Recent "Alice in Health Care" columns by Thomas Sowell have encouraged me, as I see that someone is pointing to one of the key problems in our current health care system. It is not that too many people have to pay for their own health care, but quite the opposite: too few people pay for their own care. As Sowell puts it in his March 4 edition (emphasis added by me):

Insurance companies or the government pay directly for most of the costs of most medical treatment in the United States. That is virtually a guarantee that more people will demand more medical treatment than they would if they were paying directly out of their own pockets, instead of paying indirectly in premiums and taxes. …

If medical insurance simply covered risks — which is what insurance is all about — that would be far less expensive than covering completely predictable things like annual checkups. Far more people could afford medical insurance, thereby reducing the ranks of the uninsured.

But all the political incentives are for politicians to create mandates forcing insurance companies to cover an ever increasing range of treatments, and thereby forcing those who buy insurance to pay ever higher premiums to cover the costs of these mandates.

Everyone should read his columns for common sense answers from an intellectual powerhouse. His analysis is based on reality...quite unlike most of what we hear from Washington DC these days.

In December, I wrote: 

“If you can buy without paying you will buy without thinking. Unless you must give something up in order to acquire health care, you cannot and will not appreciate its value. As a result, you will over-consume and the costs will be shifted to those who do pay.” (see bottom of page 3 of my business newsletter HERE.)

“If a service or benefit is free to you, are you more likely to accept it? If I insist on buying your lunch are you more likely to join me for lunch? As a matter of fact, might you select a larger entrée and add dessert you would not if you buying your own? In the health care marketplace, this translates into people obtaining services they would not really need. They over-consume, because someone else is paying the tab. More services are delivered less efficiently, and fewer people are paying. This is a collision course with reality check.”

If we don’t face the reality…especially the reality of human nature and it’s impact on these economic decisions…we are doomed to fail, repeatedly, to solve the real problems our nation faces. It doesn’t matter whether there is an R or D after their name, the politicians will never solve anything by acting on false premises.

What kind of morons do Senators think we are, anyway? According to My Way News, Harry Reid (Socialist-NV) said,

“On average, an American dies from lack of health insurance every 10 minutes. That means that in the short time I have been speaking, our broken system has claimed another life."

This is just one more example of the Democrats, with their media is tow, spinning this debate so as to equate "whether we have insurance" with "whether we have health care."

Once upon a time there was a man named Bob. Bob operates a produce stand. He sells fresh green beans for $1 per bag. At that price, he makes a profit of about 3 cents. He has an average of 100 customers per week. One day he is notified that the county has enacted an ordinance to help make beans more affordable for all:

“All customers over 65 and those of low income are entitled to get beans from Bob, and the county will pay for them. Since we must tax our citizens to raise the funds, we will only pay 60 cents, however. Bob must sell to these people at that price or he cannot sell any beans to anyone at all.” 

Bob complies with the law, and over the next few weeks comes to realize that about 50 of his customers are either low income or over 65. Where he used to bring in $100 and make $3, he is now bringing in $30 on the county sales, and $50 from the rest of his customers, or $80. His costs have not changed, so he is losing $17 a week. In order to stay in business and still make $3 profit, he raises his “normal” price from $1/bag to $1.40 per bag. Assuming the same 100 people buy a bag per week, he now receives $70 from the 50 regular-paying customers, and $30 from the county, for a total of $100 per week and his $3 profit is restored. Whew! Still in business.

However…half of the customers’ personal cost of beans went to zero, making beans an absolute steal! So they start ‘buying’ (at county expense) an average of 1.5 bags per week; after all, the county would never ‘ration’ the beans, would it? So the cost to the county skyrockets beyond what had been budgeted: instead of 50 bags for $30, the county is buying 75 bags for $45. 

Meanwhile, what happened to the 50 private-pay customers? Their price for beans jumped 40%. Some are going to make the reasonable choice of some other, cheaper food! Say they cut back to ½ a bag a week.

