ACA Repeal/Replace: Progressives Face Moral Dilemma

[Bob Butler 54]

I’m seen the main values clash as a blue leaning towards inclusive care against a red leaning towards economic values.  That seems the main disconnect, where the goals of the two groups go flying by one another without comprehension or contact.  I’ve been trying to peg the blue perspective on positive rights, Freedom from Want and UDHR 25.  I haven’t as clear an opposing concept other than a bunch of bills which leave fewer people covered… the opposite of inclusion.

To a great degree, there is no breaking that clash.  One either cares for one’s fellow man and seeks to share the burden, or not.  If one is strong into economic values, one can find a way of saying this way of sharing the burden or that is unfair and should be eliminated.  By the time you eliminate everything ‘unfair’, the system collapses.

I’m reasonably confident something fair could be implemented if folks were willing to contribute.  Other nations have made reasonable attempts.  Massachusetts was doing well enough under Romneycare.

The other question is how to make it cheaper and still effective.  This might almost be a separate set of questions.

Part of it is the partisan distrusts.  Blue leaning folks look dubiously at insurance companies seeking profit.  That is often seen as a layer of overhead and profiteering that returns nothing.  Red folks are often dubious of anything approaching government takeover.  Both I believe have reason to be dubious, but something has to be found that works.

Then it seems like the medical culture is changing as health care evolves.  My father’s best friend was a general practitioner with rights at the local hospital should he need them.  He was pretty much his own man, doing his own thinking, making home visits and knowing his patients well.

The modern structure seem more like corporate medicine, cookbook medicine.  The insurance companies almost write the cookbooks.  You still are assigned a general practitioner, but he has a specialty and as soon as you leave his specialty you are off to visit a specialist.  In recent years I’ve visited a skin specialist, who froze off certain pre cancerous growths, a digestive specialist, who used a laser to burn certain polyps out of my intestines, and several others.  I got the impression that they repeated the same specialty procedures regularly, several times a day, scheduled by a specialist secretary who does it by rote.

Perhaps the new style is an effective one, with people doing what they know and do best.

Perhaps the new style is driven by lawyers.  If you have this symptom, if this test isn’t run, if that drug isn’t administered, if that procedure isn’t performed, and if something bad happens, we live in a nation of lawyers.  Money moves around.  The style of the medicine is in part driven by the style of the legal system.

Until recently, I was upset by the overly active lawyers upping the cost and complication of the medicine.   I more recently got to witness a real world case.  The doctors prescribed a medicine that was clearly listed as allergic on a friend’s medical records.  The doctors clearly made potentially and nearly deadly mistake.  The facts of the case were crystal clear, unquestioned.  The result?  Lawyers lawyers everywhere, but in a system that was rigged for the rich and the doctors.  If you could afford to keep feeding money to your own lawyer, you got justice…  or at least financial compensation.  If you were poor and could not afford to enrich the lawyers, you were dumped to the wayside.  It would be impossible to buck the system unless you were rich enough to be part of the system.  My role has been to contribute enough funds to buck the system.  Bucking the system is not a cheap hobby.

Can the government impose change upon the medical community, legal community and insurance industry?  That is not easy given the lobbying industry.  The voices of those profiting off people’s suffering drowns out the voices of the people suffering.  The voices of those with economic values seems to drown out the unhealthy.

And this has me wondering about my experience with modern medicine.  Did those intestinal pylons and skin pre-cancers have to be removed?  To what extent does an ounce of prevention save both larger health problems and the greater expenses that follow?  How hard do we look at the notion that the ounce of prevention only helps a few, and we can save money by letting those few suffer?  Are we back to inclusive vs. economic values?

There are no easy answers, but I genuinely think the problem should be talked about.  My own values still wrap around positive rights and HDHR 25.  The health system should be inclusive.  I expect to run head on into those with strong economic values attempting to frustrate the positive rights.  That’s where I see the main conflict.

One of the few certainties is that the current ‘system’ is messed up.