Monday, February 13, 2012

Republican party and public health care

I'm going to take a small break from cycling to vent a bit...

The Republican campaign for president continues... but I have no interest. I gave up on the Republican party long ago.

Actually, I'm a Republican wanna-be. I want to vote for a party which is fiscally responsible, which balances its budget, which limits its federal involvement to things which the federal government is uniquely qualified to do like interstate commerce and international relations. I agree states should be granted broad freedom in their ability to decide on local matters, that competition between states is good, and that free market principles should be harnassed whenever externalities don't dominate. I have a strong appreciation of the tragedy of the commons. Further, I am a champion of individual freedom: I agree we should be able to express ourselves freely, travel freely, choose if and how we practice religion freely, and have input over the policies and actions of our government. These should be positions embraced by the Republican party.

But the Republican party really has little to do with these matters. Instead, it's just another face of the same old machine where money buys influence, influence used to drive the short-term profits of the few, virtually ignoring the long-term health of the nation. The fact the Republican Party wraps itself in the cloak of Christianity is the ultimate in hypocracy. This alone is sufficient reason to reject it.

This is nowhere more obvious than it is in the rhetoric on the public health debate. "Nobody should be required to pay for someone else's health care," I read over and over again. These people seem to have no issue with "public fire protection", or "public police protection", or "public military protection", or a "public road system", or in most cases even "public education system". But for some reason if I'm hit by a car and am bleeding to death on the street, my ability to pay is supposed to be assessed before I can be administered aid. Or if I'm stricken with a heart attack I'm supposed to be provide proof of insurance before my heartbeat is restored. It's all part of the inherent efficiencies of the free market.

Or perhaps this isn't their position. After all, it was Ronald Reagan who signed into law the Emergency Medical Treatment and Active Labor Act which requires emergency rooms on private and public hospitals to provide emergency care to people without regard for ability to pay. That care, of course, is passed on to those who are able to pay. This is socialized medicine in its purest form. In comparison, "ObamaCare" is it a laughable imitation.

So given this, that hospitals must care for those who can't pay for the service, there is immediately a direct public financial interest in helping people stay healthy, since emergency care is outrageously expensive (this is another matter, another problem; it's not obvious this needs be the case). This is in addition to the "well functioning society requires a healthy population" argument... an unhealthy population, like an uneducated one, is simply unable to provide for a competitive nation, any more than an unhealthy sports team is going to compete.

So what's the Bible say on the matter? The bible, many Republican supporters argue, is an important document for national policy. Well, it takes only a brief Google search to turn up the following verses from Luke 16:

19 “There was a rich man who was dressed in purple and fine linen and lived in luxury every day. 20 At his gate was laid a beggar named Lazarus, covered with sores 21 and longing to eat what fell from the rich man’s table. Even the dogs came and licked his sores.

22 “The time came when the beggar died and the angels carried him to Abraham’s side. The rich man also died and was buried. 23 In Hades, where he was in torment, he looked up and saw Abraham far away, with Lazarus by his side. 24 So he called to him, ‘Father Abraham, have pity on me and send Lazarus to dip the tip of his finger in water and cool my tongue, because I am in agony in this fire.’

Seems pretty socialized to me: everyone has the responsibility to contribute to the needs of the sick, or else they will burn in Hades. It makes me question which Republican candidate Jesus would support....

Not that he'd support Obama, either, a president who has continued a needless state of war, perpetuated our destructive squandering of a precious resource (oil), and overseen a budget which is condemning future generations to supporting a crippling debt load so we can live an unsustainable lifestyle.

It's easy to despair.

added: As I write this, NPR is doing a story on the success of the Massachussetts health care law, which was supported for and signed by then-governor Romney. Rick Santorum has sharply criticized Romney for this. However, this doesn't stop Romney from prominently featuring "repeal Obamacare!" on his policy page.


ammon said...

On this silliness, there's a picture caption on the nyt article below that reads like it came from the onion: "“I don't demand that the government does this for me. I don't feel like I need the government,” said KI GULBRANSON, who counts on an earned-income tax credit and has signed up his children for free meals at school."

Robert said...

You wrote about EMTALA: "So given this, that hospitals must care for those who can't pay for the service..."

That's not exactly correct. EMTALA requires that (almost all) hospitals must provide emergency care to patients whose conditions are unstable or who cannot be safely transported to another facility without regard to ability to pay. That means if a husband and wife are in a car accident in front of a hospital and the husband has a broken arm while the wife is unconscious and is bleeding from a head wound, the hospital must care for the wife until she is stabilized and safe to transport but the husband can be denied care and sent in a taxi to another facility. Once the wife is stabilized she can be discharged and presented with a $40,000 bill. Once again, the provision of emergency care is not dependent on the ability to pay -- but that doesn't mean they can't be presented with a bill after the care has been provided.

djconnel said...


I really like your example. The problem with treating health care as a free market is for a free market to work, both parties in a transaction must be competent to negotiate, and additionally aware of the value of the proposed transaction. In the case of that $40k bill, there was no opportunity for negotiation, no awareness of the value of what is to be transacted: the victim is unconscious or, in another case, maybe even dead.

Free market health care works when I'm considering whether I should take blood pressure medicine or perhaps improve my diet. In this case, if the blood pressure medicine is subsidized but eating healthier is not, that fails to provide the proper incentive. But in many cases the free market model simply doesn't work.