What happens to Bob who made all the beans available in the first place? He is now selling each week an average of 75 bags at 60 cents and 25 bags at $1.40, for total revenue of $80! His costs have not changed, he still supplies 100 bags of beans, he’s back to losing $17/week, something that he cannot afford. He will have to raise prices again on private-payers, cut quality of his product, implore the county to limit the beans bought by their 50 customers, or find ways to pad the books! Or, he could just quit and find some other profession.

The county fathers finally compromise: Bob doesn’t need to make $3 profit! After all, food is a basic necessity. They pass another ordinance: they forbid bean-sellers charging more than $1.40, the county will only reimburse 50 cents on beans to the elderly and needy, and will only reimburse for 1.3 bags per week. There, that solves it!

Is Bob a slave, an idiot or a wealthy philanthropist? Nope, none of the above. So, he closes his produce stand, becomes one of the needy and goes to his former competitor to get his free, stale green beans. 

The End

"Despite the administration's assertion that the $787 billion stimulus package helped catalyze the drop in unemployment, when measured against reality, this fantasy falls flat. According to economist and New York Times blogger Casey Mulligan, second-quarter federal and state stimulus spending amounted to only $12 per person. And the AP reports that while the employment rate "dropped marginally from 9.5 percent to 9.4 percent ... one of the reasons for that change is that hundreds of thousands of people left the labor force." How convenient for the White House."

My family is among the estimated 40 million Americans without health insurance...and let me be very clear: I don't want health insurance!  My family takes responsibility for our own medical care, and since we pay out of our own pocket we use it only when it is actually necessary, or when we feel it is worth the price (braces for the kids, for instance).  We participate in a voluntary needs-sharing organization (you should become familiar, if you aren't, with Samaritan Ministry, Medi-Share, and others like these) to help us cover extraordinary needs, so we will not become a burden on the taxpayers.

The problem with medical insurance, and even worse with government-funded medical care like Medicaid, is over-consumption.  This is a result of two facts of human nature:

1. When people have no personal responsibility to pay for what they buy, they buy more than they otherwise would. 
2. People who don't pay for their own care often choose to engage in riskier lifestyles and activities (antecdotal evidence documented HERE) and then need more medical care than people who know they will bear the cost of their own lifestyle and activities.

This over-consumption is simply not fair to responsible people.  To force--either through forced pooling of costs through mandatory health insurance participation or through extraction of tax dollars through a government-funded plan--people who are careful in their lifestyle and activities and who use services sparingly to pay for the decisions of others is simply immoral and unjust.  

 

Would you make everyone pay green fees for people who choose to golf? the dinner tab for those who prefer expensive restaurants? for a boat for those who go to the lake on weekends?  Of course not, that would be unjust and immoral.  (On the other hand, that is where socialism is leading, and many elected officials would probably not bat an eye at doing so!) Then why force people to bear the costs of others' health-related choices?

 

We (my family) choose to live a healthier, lower-risk lifestyle and bear the burden of our own health care costs (with a "safety net" of the medical sharing group in case of disaster).  We do not want to be forced into sharing the expenses of others who choose different paths: everyone should bear the cost of our own decisions.

Don't be bullied down Obama's path!  Any Health Care reform should create more private competition and personal accountability, not government subsidy or mandatory pooling of risk.  Any reform should make the buying decision closer to the payment responsibility.

Traveling last week on business, I was seated on the plane next to two teachers.  One of them was also a counselor.  In the course of our conversation she told me about a ten year old boy she had counseled, and whose home she had visited.  She was trying to motivate the boy to work harder in school:

"What do you want to be when you grow up?"

"I wanna be a thief," he replied seriously.

The counselor, a bit surprised, maintained her composure.  "Tell me, what does that mean to you.  What does a thief do?"

"Well, you go into other people's houses, usually while they're gone, and take some of their stuff.  Then you sell the stuff and that way you get money to take care of your family."  He never missed a beat, was as earnest as could be.

"Hmm.  How do you suppose it makes the other people feel...the people whose stuff you took?  Wouldn't that make them sad."

"Oh, you don't understand.  There's this thing called 'insurance.'  When we take their stuff, they tell the insurance people, and the insurance people buy them new stuff to replace it.  So if we take their TV, then they get a brand new TV.  So it works out pretty well for them, too."  This little boy hadn't thought of that on his own, of course.  The counselor had been to their home, and knew that his daddy didn't live there, but he and his mom and siblings lived there with some of his cousins, two of his uncles (when they weren't in jail) and grandma.  These things had been worked out in the minds of the older generation, and were passed on to the younger.

