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Originally Posted by AGDee
Health care: I've been working in health care for 21 years now so I feel like I know a bit about it. There are so many facets to this. Some facets are commodities (pharmaceuticals, durable medical equipment, etc), some are not. In Michigan, all hospitals are required to be non-profit. As a non-profit, I don't think you can argue that it is a commodity. However, all the vendors that a hospital must use are commodities. It's just not cut and dried. *If* we don't see health care as a right, then why must hospitals treat anybody who walks into the ER and eat the cost? They should be able to require payment immediately. Physicians in our medical group earn approximately $150K a year. This is NOTHING compared to what the top earners in "commodity" businesses make. They aren't getting $47 million severance packages, that's for sure. They are saving lives, keeping us alive, making us healthy and that's what they make. They also spend significantly more than the rest of us on their educations and pay extraordinary amounts of money in malpractice insurance (another commodity that feeds off of the health care industry). Blue Cross/Blue Shield of Michigan is non-profit. Other health insurances in Michigan are not.
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To be clear - I'm not saying that medical care is a commodity, but rather than pooled insurance risk is a commodity. Under the definition below, this is clear:
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Originally Posted by AGDee
Dictionary.com's first definition of commodity is: 1. an article of trade or commerce, esp. a product as distinguished from a service.
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Insurance is not a service - it's a product. You're paying for the ability to pool risk with others.
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Originally Posted by AGDee
Health care is a service that needs to utilize commodities to provide that service. I wouldn't call it a commodity in and of itself.
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Remember that when these two specific politicians talk about "health care" they are NOT talking about "medical care" - each of their plans calls for nationwide health insurance coverage. That's why I'm using the commodity angle - otherwise, I agree that medical care is a service and separate. That's my entire frustration.
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Originally Posted by AGDee
I believe it is a right as in "The right to life, liberty and the pursuit of happiness". Without health care, the right to live and pursuit of happiness is pretty near impossible for many.
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This is kind of a strawman - remember that the original ideals of the frames were "life, liberty and the pursuit of property" . . . and 'life' refers to the ability to live without impediment from others or murder at the hands of the state or individuals, not the ability to live until you're 80.
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Originally Posted by AGDee
Personally, I put it in the same category as Education. Education is also a service that utilizes commodities to provide the service. We have a right to equal opportunity to education and it is my personal belief that health care should be treated the same way. I don't think the agencies (hospitals) that provide the service should be the ones who bear the burden when the people don't have a way to pay for it. Car mechanics aren't required to fix your car if you can't pay for the service and parts. Why are hospitals required to fix people if they can't pay? Because we (society) recognize that human life is valuable.
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I think this paragraph kind of argues against itself - there is a key difference between education and health care, as well: people are far more willing to pay high-end prices for high-end health care, and the individuals who practice are much more specialized and highly trained.
Teachers don't get paid nearly what they're worth, and I think most of us agree that we suffer for it. What would happen if doctors suddenly became (
de facto or literal) government employees, too? Will people move to the suburbs to live near the good schools and hospitals? Does the inner city get screwed again (and I realize they already are in this regard, but the point remains)?
Again, I think there are dozens of unintended consequences that we miss when we argue for the idyllic 'forest' of universal health care and don't examine the 'trees' of "how on Earth did this system get so screwed up, and why aren't we simply tearing it down instead of applying a Band-Aid?"
I agree completely that the burden should never be on the hospital itself - the rise of "mandatory-care" ER policies and the like is probably just as detrimental to the average person as the conduct of insurance carriers to drive up costs and reduce coverage.
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Originally Posted by AGDee
My basic point is that health care is not nearly as cut and dried as "is it a commodity, right, privilege or responsibility?"
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Agreed completely - great post, Dee. Thanks!