Tuesday, July 28, 2009

Who's Afraid of the Big, Bad Government?

Since this will probably be my last post for a week or so, I thought it ought to focus on an important and timely topic. Like the national health care debate, and what it says about our love-hate relationship with government.

I'm sorry, did I say debate? What I meant to say was meaningless shouted accusation and innuendo fueled by questionable statistics and political buffoonery.

Few problems are more important, and few are less likely to be satisfactorily resolved any time soon. As with many other thorny issues, there is an element of truth and sincerity on the part of every side to the argument...but the elements of truth are so deeply buried under hurled accusations and countercharges that the average person can't begin to understand what the options are, much less evaluate which one is the best.

One of the most amazing aspects of this debate is what it says about our views of and relationship to our government. As soon as any mention is made of a health-care option that involves any degree of government involvement, the airwaves and print media are filled with ads that thunder about how the world will end and we will all die horrible, lingering deaths if that inept government sinks its twisted claws into our medical care. Announcers, their voices dripping with scorn, warn us of the unspeakable danger of unelected government bureaucrats making decisions on our health care.

Hello... hello... can we take a moment and cash a reality check here?

You may not have noticed it, but unelected bureaucrats are already calling the shots on what sort of care you receive. The only difference is that they don't work for the government (which we elect), they work for insurance companies and the health management industry (which we don't).

The American tradition of mistrust of government is rooted deep in our national psyche. It began with rebellion against the arbitrary authority of a distant king, and continues to this day. We don't trust government writ large, and still less the fallible individuals who compose the leadership of that government. I'm no different in my scorn for individual lawmakers than anyone else.

But is the government really as bad as we think?

Take a minute and read this article by Julian Zelizer, a professor of history and public affairs at Princeton University's Woodrow Wilson School. In it, Professor Zelizer looks at the history of the Medicare program as an example of how the government can create a successful and beneficial program. Whether you agree with his analysis or not, it's useful to read something that takes a bit less hysterical approach than most of the drivel you read or hear nowadays.

In a perfect world, when we needed medical treatment we would walk down our tree-lined streets to the clapboard home of the local doctor behind its whitewashed picket fence. We'd go in and a kindly, avuncular Marcus Welby would carefully examine us, prescribe necessary medicines that would be filled for free by the local pharmacist, and never mention payment for his services. But the world ain't perfect. Marcus Welby owes his medical school hundreds of thousands of dollars for his education...and wants to make a decent living, and the drugs he prescribes are developed by companies that spend billions of dollars on research and development, testing, and lawsuits...and want to make a profit.

One way or another, decisions on our health care are going to be made not just by kindly doctors, but by people hunched over ledgers and computer screens in hidden offices. We just need to decide whether those people - those bureaucrats - work for the government over which we have some measure of control, or for an insurance company focused on profits, which we don't.

Let's stop shouting and start thinking and discussing.

Have a good day. More thoughts later.



Debbie said...

The USA has the best health care in the world, I see no reason to change that. What has driven up the costs is attorneys! You mentioned pharmaceuticals, but also the hosptials and clinics, their doctors,nurses,and even their clerical staffs are subject to major lawsuits, thus have high insurance premiums to cover them for not only malpractice, but for confidentiality issues. Every state has an Insurance Commissioner to keep insurance companies in line, making sure their premiums reflect the risks they are assuming. What our government should be doing is finding ways to limit liabilities in malpractice and frivilous lawsuits to bring the costs down, not creating more beauracracy to drive costs up.

Anonymous said...

The difference is, Bilbo, is that we can opt out of an insurance company we don't like, change our doctor, go to a different commercial pharmacy, and be sure that each entity is trying to entice us in their door with cheaper and better service.

You ever hear of a government that does that? Dr. Buchanan at George Mason University, right down the street from your house, got his Nobel Prize by proving all bureaucrats make their decisions on one criteria: What's in it for them!

You wanna get your health care from that guy? Especially if as a result yo mama dies and he don't have to budget for her anymore.

Eminence Grise

Mike said...

My family has been the victim of the insurance industries 'preexisting condition' exclusion several times. My daughter was also terminated from a job becuse she used her healthcare. It's time to get the capitalists out of the healthcare field. We need national health insurance NOW.

And by the way, the state insurance boards are run by the insurance industry.

Leslie David said...

As long as healthcare is a business the consumer is going to get screwed in the name of profits. We were both in the military. We (and your family members) experienced single-payer healthcare.

Bob said...


Stop with the objective sense-making, Bilbo. You will be run out of DC on a rail.

Twinkie said...

Mike, my previous employer offered that type of insurance. Low rates, unless heaven forbid.. somebody got sick. Then ALL our premiums went up. You almost resented the person that got cancer. Because of THEM now I can't afford my insurance premium. Sad. And Pathetic. And YES reform is necessary.