The counselor thought of one more approach: "What about the fact that it is against the law, and if you get caught being a thief you would go to jail?"

Without hesitation, the reply came: "Oh, jail!  My uncles go to jail, and do you know what?" Continuing with a touch of incredulity, "They feed you three meals every day, and you get your own bed to sleep in!"

The counselor knew that in his home, they didn't get three meals a day, and there were only three beds shared by the conglomeration of 'family' who lived there; one child slept in the bathtub, most on the floor, some with a parent (when the parent didn't have a 'friend' over for the night).

Hearing the story nearly moved me to tears.  What a tragic example of the consequences of many choices.

When small children are taught in their home how to justify robbery as an acceptable career path, something is wrong.  We are clearly reaching a crisis in our nation.  It is a moral crisis, more than anything.  Often we think 'moral' is just about sexual issues, but morality touches every area of life; it's the question of objective right and wrong. 

The proliferation of regulation is the result of, and at the same time I believe is a contributing cause of, this moral crisis.  No longer do we teach simple honesty as the standard for dealing with our fellow man.  No longer do we suggest that there may be eternal consequences.  No longer do we explain that there is a Creator God who knew best, knows best, and therefore deserves our respect and obedience.

Perhaps it started with Bill 'Philanderer-in-Chief' Clinton lying about his sexual harassment of an intern, but I don't think so.  Maybe it began with stealing information from the DNC headquarters, by Richard 'I-am-not-a-Crook' Nixon?  Or when the Supreme Court said you could not post the Ten Commandments on the wall of a public school?  Or pray in school?  Maybe it began with the New Deal, when it became fashionable to presume that others should be responsible for your retirement needs?  Probably each of these was just one more small step, one more choice that seemed right at the time, disregarding objective morality.  Each was just one more 'situational ethics' decision, and 'everything is relative' conclusion. 

As man has continually rejected any outside, objective standard of morality, he has gradually, ever so slowly, step-by-step, slid into a slough ...where little boys are now being taught robbery as a perfectly acceptable, logically-justified career option.

We need to get some facts straight, and figure out the right position to take, and stand on it, or we are going to be picked to pieces by the vultures on the left, and never know what ate us. As clear as one might believe the Bible is in condemning homosexual activity—as it is on adultery, pornography, lying, stealing, envy and a host of other activities common in our culture, some but not all of which coincide with civil law—the Bible will not be the basis for the civil definition of marriage. To make it so will speed Conservatives’ defeat. Activists like those in Maine can turn it against us in the debate.

I propose that we put aside nuanced rhetoric and be clear and unembarrassed in our beliefs, and aggressively pursue legal means of protecting or regaining the proper definition of marriage, as follows.

1. Conservatives don’t believe in discrimination (jobs, taxes, access to public accommodations and services, etc.) on the basis of benign, immutable characteristics.  Homosexual inclinations are in many situations benign traits, but in other situations (military barracks, for instance) they are not benign.

Though it is not essential to this debate, we should note that immutability remains a scientific debate. The American Psychological Association recently pronounced that despite all the efforts to prove homosexuality is genetic, there “is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors.” (See here)

2. The term “relationship” applies to all sorts of legal and emotional interaction between humans. Conservatives believe everyone should be free to engage in relationships that the individuals deem appropriate, unless those relationships injure others. (As Thomas Jefferson said good government will “restrain men from injuring one another”) All sorts of contractual relationships are permitted, and discrimination is against the law. 

These relationships are based on economics as well as pleasure: I pay $40 to the proprietors for a day riding roller coasters at an amusement park; clients hire a professional to render particular services that bring them peace of mind, economic benefits or other satisfaction; two individuals with complimenting skill sets who trust each other agree to form a partnership for their mutual economic gain; one person appoints another (as his 'agent') to make medical decisions (power of attorney) for the individual.  The existence of homosexual inclinations makes no difference in these relationships.   

