|
Forecast provided by HamWeather, LLC
|
 |
|
|
Plumbline Author: Michelle Kirtley
Date: August 31, 2009
Topic: Missing Balance in Healthcare Reform
The focus of the current healthcare insurance debate has been on whether to establish a government-run “public option.” Liberal Democrats insist that a public option is necessary to control healthcare costs and “keep insurance companies honest.” Conservative Democrats and most Republicans suspect that a public option is merely the first step toward a nationalized, single-payer system and are skeptical that the public option will truly rein in costs.
The result is something like guerrilla warfare involving all the bare-knuckle tactics modern politics has to offer. Even the group seeking to craft a bipartisan proposal in the Senate Finance Committee seems to be close to giving up hope for a workable compromise. Commentators on all sides are wondering if there will be enough votes to get any proposal through Congress.
At the extremes, neither side seems willing to give any ground. Liberals, suspicious of the market’s sometimes cutthroat nature, want to divorce the provision of healthcare completely from for-profit ventures, placing it in the hands of government. Conservatives, on the other hand, doubt government’s ability to control costs without rationing care and are wary of an increased government presence in something as personal as one’s health.
Yet blind trust in either the government or the market is insufficient for dealing with a problem as complex as health care. Modern technology has made even basic health care too expensive to allow for a return to the days when doctors provided services in exchange for goods or cash. At the same time, medicine’s relatively new but very real capacity to improve the length and quality of life has made access to healthcare a matter of basic human dignity.
There is broad, bipartisan agreement that there is a role for the federal government in providing increased access to health insurance. The focal point of the debate is whether government should administer the healthcare it subsidizes. The key to answering this question lies in our understanding of human dignity.
While human dignity may require guaranteed access to healthcare, that guarantee is not sufficient. We learned this from welfare reform. It is not enough for government to offer financial assistance to the unemployed. Government programs that unintentionally encourage vicious cycles of dependency and poverty may actually subvert human dignity. The need is for the right kinds of programs that encourage the exercise of human responsibility.
There is no conceivable means of expanding health coverage to those who need it apart from government support. But government support can be used to enable recipients to participate in the same private insurance system that most Americans enjoy.
Both state and federal governments have undertaken promising experiments in partnering with the private sector to provide health insurance. In Medicare, about 20 percent of the beneficiaries are covered by private insurance companies through Medicare Advantage. Similarly, several states are attempting to offer Medicaid recipients either Health Savings Accounts, which they manage themselves, or vouchers for the purchase of private health insurance. These models offer the added hope that a Medicaid patient carrying a Blue Cross insurance card may actually be treated the same as any other privately insured person.
The debate on health care reform need not be reduced to a choice between an expansion of government-run health care and an affirmation of the status quo. Instead, the goal should be a more robust affirmation of human dignity in which the provision of needed assistance also empowers individual and institutional responsibility.
|
|
