In one sentence: people today overwhelmingly believe that they enjoy a "right" to life when in fact no such right exists. What do I mean by this? How can an aspiring medical doctor say such cold and heartless words? Before you judge me, allow me to define some terminology and establish my platform clearly. Then you can truly judge what I say and decide for yourself if my beliefs are intelligent or idiotic.
If you wish to, skip ahead to the next orange word. All of this is a preface establishing what I mean by "rights" and has nothing expressly to do with healthcare.
In common parlance, when one uses the word "right," he means "an inviolate, immutable property of one's very being." However, when one asks another person to list off some familiar examples of God-given rights, we quickly see that what people today think the word "right" means does not match up with what they're actually talking about:
- people have the right to breathable air
- people have the right to potable water
- people have the right to be free
- people have the right to defend themselves
The speakers' intention is to suggest that people have the right to live; that no individual or organization should be allowed to purposely end his or her life. But what they've just said and what they meant are two very different things. Let me show you:
- many of these same people agree that people should have the right to smoke, despite others' "right" to breathable air (what the heck is "breathable air" anyway? air that's pristine? air that lets live to be 100? air that lets you live to be 50 as well as mentally impaired from your potential self, such that you can no longer be a rocket scientist but you can still manage as a pre-modern farmer, tilling fields and milking cows?)
- many of these same people agree that potable water isn't good enough and that they are owed Brita/Pur-filtered water instead of Lafayette city water
- many of these people support incarceration and/or medically-warranted restraint
- people disagree on what it means to "take the measures necessary to defend one's self." This is why every so often you hear about a man on the local news who police discovered had anti-aircraft artillery hidden under a tarp in his backyard and over 1000 sticks of TNT in his basement. It's the same reason why we have people who argue over the 2nd Amendment, and why some people even say that because life is inviolate, you do not have the right to end someone else's even if it means that you and people you care about will die (i.e. "let them be the sinner and let God decide their fate").
So, having established this hypocrisy (at worst) or semantic confusion (at best), let us move on. The idea of a "right" (in the contemporary sense of the word) is bogus, desired by man, and made up by man to in order secure his quality of life. When people speak of "rights," what they really intend to speak of is "mutually agreed-upon compromises" or "mutually agreed-upon privileges." Examples:
- "I don't want to die. You don't want to die. Let's forge a social contract together. Let's agree that in our society, we forfeit the right [sic] to kill others in order to secure the right [sic] to live."
- "I don't want to be raped. You don't want to be raped. Let's forge a social contract together. Let's agree that in our society, we forfeit the right [sic] to rape others in order to secure the right [sic] to not be raped ourselves."
On and on the examples can go. Now you may say, "Ryan!? I thought you abhorred things like murder or rape!" I do. I absolutely do. But what I am trying to get across here is, these "rights" are made up. They don't really exist. And if you want proof of that, you need only look outside of mankind's society. Examples:
- tornados don't respect our "right" to live!
- plagues don't respect our "right" to live!
- lightning strikes don't respect our "right" to live!
- subzero temperatures don't respect our right" to live!
- asteroids colliding with the planet don't respect our "right" to live!
Et cetera, et cetera. Aconscious entities have the power to kill us, and do kill us, without having any intention to kill or to not kill. They simply are, and they simply do. Aconsciously. Amorally. The idea of a "right to live" is a moral construct invented by one of the few entities in existence capable of moral reasoning: Man.
To clarify, does that cheapen it? Not necessarily, and not in my personal view, no. I respect Man's concept of a social contract. I respect that he has the intelligence and the moral reasoning which he can couple to his primitive impulse to live at all costs. I respect that he can say, "In order to live forever, I have to avoid being stabbed, avoid being poisoned, avoid being killed for food, etc. In order to live happily, I have to avoid becoming a slave, becoming incarcerated, becoming maimed or mutilated, etc. So I will forfeit my right to do these things to others if it means securing my own person from these evils." It places man above the "dog eat dog" world in which he exists. But what I am saying is, despite all of this mental magic, we still are ruled by the laws [of Nature] of a dog-eat-dog world whether we wish to be or not.
So! Having said all of this, we can finally move on to the main point I wish to make. Which is simply this:
The amoral world says "To hell with your notions of moral justice!" when there's not enough money in the pot to go around. In other words, health care is allegedly "in the toilet" today because of health insurance this or Medicaid that, but the reality is the most inconvenient truth of the last 100 years (sorry, Al), and that is it costs more money to keep people alive than there is money available. Per individual, this true: the average person has only $0 to $2000 of spare income each year but the cost for anti-cancer or anti-stroke or anti-heart attack anything can range from $10,000 to millions of dollars. Per society, this is also true: there are more claimants in the system than the system can handle. To clarify:
The idea behind health insurance was fairly simple: persons 1-9 would pay for insurance but not end up needing the money anyway (i.e. they remained healthy and effectively flushed their own cash down the toilet) but person 10 would become sick, require more money than he could normally manage to secure, and at the same time would require less money than persons 1-10 had put into the pot. That is to say, persons 1-10 together would fund person 10's health care needs, and any extra money was profit for the insurance company for arranging this scheme.
