This is the day when, as they say, you won't be able to swing a cat without hitting an argument over whether or not Hillary Clinton or Barack Obama has the better plan for health care reform. However, I cast my vote almost as soon as my polling station opened; and my cat is now comfortably asleep in a patch of sunlight. So I would now like to go on record as saying that the discussion I found most enlightening was a Huffington Post blog post by Raymond Leon Roker, who describes himself and his situation in the following sentences:
As an independent magazine publisher and owner that both employs and targets mostly 20-somethings, my perspective on the health care debate is specifically informed by the proximity to these Gen-Y citizens. Our company subsidizes employee healthcare and has done so for a decade or more now. But the recent debate between Obama and Clinton -- specifically the Obama stance that mandatory coverage is not needed -- really fails to meet reality head on.
The reason I enjoyed reading Roker's post had to do with the way in which he used these sentences as a point of departure to lay out that sense of reality (if I may impose one of my favorite phrases on his text) that both Clinton and Obama were ignoring:
Over the years, I can count dozens of 20-something friends, employers and acquaintances that routinely skip out on insurance. Seen as a remote need and a mundane life expense, these healthy young individuals would rather fund something else in their lifestyle and who'd blame them? Who really thinks they're going to end up in a hospital at 25? Even the employees I insure -- especially the guys -- seem to rarely even visit the hospital for check-ups or preventative care. And many -- easily a relevant portion of the millions of uninsured -- feel that the risk of getting caught without insurance in an emergency room is worth the several hundred dollar per month in savings. You don't have to look any further than to the millions of un- and under-insured motorists on the roads. It's obviously partly an issue of costs, but one can't deny the simple issue of personal risk management. The only problem is that this ends up costing everybody else when the proverbial chickens come home to roost and something goes wrong. You and I pick up the tab in the form of taxes and medical costs.
As I see it the crux of this paragraph is the most important economic proposition that, in the long run, health maintenance costs less per capita than medical treatment. In other words it costs less to finance regular check-ups that can lead either to preventing certain maladies or to catching them in earlier stages when treatment is likely to cost less. I am not sure if there is a hard-and-fast argument to confirm this proposition; but my own life style has accepted it as true for as long as I have been on my own. I would say that early detection of my prostate cancer was sufficient to justify it.
I suspect that one reason why debates will not speak in these terms is that the very concept of "health maintenance" has now been fouled up beyond all recognition by the HMO businesses. I am not suggesting that this is the reason why those "20-something friends" are so negligent of their health care; but I would suggest that a national culture that has suppressed the "true semantics of health maintenance" at least contributes to the problem. Needless to say, a reformed health care system that mandated regular physical check-ups would face a lot of attack on grounds of being too paternalistic; but a more integrated system would at least have the leverage to experiment with incentive programs.
All this is a long-winded way of saying that, without a clear "vision statement of a healthy society," arguments over who pays how much for what are not going to signify very much in the long run; but, since those arguments (rather than the welfare of the electorate) are the bread-and-butter of politics, I know better than to expect politicians to get beyond them.
No comments:
Post a Comment