Human health care isn't a business

Posted: Wednesday, September 09, 2009

For all the controversy about President Obama's proposed health care reform, there's been very little discussion about health care itself. The debate is limited to medical expense insurance programs. Unfortunately, we'll never solve the problem of spiraling costs until we recognize that health care is not primarily an economic issue.

This debate isn't about the nation's sagging economic health. No one is suggesting we need to grow the economy by increasing consumer spending for health care. In fact, we would all prefer to never see a doctor because even preventative care is a reminder that human suffering is part of life. If we all got our wish, we'd never need health care or insurance to pay the bill.

Heath care is an essential human need though. Insurance isn't. It's a business venture where the first priority is to generate profits. In its own way the insurance industry is as cold and heartless as big government. To the agent who processes our claims, we're not patients. We're a matrix of codes developed to match the rules of reimbursement that also help the industry analyze risks and establish the basis for premiums.

Insurance is about risk and its steady companion we call fear. It's an industry that wouldn't even exist if people never worried about losing their material wealth. The origin of protection against financial disaster goes back several hundred years. Businesses selling merchandise across the ocean sought ways to guard against the losses in the event a ship never completed its journey. Building owners wanted to protect their property from destruction due to fires.

But buying insurance never prevented ships from sinking and buildings from burning to the ground. No one claims that life insurance makes us immortal either. And back to the point; health insurance itself doesn't prevent illness and disease and certainly doesn't help us cure from these unwanted visitors.

Insurance is nothing more than a means to pool resources that can be dispersed as necessary to ward off financial hardship. We don't contribute to the fund expecting to earn a dividend. In fact, we'd be happiest if we never had to file a claim. It seems it's the only system where we readily accept portions of our wealth being redistributed to those who need it most.

How different is privately managed insurance from a government program? Corporations run by unelected individuals are bureaucratically equal when it comes to creating rules, red tape and reams of paper. They become deep pockets too, which means medical professionals are less restrained from unnecessarily increasing their fees. The system is also ripe for fraud and abuse, leading to more government oversight, legislation and high paid lawyers on government and insurance company staffs.

More programs and/or regulation aren't going to solve the rising expenses for health care. Third party insurance, whether it's run by the government or private businesses, is the triangle that sustains the never ending cycle of increasing costs. Whether it's taxes or insurance premiums, we're feeding the beast without addressing why we need health care in the first place.

Human health is about biology. But as creatures of social habit, we want to be recognized as people, not laboratory specimens. The only thing worse is to be turned away without being examined because we don't have medical insurance.

Health care reform is doomed to fail until we recognize it's a social science and not just an economic enterprise. As such, we need to be open to discussing the philosophy of socialized medicine. It doesn't mean we have to turn the medical profession upside down and give the government control over the care we receive. Rather, we need to consider the diversity of ideas available to discover the ones which haven't yet seen the light of day.

We shouldn't mistake socialism as a system of governance when it's just an economic theory. The fact that we're not even willing to give it serious consideration in any form is psychologically immature. Instead of acting like the bogeyman is in the closet, it's time we open the door and examine our fear. We should leave no stone unturned in the quest to create a new model for human health care.

• Rich Moniak is a Juneau resident.

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