A Frank Exchange of Views on Health Care Reform

I couldn’t resist baiting a conservative friend earlier today. He had sent me a derogatory cartoon caricature of Obama, and I accused him in return of being a “rightwing nut job.” I trust he knows I was just kidding about that, but I also have to give him credit for sending me a better and more thoughtful response than I deserved:

Ed,
I don't think anyone believes that health care/insurance in this country doesn't need some attention. Certainly this right-wing nut job believes it does. My disagreement is with government doing it. The lefties I know absolutely reject things like tort reform, allowing insurance sales across state lines, eliminating insurance policy mandates (sex change operations, health club memberships, etc.) that increase costs, medicare/medicaid bargaining with big pharma for drug prices as foreign countries do, allowing private citizens and small business the same tax relief on insurance policies that big corporations get (pay with pre-tax dollars, not after tax dollars), and so on.
     Some of the above would require regulation, I understand that, but all would save money (the single biggest problem with health care) and none would involve a new and very expensive entitlement program.
     The biggest point of disagreement I see is between those who insist on a government program (public option) and those who want to keep health care in the private sector. I come down on the side of "private sector."
     When, I ask you, has government ever done anything efficiently?
     I could argue this for along time, but will not aggravate you with further discussion unless you wish to continue it. Blast your ideas? Not with malice in my heart, you can be sure.
Warmest regards,

      I think my friend makes some good points here. I’m one of the “lefties” who supports tort reform and eliminating unnecessary and absurd insurance policy mandates. But, at the same time, I do have a few quibbles here.
     First, like many conservatives, my friend seems to have taken it on faith that the controversial insurance mandates he mentions are widespread and indeed largely responsible for making health insurance unaffordable. I have to hand it to conservatives. They certainly seem to have gotten “on message” in blaming liberal government mandates for our economic woes.
      Other conservative friends of ours, for instance, fervently believe that the main reason for the mortgage meltdown was a government mandate requiring lenders to give mortgages to insolvent and irresponsible minorities. To the contrary, I have to believe that young Americans of all races, colors, and creeds felt entitled to houses they really couldn’t afford and were willing to gamble on ever-increasing housing values. And there was no shortage of unscrupulous private-sector lenders eager to capitalize on this housing bubble before it burst. Similarly, I have a hard time believing that the poor insurance companies have been victimized by liberal government mandates.
     Second, while I do believe that malpractice suits have driven up our health insurance costs, private-sector lawyers are largely responsible for that, not the government. And I dare say that if a surgeon mistakenly amputates your good leg instead of the gangrenous one, you will see the tort reform issue from a different point of view.
     Third, behind every argument against Obama’s public option, I can hear echoes of Reagan’s famous maxim: “Government is not the solution to our problems; government is the problem.” That maxim is more rhetorical than meaningful. Granted, the military I served in was rife with waste and malfeasance. But only the most rabid of conservative ideologues would ever consider entrusting our national defense entirely to private security firms like Black Water. (At least, I hope that’s the case.) The answer is not to give up on government; it is to insist on better oversight and accountability of government functions and officials. There are some functions that only government can muster the resources to accomplish, and providing health care for all its citizens is one of them.
     Finally, if we did give completely free reign to the insurance marketplace, would competition really bring health care costs down? Private companies exist, first and foremost, to make a profit. Meeting our needs comes second—if at all. Capitalism is Darwinian by nature, and only government can temper that impulse. --EFP