Would you be willing to buy a comprehensive Auto Care Insurance policy?
It would cover the obvious things we buy insurance for, like an accident, flood, falling trees...or any other form of catastrophic occurrence.
It would also bundle oil changes,transmission service, diagnostic check ups, tire repair/replacement, brakes, washing and waxing... for however often the owner of the policy deemed these things necessary.
Of course, those with pre-existing damage, bad rings, grinding brakes, blown gaskets or bald tires cannot be discriminated against; while premiums would be the same for the 20yr old, three-times DUI male driving a street rod as they would be for the granny who only drives three miles to Mass on Sunday...
...While anybody who doesn't have coverage has the privilege of driving their vehicle into any auto care center with full expectation of service... even if the vehicle is not properly registered, has foreign plates, and suspicious VIN numbers are used for identification.
How much do you pay for auto coverage now? How much do you think it will cost with the new policy?
Much of the problem with the way we approach health care can be seen in what you would predict to be the issues facing us if we were to take the same approach regarding auto insurance as we do in our attempts to make sense out of what we call the health care system.
Which is not really a system at all, but a case of severe governmental meddling in the affairs of a large industrial segment of our economy, a population with an entitlement mentality in regards to the fruits of that industry, and lawyers who know a teet when they see one.
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Well, now, Gino, I don't know.
Certainly the government has imposed a lot of "you must cover this" statutes.
But from when I was working in the system, this had the effect of raising the costs so much that the insurance companies (I worked in a strange vertically integrated system that provided services and insurance--and wasn't Kaiser) started strong-arming both their clients (via incessant health education materials) and the physicians (via requirements developed during contract negotiations with physician groups) to heighten the focus on preventive care and regular maintenance.
The costs went up for sure, and priced a bunch of people out of the market (since they provided their own insurance to their employees, this was an interesting inverse economic stress as well) ... but overall the focus of the medical systems they were interacting with shifted (not completely but significantly) to prevention and overall health. I think most insurers (at least in the Oregon market) now reflect this changed focus.
I don't agree with pulling the government out of regulating industry--at all. Lazziez faire is an incredibly dangerous approach to anything that involves people, because people are NOT instinctual animals--we are instinctual animals with additional intellectual powers and generally no instinct for ethics and only a small instinct for morality (when it can obviously benefit us). I think Libertarianism is a great idea, as soon as humans show themselves to be deeply ethical beings.
This would require either an unexpected evolutionary jump of some weird sort or a couple of generations raised under a much better set of social teachings.
i'm not calling for a total elimination of govt from the industry.
govt does have a role to play as far as setting standards, licensing, oversight, and enforcement of contracts, etc...
basically police powers, but no more than is necessary.
but what i am calling for is a reduction in govt before we start thinking of new/more things govt can do, which , beyond its mnost basic duties, it generally does poorly anyway.
well, ok then ... except that in setting standards and licensing, they have most often let the people with the money win, so although I don't have a *much* better idea i want the gvt OUT of licensing. Professional organizations can and should set their own licensing and standards, and take the fall when they fuck up. it's a built-in check and balance, in a direct service industry trying to survive in a media-saturated society.
I think government has a legitimate role--as long as we as a society of individuals are falling down on the job--to offer assistance to the downtrodden (even if they put themselves there), although perhaps only if the downtrodden are doing a reasonable job trying to pick themselves up ... this *should not* be the realm of the government, I think I agree with you there ... but the fact is, we have raised at least a couple of generations to be self-interested and stupid about maintaining human society ... and I think it is legitimate to charge 'us' for our social/educational stupidity in letting that happen, in order to alleviate or maybe even heal (some of) the suffering that set of choices has caused.
Ultimately, it gets back to your objection that noone takes personal responsibility anymore. It is *absolutely* a duty that lies with the individual. But recognizing and redressing some of the suffering caused by our lack of social health, is not necessarily enabling a victim mentality ... some of it is just, caring.
If my younger self had to pay more so my older self could afford to have health insurance, I would hope that my younger self would pitch in on that. If my sometimes semi-anorexic self had to pitch in to support someone whose personal history and genetic inheritance predisposed them for diabetes and weight gain, I think that's legit ... there are nearly no useful avenues for getting over these things.
But for the grace of God go I. (And for a while, I went there anyway. Certain health issues, I will not be able to recover from. Hopefully they won't have too great a total economic impact on me or society at large ... but if that's true, I'm just one of the lucky ones.)
