to drugs or gambling? And couldn’t we also say “no one should go broke because he or she is the victim of a crime?” And yet we hear no calls to establish mandatory insurance against Ponzi schemes, e-mail fraud, or insider trading.
I understand and applaud the sentiment behind the “no one should” slogans. However, advocates of health care reform must be held to the same rigorous standards as opponents of health care reform. If we’re going to ridicule their comments about mandatory abortions, rationing, and government-run health systems, we have to watch what we say and how we say it.
Comments
Comment from Anna Sarah
Time September 3, 2009 at 2:29 pm
Well, you’re right: no one should die because they can’t afford health care, nutritious food, clean water, adequate housing, or a safe neighborhood either. However, the fact that just because US citizenship doesn’t guarantee the supply of all of those necessities does not make it right. Rather, isn’t it something that we ought to protest against and attempt with all of our might to change? And yes, health care rationing, such as $500 treatments that can extend life 50 years vs. horribly expensive treatments that have a less dramatic effect, DEFINITELY needs to be part of the discussion (and no, it is not reasonable to expect someone else to subsidize that sort of extravagance!).
As for the “moral hazards” of which you speak, these are interesting points and raise good questions. Yes, people need to get support for addressing and breaking their addictions, but perhaps there ought to be something like a health care rationing or cut-off point because, ultimately, we can’t utterly control people and their outcomes or journeys, and some people perhaps have to hit rock bottom to come back up — or not. And yes, perhaps we should consider establishing mandatory insurance against Ponzi schemes, email fraud, and insider trading (those are some issues that I haven’t considered as much, though…).
Keep on blogging, David!
Comment from david
Time September 3, 2009 at 2:44 pm
Anna Sarah, if we are prepared to try with all our might to ensure that everyone has adequate everything, then the health care reform opponents are right: Obamacare is just one step toward socialism or communism. A free-enterprise society can provide a safety net, but not a safety hotel. Fortunately, when it comes to health care we should be able to provide far more value than we currently do at not much more cost. We can only do that, though, if we are willing to divert some of the money that is spent on the sickest people at the end of their lives and spend it instead on basic treatments for more people. Whether that is accomplished through incentives or mandates doesn’t matter all that much to me.
Comment from Melissa
Time September 3, 2009 at 1:09 pm
Posting your link to my cut/paste FB message today was the BEST way to get me to discover your blog. Thank you for giving me this link and something good to read (and my boss will hate you further b/c I’m “wasting” my time online)!
I’m bookmarking you now.