But there are two serious problems in the real world:
1. More people claim health insurance than the system can compensate for. (e.g. it's not just person 10, but let's say persons 3-10 who claimed health insurance needs last year)
2. Each one of those people (increasingly, as time goes on) are filing claims which are ridiculously expensive.
To put some made-up numbers to the faces, let's say this is the case.
IN THEORY: Persons 1-10 each pay $500/mo. By the end of the year, only Person 10 has filed a claim; and it was only in the amount of $30,000. This is much more than he could have afforded to pay out of pocket (500 x 12 = 6000) but is only half of the total pool (30,000 claimed vs. 60,000 available)
IN REALITY: Persons 1-10 pay $500/mo. By the end of the year, Person 3 has filed a claim for $20,000; Person 4 has filed for $50,000; Person 5 has filed for $2.1 million; Person 6 has filed for $74,000; Person 7, 8, 9, and 10 similarly have filed for large sums of money.
Are they lying? No: their medical bills really cost that much.
Is the health care industry overcharging? No: it really costs that much with today's technology and scientific know-how to make the drugs and train the people, etc etc, who made curing these patients possible. For example, an MRI machine costs millions of dollars to purchase; and it costs several thousand dollars to operate (i.e. each individual scan costs that much! If you get 10 MRIs, you're looking at tens of thousands of dollars of debt!); so the hospital has to charge you in order to *a) cover usage fees and (b) cover maintenance fees (which in this day and age is the same thing as buying a brand-new machine when the old one dies).
Let me give you some non-medical comparisons ...
- What if we had such a thing as book insurance? And what if I filed a claim for $10,000 to purchase $10,000 worth of books? And what if other clients did, too, and it swamped my insurer? If he tried to say "You can't all do this," it'd raise hell. (Though not as bad as when a health insurer tells patients that they have to accept death!) Might society point a finger at the publishers and authors and claim that they're overcharging, and that $5 books should only cost $0.0005 instead? Sure, we could try: but we'd be lying. We know that paper costs X much, ink costs X much, the author has to be paid, the publishing staff paid, their machines maintained, the shippers and their trucks have to be covered too, the bookstore staff has to be paid, their store maintenance fees have to be paid, etc etc etc. BOOKS COST MONEY!
- Same thing for video games.
- Same thing for food.
- Same thing for any improvement which requires limited human time and limited natural resources to produce.
Not everybody can have a Wii, a PS3, and an XBox 360. Most Americans can't afford more than one; and most people on the planet can't afford any of them! And yet while nobody cries foul about the market being cruel to deny people their "right to game without any limitations," people raise a fuss when it comes to health care because this is the literal fight over life or death, a fight people (duh) do and should take very seriously. People seem to think they enjoy a "right" to be cured of colon cancer *AND* receive a heart transplant *AND* have their million-dollar brain cancer chemotherapy bills covered, etc. They selfishly refuse to acknowledge the painful and obvious truth: there aren't enough organs to go around, there isn't enough money to go around, and the cost of keeping somebody alive forever is astronomical. At some point, you have to pull the plug. At some point, you can no longer say "We will do everything we can to keep this person alive; only a death which we cannot scientifically defeat will be the thing that claims this person's life." You cannot ethically do that if it means spending $1.3 billion dollars to keep a 3-year old alive who was born with a messed-up heart, one shoddy kidney, a rare neonatal leukemia, and somehow-contracted hepatitis C. You just can't do it: not when that 1.3 billion dollars could have been spent to keep hundreds, even thousands of other people alive. The sad thing is, at some point, you *do* have to put a price on a human life. AT SOME POINT, YOU DO HAVE TO DECIDE WHETHER YOU'RE GOING TO CONDEMN PERSON A OR ELSE CONDEMN PERSON B TO DEATH. The idea that choosing to save the maimed infant is not the same thing as choosing to sentence the hundred other people to death is nothing but embarrassing and classic denial.
3 comments:
I certainly appreciate the commentary on rights, though it's a bit of a tangent; nobody with any real-life experience can deny that Nature's red in tooth and claw. I'm not sure how you thus derive that "rights don't exist" -- what does that phrase even mean? But that's really another tangent, let's stick to the pragmatic aspects of the health insurance system.
You say: More people claim health insurance than the system can compensate for.
I don't see any reason to believe that the insurance companies are as hapless as you would say they are. They have plenty of statistics to tell them what expected claims will be, and they adjust premiums accordingly so that they make a profit. If it were otherwise, there wouldn't be any health insurance companies.
You say: Each one of those people (increasingly, as time goes on) are filing claims which are ridiculously expensive.
This is an excellent point, but you should recognize the root cause of this problem, which as I understand it is at least as much due to the cost of malpractice insurance as it is the high cost of modern technology.
