Putting Healthcare Back into Consumer’s Hands

The Right pushes the idea that under a government controlled plan, bureaucrats control an individual’s health (“death panels”) in that they make decisions as to which doctor one can see, tests one can have and medications one can take whereas under an insurance plan purchased on the free market, you make these decisions. First let me say that people working for insurance companies in the private sector are as much bureaucrats as those working in government except that the organizations they serve are motivated by profits instead of public good. In reality however, insurance company staff also decides what doctors one can see, what tests one can have and what medications one can take. So the illusion that in a private healthcare insurance plan you can decide these things is just that, an illusion. Now of coarse one can pay out of their own pocket and in either case make these decisions themselves. What putting healthcare “back in the consumer’s hands” is really meant to do is put the responsibility for making cost/benefit decisions regarding their health into the hands of consumers, some of these decisions resulting in life or death. To make any cost/benefit analysis one does not only need to understand the implications of cost, which most consumers do, but also the other element in the decision, which they don’t. What the Right is asking an average person is to decide whether the results on their health of a procedure are worth their cost? To make this analysis properly one needs to also understand medicine and for most things a casual google search is totally inadequate. Even general practitioners, doctors themselves, rely on specialists. If a cost/benefit analyses are done improperly, the action taken will not only result in less benefit but also higher cost. The more affluent among us of coarse will avail themselves of the best health plan and not face the necessity of making this analysis while the middle and lower class will. And even if they do, cost will have a very low priority. (Hopefully the very poor will still be covered by some government subsidized plan and avoid making the analysis.) As a result, the “one percent” will not only be able to buy more stuff but be healthier while they do it. A healthy nation, like a well-educated nation, is necessary for a country to prosper and compete in this global economy. Better healthcare is not only good for the majority of those benefiting from it directly but is also good for the “one percent”. Healthy people can be more productive, increasing the bottom line of a company. Most of the increase in profit going to the wealthiest (Unfortunately the gain does not trickle down). Healthier people will have more income which they can spend to buy more widgets, also increasing the bottom line. Finally, if we are ever in a major war, a healthy army will outperform a sickly one. The answer is not to put decisions relative to healthcare in the hands of the consumer but to put in place a system that will ensure that the entire population is healthy and strong and able to contribute to our society.

Who are your Other?

We all see ourselves as members of different groups, or tribes as I would like to call them, with a wide range of importance placed on the memberships. We can be a member of a family with family being only immediate family or our tribe can be an extended family. Our membership in a very local community can be a source of pride or in some cases a state (Texans take great pride in being from Texas) and of course a country (“Deutschland, Deutschland uber ales”, the Nazi’s slogan meaning Germany above all else or in our case, America First). We may be members of a religious group, be it Jewish, Christian, Muslim, Hindu, Buddhist or a subset of these, Haredi, Protestant, Sunni, Jane, Mahayana or even small such as Baptist, Wahhabi, or local like Temple Emanuel, Mother Emanuel Church, Westboro Baptist, Sudbury Mosque, etc. We can see ourselves as members of broad geographic area; European, North American, Middle Eastern, African, Asian, or more locally; Northern European, Arab, Southeast Asian or finer; Irish, Russian, Moroccan, Israeli, Vietnamese. Ethnically, we can think of ourselves as Basque, Sicilian, Kurds, Tutsi, Tatar, Yakut; go even more granular; Iraqi Curds or Turkish Curds, Lipka Tatars or Crimean Tatars. We can group ourselves by Race; White, Black, Asian, or by language; Hispanic, Slavic, English, Arabic (I’m starting to run out of steam but you get the picture). Then of course we can think of ourselves most broadly as Humans or even as a part of the Earth or Universe which is how many of the indigenous peoples think of themselves. Between these various groups there are some long standing animosities ranging in degree from disrespect to murder. There has been friction between religious groups throughout history. The State of Pakistan resulted from the Muslim/Hindu turmoil in India. Conflict can exist even within religious groups. There is the Protestant/Catholic issue which has abated somewhat in recent years and the Sunni/Shiite conflict has become more bloody with the growing unrest in the Middle East. Throughout history there have always been bloody wars between nation states and conflicts in ideology as those between Capitalism and Communism lasted for almost a century and resulted in, among others, the Vietnam and Korean Wars and revolutions in Russia, China, Spain and Cuba. Ethnic differences were at the bottom of the most horrific acts; the millions of Jews were murdered by the Germans, many Armenians lost lives at the hands of the Turks and 800,000 Tutsis were slaughtered by the Hutu in Rwanda. On a smaller scale ethnic cleansing of Croats at the hands of Serbs in Croatia or Arabs at the Hands of Jews in Palestine caused many to lose their lives and even more to be displaced. There are even wars between families not to mention within them. In the latter part of the nineteenth century in the Ozark Mountains of West Virginia, two families, the Hatfield and McCoy, feuded for almost thirty years resulting in the death of about 15 individuals. So what is your tribe? The answer to that in part determines who you consider “the other” and your importance of the position in the tribe, the altruism or hatred toward your fellow man. Our Vice President Pence on numerous occasions describes himself as Christian, Republican and conservative and emphasized “in that order”. I found it interesting and disturbing (not being a Christian) that he didn’t mention American, given he is the VP of the United States of America or human being, given he is the de facto vice president of the World. Seeing that his prime tribe is Christians, then most likely his “other” might be non-Christians and governing according to the laws of the New Testament might be an imperative for him. I have been fortunate (or in some cases unfortunate) enough to have lived or visited more than 20 countries. I have had the opportunity not only to mix with people of different cultures, religions, races and ethnicities, but socio-economic positions from people who literally “didn’t have a pot to pee in” to people on the Forbes richest 800 list. All of this has led me to the conclusion that even with our many differences; we are much more alike than different. So what is my tribe? First by far, I think of myself as a human being (though as I am aging I am starting to think of myself as part of the earth and leaning even toward a part of the Universe), second an American and a very low third a Tatar. When asked on various forms to list my ethnicity or race, I don’t answer. I met a friend of a friend and after chatting for a while he said “oh, you’re a globalist” to which I confessed. The lives of my family members are important to as those of my countrymen but so are the lives of people in Rwanda and Nicaragua. So what are your tribes and what is the priority of your membership in them and how important are each? This will determine your “other”. Are you afraid or envious of them; or maybe just impartial to them. Do lives of those outside your tribe matter? How much? Though we are having a bit of a setback at the moment, hopefully our tribes continue to expand to include more and more people and our loyalties to tribes diminishes. Who are your Other?