The Health Care Question at the Republican Candidate Debate

This has been bothering me ever since that debate, complete with all the left wing crap about conservatives cheering for a death. They weren't cheering for a death; they were cheering because someone running for public office wasn't giving an emotional knee-jerk response and managed to actually - and correctly in my opinion - consider the counterarguments.

Let us consider the question as asked. It posited a young healthy man who could have afforded health care - could *EASILY* have afforded health care as he was young, disease free, and had a good paying job. He makes makes a decision not to purchase insurance, and some such young men do every year, loses the bet he is effectively making by getting into an accident that puts him into a hospital in a coma.

Where does the money to treat him come from? Increased cost to the provider. But who really pays those costs? Why, the other customers of that provider, of course. This means they get less health coverage than their dollars would otherwise buy, or it costs them more. For some of them, it makes the difference between a bill they can pay and one they cannot. So paying that young man's medical bill means that these people cannot afford health coverage. Guess what happens? Some of them - a larger number this time - need care and cannot pay for it. We get another entire round of this whole circle. And another. At some point people start asking why they should pay at all, as they can "free ride" off other people's coverage. Soon, nobody is paying for it, and immediately after that, there is none. Doctors can't get paid, there is no money for the machines, no money for the hospitals, no NOTHING in the way of health care. Maybe there's a few charities providing small services somewhere, kind of like Doctors Without Borders, but there is NOT the entire edifice of aggressive, comprehensive health care like we have come to expect in the last several decades.

You think I'm making a mountain out of a molehill? I am not. This is elementary behavioral psychology and basic economics. Them's the facts. It takes time to get to the conclusion, but we're not starting from zero and it's a compound interest expansion. Furthermore, the farther down this road we travel the harder it is to reverse, and from the point we reverse it, it is at least as hard to get back to this point as it was to get here in the first place.

Make it a government program, and it gets worse faster because government employees have no sensitivity to cost or efficient care or anything along those lines, plus you have government paid people imposing nonsense rules on everyone involved - providers, consumers, and all points in the supply chain on the basis of all the minor abuses that have ever been found in the system, whether or not that abuse applies to the situation at hand. All of those rules have their own costs, which in turn means that the resources to treat even more people are wasted on bureaucracy, and fraud prevention, and investigation into the merits of every claim, which delays treatment and allows the condition to fester (assuming its not one that would get better on its own, in which case I ask does the person really need health care?)

There are alternatives. Family friends and charity could decide to pay the cost of the young man's care. It was stipulated in the question that the young man was in a coma, but if not unconscious he could use that income he has been earning to persuade someone to give him a loan that would pay for the care.

But the question was "what should the government do?" and once you have examined all the costs of the two alternatives, my emotional value driven judgment says that the course of action with the lowest cost in terms of preventable deaths, treatable lesser conditions becoming prohibitive, and general availability of healthcare to the population at large is likely - in fact almost certainly - for the government to do NOTHING in that situation. It's not a popular solution. That young man has those friends and family members all crying about what a tragedy this would be, while the victims are at this point unknown and nameless. But they're not any less real for all of that, and refusal to face precisely these facts is one of the factors driving up the cost of health care and therefore insurance to those who want to pay it.

By all means let us have this debate. But let's drag the actuaries into it so that we're all aware of all the costs - the real costs - and make our choices based upon that, while both sides are equally abstract and we can choose a compromise that everyone can live with. Because the choice given is a rotten one at the point you have a specific face to put with the course of action that actually costs more lives and more misery, and no comparable faces to put on the other side. Like say, a hundred 7 year old girls who don't get their medicines or who don't get quite enough medicine because the money that was used to pay for this clown's intensive care mean there's no resources left for them.

In short, the question itself was either so viciously dishonest and one-sided as to evidence a political partisan trying to score cheap points, or so deliberately ignorant of the real choices we face in health care as to evidence that they should not be allowed input into the issue.