3. Conservatives also believe that there are some specific relationships which deserve government favor or recognition: parent-child relationships, for example deserve special treatment as compared to brother-sister, cousin-cousin, neighbor-neighbor, professional-client, principal-agent, etc.  Marriage between man and woman is one of those special relationships that deserves special recognition.

The relationship between a man and woman who have made a solemn religious vow and/or civil pledge to be husband and wife for life is called “marriage.”  Marriage is a unique relationship which goes beyond pleasure, economics, convenience, satisfaction or peace of mind.  It is not subject to the whim of the parties…they cannot simply agree to dissolve the relationship. 

The essence of marriage is that a man and woman are biologically designed to bear children when they engage in the intimate activities associated with such mutual promises of permanent fidelity, and their promises are held to a standard of legal permanence that assumes as at least one major purpose the nurturing of their offspring. Not only is this obvious from their physical makeup, but it is supported by thousands of years of civil and religious culture and law. I defy anyone to produce evidence that the term "marriage" has been used by any culture to define any other sort of relationship.  The commitment between two humans biologically designed (or “evolved” if you buy that explanation of origins—it matters not for this discussion) to procreate is one that has gained deserved governmental recognition and preferential treatment. 

The government has a long-term interest in the continued replacement of population. Some countries are providing direct financial incentives to its citizens who bear and rear children. (Don't believe me? Click here)

And for good reason. Various studies show that economies are suffering greatly, and the well-being of the elderly is in jeopardy, in large measure because of the declining birth rates. As fewer people have children and those who do bear less than “replacement” levels, our population is getting age-heavy, and there are insufficient producing individuals to provide for the elderly and to support the tax revenue required to deliver the social services promised to the elderly. (See Demographic Winter, for specifics.)

With the unique benefits—pleasure, companionship, security, and more—of the marriage relationship come inherent obligations.  The parties cannot opt out of their duties to the natural product of this unique union—a child. People of ordinary mental capacity recognize and embrace, at least at an emotional level, the natural duty of parent to care for their child even when it means subordinating their own desires. The law also enforces this duty: even giving up the child for adoption is subject to judicial approval, and permitted only if the well-being of the child is assured.  

In addition, marriage between man and woman creates a type of stability in society because of the inherent difference between men and women. By and large, they complement each other in a family or household, each brings strengths not found in the other, each filling a necessary role in the home. Even by the most basic biological differences such as the ability to nurse and usual disparity in physical strength for protecting and providing, nature makes evident that this is the proper balance and order in society.

Because it is the building block of the human race—since we accept the recognized value of life, the value of children, the value of new workers, the value of new voters, the value of new soldiers, the value of new doctors, the value of new scientists, and on and on—the government recognizes and gives special privileges to that solemn man-woman relationship called marriage. Because of the value it brings to culture we go on to provide incentives for marriage: the right to engage in consensual sex without shame (after all, premarital and extra-marital sex are still frowned upon in most religions and are illegal in some jurisdictions), inheritance rights, transfer tax exemptions, modest (barely!) income tax incentives, the right to be executor of an estate, and other such privileges. 

No homosexual (man-man or woman-woman) relationship, even if coupled with a public promise of lifelong monogamous commitment, can be compared fairly to marriage between man and woman. No homosexual relationship gives the government anything in return. Homosexual relationships are essentially about nothing more than the personal happiness and pleasure of the parties. This doesn’t mean we discriminate against people who want to have these kinds of relationships; it just means that such relationships should not entitle the participants to any special governmental incentives.

ANSWERING THE OBJECTIONS:

“Marriage has evolved to being just about the mutual pleasure, companionship and happiness of the parties.” Inroads have been made, as acknowledged above. And the battle should not be conceded in that area.  If marriage is about pleasure of the parties and no-one else has the right to deny them the pleasure and happiness afforded people who love each other, then there would remain no reason to prohibit polygamy, for instance. Why not three men being married? Four women and two men? Under what theory would we prohibit incestuous marriages, so long as the parties are at the age of consent and take steps to assure no biological offspring result from their marriage? The definition has served civil society very well; there is no reason to start down the slippery slope.