I think the bottom line, though, is that we're all better off when we bargain as a group, which is the big benefit of having insurance through an employer. Last year, before I got married and Colleen got a job, I was paying Assurant $150 per month just to cover only myself for ER visits (in case I got hit by a truck or something, forget routine doctor visits, prescriptions etc.). Now I and my wife pay $200 per month to cover us both for anything from Dentists and Dermatologists to ER visits, prescriptions, etc. So we're paying less per person for astronomically better benefits -- available simply because Colleen's employer can bargain with the insurance companies by providing them with hundreds of thousands of customers! And the insurance company is not doing this out of generosity or fear, but simply because they have a guarantee of a steady and large stream of income. I'd say it comes cheaper because the employer pays part of the bill, but in reality that's probably just deducted from what the employees would have been paid anyway, though I'm not certain.
That's why the Time article makes a great point, and why Obama's plan to force employers to offer health insurance would be a huge benefit for people who need it most. We don't have to cease being hard-headed pragmatists to extend the benefits middle-class people enjoy to the poor!
1. In 2007, there were approximately 301,621,000 Americans.
2. In 2007, there were 776,860 new cases of cancer (all types) for American males. This equals about 2.5 American men who find out they have cancer each year out of every 1000.
3. In 2007, there were 678,060 new cases of cancer (all types) for American women. This equals about 2.2 American women who find out they have cancer out of every 1000.
4. 45% of American males will develop at least one cancer in their lifetime.
5. 37% of American females will develop at least one cancer in their lifetime.
This is cancer alone. I looked up and found the statistics for other diseases such as diabetes, heart disease, obesity, renal failure, stroke, etc. And *these* alone are all problems of one's body falling apart, never mind the host of exogenous factors -- from bacteria and viruses to gunshot wounds and house fires -- which injure or kill people every year.
While the dead do not tax the health care system significantly, it is cruelly that we are able to report such a low mortality rate in this country compared (a) with other countries and (b) with other eras in history that our nation's health care system finds itself on the brink of collapse.
I want you to imagine if you will the cost of the following tests and procedures:
- 2 MRIs of a critical organ showing impaired function
- miscellaneous blood work-ups
- invasive surgery into a critical organ to remove a malignant tumor
- chemotherapy (@ an arbitrary-but-realistic regimen of your choosing) for a duration of 1 calendar year
These costs are high. For example, the MRI scans alone will cost tens of thousands of dollars. But there are other costs, too, that are not of the health insurance company's or the hospital's making. These are just some of the hidden costs to a diagnosis of cancer (or similar life-threatening diseases):
- if you work, your doctors and/or employer may force you to take medical leave. Depending on your situation, you may not be able to collect the full amount of money you did as a salaried full-time employee. Also, your employer may even eventually be forced to let you go. Fighting that in court would cost more money that you don't currently have.
- if you are physically impaired as a result of your disease, your therapy, or both, you may have to make costly renovations to your existing home in order to accomodate the new you; or you may need to move out of your existing home into a new home which (a) may be beyond your means to pay off or (b) may be a poor deal that you are forced to accept because you have no better alternative.
- if your medical condition does not qualify you for an insurance-paid hospital stay but does require bedside care, you may have to either (a) hire a private nurse or (b) have your spouse and children take care of you. Neither option is without its financial and emotional costs.
- your medical condition may generate stress in family members which in turn may require counseling or medication, adding to the costs
And I could go on and on and on. The point is, a disease does not end with the diagnosis or the hospital testing. Years after a patient is released from the hospital, their disease may still be costing them thousands, perhaps tens of thousands of dollars annually in medications, lost wages, etc.
Without getting into the Blame Game (i.e. it's the insurance companies' fault vs. it's the HMO's vs. it's the doctors vs. it's the pharmaceutical companies and the med-tech companies), the only point I'm trying to establish here is that with so many deadly diseases to choose from, with so few cost-effective cures, with so many people demanding to be cured, and with so little money to go around, SOMETHING'S GOTTA GIVE. You can't save all of the people all of the time: and yet that is the exact opposite of what the average American thinks when it comes to himself and his own family. Everyone is quick to write off other people and condemn them to die but nobody's willing to accept that maybe their own loved one is the one selected to perish. Everyone is eager to blame the system, looking for imaginary cracks that they can point to and claim that their loved ones fell through -- or sometimes were pushed into the evil money-hungry doctors and lawyers and politicians who couldn't give a damn about what they swore an oath to do in the first place. So quickly do people abandon their faith in the health care system the moment it fails them, despite the fact that our health care system is the most successful (with emotionless statistical data as proof of this) in the known history of the human race.
When I say ours is the most successful, I am not trying to get into a health insurance debate with people over Sweden or France or the Netherlands vs. the United States. Michael Moore did that for us already. I'm simply saying that:
(a) we are definitely one of the best to this day, but more importantly
(b) we are *the* #1 nation to have come up with all of this world-class life-saving medicine and technology
(c) 3rd world citizens still point to America as the ultimate health care haven despite (allegedly) superior health care systems elsewhere. This cannot be a case of global misunderstanding. It is likely more reflective of the fact that other nations do not welcome morbid foreigners as readily into their fold as we do, i.e. other nations may be less inclined to grant full citizenship to an old lady from Morocco who has lung cancer and diabetes.
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