I'd consider a single-payer system a really acute way to gauge the total economic damage our 'elite' society has done itself, actually ;).
SIGH.
great post.
One wonders how the posting at Luke.10.25-37 would have been altered if the government had taxed the priest, the Levite and the Samaritan in order to pay for the man's injuries.
Bad people do bad things at times. Good people do bad things at times. But to impune all people all the time is a bit too too.
Governments are messy vehicles for enforcing moral views. This is especially true when governments create classes of men; those who deserve the fruits of the labours of others. Governments that do this to excess tend to impose their views of what is right and wrong to excess. They get on a roll and there's no way to stop well meaning men and women from adopting rules that end up favouring groups of people over the rights of the individual.
New, related thought.
Ten years ago or so, when eating organic food was still looked upon with suspicion by the majority of Americans, one survey found that the fastest-growing demographic segment buying organic food was inner city African Americans. While I suspect this was at least partly because that population has a healthy distrust of The Man, I think the stated reason was that these people had very little access to health insurance and they saw, very acutely, the value in taking care of themselves and their families--and also (notably) the ultimate responsibility for that.
There, that plays into your 'the govt shouldn't offer handouts or people will never stand up on their own' over-theme, but digs at you a bit since the people who took this personal initiative and responsibility were a group you have historically more or less painted as incapable of doing so. ;).
kr,
i'll shoot your reasoning to hell real quick:
"they saw,vey acutely, the value of taking care of themselves and their families--and also (notably) the ultimate responsibility for that."
you ever been to the inner city?
i mean a real one, not for what passes for one in portland.
aint nobody taking care of themselves, OR their families... much less accepting any responsibility for anything.
no, it wasn't *my* reasoning, it was the reasoning of the people conducting the study, who apparently had somehow or other contacted the people in question ;).
I'm sure the early organic adopters were the take back the streets types, Gino, who do exist ...
yes I know Portland doesn't have a real inner city. I wouldn't dream of claiming we do. The nearest I have been is taking the bus through the heart of Harlem just before it got all fancy and popular again, and even then, most of Harlem wasn't as deep into the cycle as LA or Detroit.
Anyhow, the article wasn't saying it was a *popular* movement in those populations, just that it was catching on faster with that population ... the rate of growth was faster, not the overall numbers.
Since you don't want to be open to the idea that sometimes these groups can make a healthy choice, what is your explanation for their propensity to adopt (expensive and hard to find in a population that has been repeatedly proven to have barriers to accessing even basic groceries) organic food?
You do a lot of naysaying without a lot of alternate explanations or ideas ... not that that is hard to understand in a world where most of the news just makes me ask "WTF???" ... but.
ok, let see...
catching on faster.
there was one ghetto dweller (of the million)who bought organic.
the following year, he convinced his wife to buy more of it due to increases in drug profits.
there you have your proportional increase.
but i wouldnt be looking for a Whole Foods to be opening up nearby anytime soon.
no, actually, there is a whole branch of ... sociology? maybe ... apparently dedicated to figuring out how to get better nutrition to inner city folks
because of course, whether or not they are trying to feed themselves well, there are a pile of reasons why a store like Whole Foods (or even Safeway) wouldn't open there, and most big grocers have, from what I've heard(?), in fact closed up shop and moved out.
clearly the neighborhoods need to make some (about a million) changes to make it possible to get the good stuff.
yah no, I know the proportional increase could mean that. They had better numbers (% of population--and it was in %s, not tenths of percents ;) ), but I don't remember them well enough to argue them.
Anyhow, I was interested at the time because that was the same choice I was making: I don't trust The Man and I figured eating organic was just about the best health and long life insurance available, especially for little kids ... difference was, I suppose, that I had health insurance and soon after that time life insurance as well. Plus I live only .25 miles from my favorite organic foods store, oh yeah!
In any case, no health care system or industry is going to make me very happy I suspect, so WTF ever. It would be nice to not have to worry about health insurance decisionmaking and have some hope that a major medical crisis could be dealt with without financial or management (or waittime) hitches. You ever hear of a system like that?
Perhaps ironically, the only time I've heard about that is from my British and Irish neighbors, who still make their doctor visits when they fly to visit family!
(That was, of course, me. I'm more tired than I thought.)
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