 “There is discrimination in inheritance and other legal rights.” Some will argue that homosexuals are not allowed fairness with respect to inheritance rights, the right to be executor of an estate, the right to visit in the hospital, and other such privileges. This is exaggerated at least and in many instances absolutely misrepresented. Here is the truth. If a person has no will, his or her heterosexual spouse is probably the “default” heir and the “default” executor of the decedent’s will/estate. A spouse may be given “automatic” visitation privileges at the hospital.  But there are very few areas where the affirmative act of the parties cannot make these privileges equivalent for homosexuals. You can appoint not only your spouse (married, heterosexual), but about anyone who is of age—including your gay lover—as your health care proxy/agent (power of attorney) and thereby have them privileged to see your medical records, be involved in medical decisions, and visit you in the hospital. Further, the laws of every state allow individuals to appoint anyone—including their homosexual partner—to arrange for disposition of their body, and as the beneficiary to receive their estate. Modest tax advantages are still granted exclusively to a married couple; I submit they are more than justified by the procreative purpose they provide for the country.

“But marriage has evolved in many ways over the centuries; this is just one more of many.” The marriage relationship has evolved over the centuries, without a doubt. In different societies and times men have virtually “owned” the women, polygamy is practiced, marriages are arranged, and so forth. Many aspects of marriage have changed…about all but one, that is! Marriage has always been the joining of two humans of opposite physical gender, who are naturally designed for procreation.  Provide evidence to the contrary.  There is none.

“But not all marriages produce children, so you can’t limit the definition that way.”  Obviously, some married couples cannot have children; some have disabilities. Would you advocate discrmination against persons with physical disabilities?  We don’t penalize people of a particular clearly-defined category—gender—for being disabled in other ways, nor should we deprive them of the classification "marriage" because of some physical defect.  Their fundamental design--human male and female--fits, despite their physical impairment.

You further object that not all who marry and are capable of producing offspring do. Either they choose not to engage in the activities that lead to pregnancy, or they choose to interfere with the natural fertilization process, or even abort their child when they discover the pregnancy. Still, their natural state and design is for procreation; that they choose to reap the pleasurable benefits of marriage and reduce the “risk” of bearing children does not change the fundamental physical design. It could more easily be argued that the state has an interest in limiting access to birth control than in erasing the procreative design differences between men and women.

“The government has no business endorsing or providing incentives to marriage relationships at all.” This could be argued meritoriously only if we accept your definition of marriage, that is, as nothing more than a relationship for the mutual pleasure and happiness of the parties. If that is all marriage amounts to, then you truly are arguing for the abolition of the entire concept. That sort of relationship contributes nothing that the government has a valid interest in. Be careful what you wish for.

NO RELIGIOUS BASIS?

Of course there are many, many moral and religious bases for retaining the traditional definition of marriage. I leave those to our pastors and priests.  In the debate in the statehouses, Congress and courts, those bases simply are not given any weight. Rather, those arguments create the impression that the only reason we don’t want marriage redefined is because it violates “our religion”—and the lawyers and legislators don’t care about your religion or mine.

"Republicans have caught the Democrats in a midnight “stimulus” power play that seeks to cut Republican conferees out of the House-Senate negotiations to resolve a final version of the Obama “stimulus” package. Staff members from the offices of House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) met last night to put together the “stimulus” conference report." 

BILL PRESS:  ... All we want is, you know, some balance on the airwaves, that's all. You know, we're not going to take any of the conservative voices off the airwaves, but just make sure that there are a few progressives and liberals out there, right?
HARKIN: Exactly, and that's why we need the fair -- that's why we need the Fairness Doctrine back.

STEPHANOPOULOS: Hundreds of millions of dollars to expand family planning services. How is that stimulus?
PELOSI: Well, the family planning services reduce cost. They reduce cost. The states are in terrible fiscal budget crises now and part of what we do for children's health, education and some of those elements are to help the states meet their financial needs. One of those - one of the initiatives you mentioned, the contraception, will reduce costs to the states and to the federal government.
STEPHANOPOULOS: So no apologies for that?
PELOSI: No apologies. No. we have to deal with the consequences of the downturn in our economy.