12 February 2012

A few comments on the employer-based health insurance system

 
I don’t mean to dive into the whole Health Care debacle quite yet, but when I look at the political theatre taking place at the moment over the issue of contraception, I am struck by the fact that no one will entertain the solution.

We can talk about contraception and whether or not it should be used. We can talk about whether as Christians we should use it, and if we don’t, whether it matters that those outside the faith use it. We can talk about our posture on this issue as Exiles in Babylon. The Christian community has politicized this issue as they have with almost the whole of Christianity, so even discussing it grants political capital to the other side. Whatever the other side does must be opposed. It’s pretty pathetic and frankly it’s starting to make a significant contribution to the breaking of our society.


This whole problem stems from the reality that our system relies on the EMPLOYER to provide healthcare. I’m sure employers loved this 40 years ago. Employees are less likely to cause trouble when their boss holds the reins as to whether or not they can go to the doctor. They may be regretting it now as the prices and debates have turned ugly. Originally employers used it as an incentive, part of the package to ‘sell’ to potential employees. Back then you could still afford to go the doctor, so it was viewed as a perk, not toying with someone’s life.

Today, those without coverage due to their job’s lack of provision, their unemployment status, or a pre-existing condition live under a shadow. We’re all going to die of course, but there’s something very sick about a society that spends thousands on their pets while we have millions who can’t receive even the most basic health care.

If health insurance wasn’t tied to the Employer…in this case religious organizations taking tax money, but still demanding exemption from societal rules…then this debate would evaporate. I’m afraid if you’re going to take tax money, you subject yourself to certain laws.

Removing the Employer system means it either must be replaced with a state system, or it means prices would need to drop in order for healthcare to become affordable to common people in a free market. Either way it means breaking the insurance companies, something our corrupt legislators are unwilling to do. Why? The insurance industry, not to mention the pharmaceutical industry own them.

There’s another solution, but I’m not sure it would work economically and socially it would be rejected. That is…de-regulate the entire health care industry. Let anyone practice medicine, and let the public purchase any drugs they want. You’d have a true free market, but that would be operating under caveat emptor. There would have to be massive tort reform as well. I’ve floated this extreme Libertarian view at many (just to play advocate) and I’ve found very few takers. You can have this type of system or a Socialist system, but even under a hybrid Free Market system…if there’s regulation, then of course the state will be heavily involved. If the state is involved, then it seems anti-democratic to cut people off, to deny people services which are considered the social norm for health care. That’s our present system and it’s not just about birth control, it’s about things like getting a check-up or a cavity filled.

Right now for many they face a reality in which they can’t get basic health care. Say you get a bad case of poison oak. Say you’ve had it before. You know what it is and know what topical medication you need. But you don’t have insurance. You can’t find a doctor who will see you because you’re uninsured. And when you visit the pharmacy they won’t sell you the drug because you don’t have a prescription. The government has regulated the system and the system won’t grant you access. The companies involved from doctors to drug-makers all want the regulation because they don’t want Fred the plumber practicing medicine, nor do they want Ed the garbage man to be able to purchase his diabetes drugs out of someone’s trunk, perhaps brought into the country from somewhere else, or even worse (in the minds of many) something manufactured in a basement.

In the end if you’re having a really bad time with your poison oak, you’re forced to go the Emergency Room and pay an inflated bill about 5 times what you would have paid to go see a doctor. And then if you can’t pay the bill, somehow you’re blamed for ruining the American healthcare system?

Of course there are a host of larger issues, public safety and so forth. And as I’ve suggested this ‘free market’ approach to many Conservative advocates of the Free Market…they recoil in horror at the thought of a de-regulated industry. They don’t want people to be able to just go and buy whatever drugs they want!

And on that note I’ll stop, before this turns into an 80 page discussion. I only mean to suggest that few are able to identify or are willing to address the real problems, the root causes of these tensions. Since few have the ability to work this out they will be endlessly subject to emotional appeals and crusading politicians who in the end are only leading the cavalry charge for their own wallets.

The Employer based system is inefficient, unjust, and probably should just be called what it is… immoral.

This isn’t the ‘Christian’ view of health care. The Christian view is that you sell your car to help your neighbour get surgery. And if you want to argue that should be a private function instead of a state function…either way I don’t see anyone doing it.

Instead let’s look at the social reality. We’re exiles in Babylon. What do we want for the Babylonian health care system? Something reasonably fair and something that works…nothing more, nothing less.

If you want to practice medicine outside of Babylonian social norms…that’s fantastic. Really it is. But you can’t take funds from the Babylonian treasury and help support the Babylonian regulatory system and think you get to be exempt. That’s called favoritism and in our system tends toward establishment. I just have a feeling these same people wouldn’t be keen to protect conscience issues of a Hindu hospital or a Buddhist one.

I have little sympathy with Obama but far less with the medical community…and even less for the religious medical community.

I heard a Church leader declare the other day that without the Church there would be no medical community in this country. A good third of the hospitals are operated by religious groups. If that’s true, that’s a badge of shame. The medical industry is corrupt and criminal and puts profits ahead of caring for people or trying to save their lives. To me the statement of this ‘pastor’ makes perfect sense…he represents the sick and polluted world of American Christianity. One in which money and the love of it is placed above the Throne of God. If the love of money is the root of all evil…then American culture and the American church are in big trouble.