Who is Responsible for Our Health Care?

Earlier this week we received an e-mail containing negative comments about CESJ's proposed "Doctors' Plan for Universal Health Care" and suggesting not only that profit is unjust, but that CESJ had no business getting involved in the discussion on how to finance universal health care. There was also a hint that allowing the State to take over direct administration of providing an individual good such as health care is somehow automatically better than anything the private sector could come up with. You can judge the comments for yourself, by reading the edited version of the e-mail. The text was edited to correct spelling and grammar, and to remove anything that might allow identification of the writer.

Sometimes I wonder if you actually understand how health care financing works. Every dollar that goes out of the system for non-medical purposes means one less dollar there is for medical services, that is Health Economics 101. So if the health insurers and in particular United Healthcare takes out a $859 Million Quarterly (Record) Profit that means that $859 Million dollars does not go for health care services. Therefore, sick people who would be receiving the necessary medical services aren't getting the care because the excess profit is going to shareholders.

So I repeat my question and I would appreciate an answer: How much is a life worth to you? I know that you cannot or won't be able to answer the question? Why? Because there is no good or safe answer to the question. The fact of the matter is that the health insurers/HMOs know that what they are doing is morally unacceptable but they just do not care because they are making billions over the dead bodies of the poor, sick and the uninformed. This profiteering in health care financing and delivery has to stop, its not good for our country, its not good for our citizens and its not good for souls.

This morning when I was reading your email I was interrupted by an email from a young relative. Here's my relative's take on the health care reform debate: "Bill Maher says 'If conservatives get to call universal healthcare "socialized medicine," I get to call private, for-profit healthcare "soulless, vampire bastards making money off human pain".' "

Now, I do not go to that extreme, but the point that I am making is that if a young person with a Master's Degree in Library Science sees the inequity in our present health care financing system, significant change is in the future.

Good luck with the Third Way Concept but I would suggest that you stay far away from the Health Care Reform debate because it is not your fight. If you make it your fight I guarantee you that you will rue the day that you ever heard of health care financing reform.

Our response is as follows:

Contrary to your assertion, we understand how health care financing works. The presumed abuses you point out on the part of private insurers can be taken care of through our recommendation to make all insurance companies "mutual" insurance companies, with the full rights of private property passed through to the owners: the share/policyholders. Under our proposal, every citizen would be covered under an insurance plan of his or her choice, and would be a share/policyholder in that same company. Any profits would then go to the share/policyholders in the form of dividends or rebates on premiums, thereby directly reducing aggregate health care costs by the amount of the distributed profits.

Assuming that we agree that the present increasingly oligopolistic health care and insurance system is not optimal, the likely alternative to the simple and more democratic reform proposed under the "Doctors' Plan" for universal health care is to put matters in the hands of the State. Any profits realized from health care delivery would not be distributed to the citizens, but (as is usual with such profit centers as the Federal Reserve and the Export-Import Bank of the United States) be turned over to the U. S. Treasury as revenue. This would, if the past is any guide, encourage overcharging on premiums to support a bloated State bureaucracy, automatic denial of claims, and anything else to enhance revenue for a government that is becoming increasingly desperate for additional sources of income and new ways to tax.

The State's proper role, however, is not to take care of all our individual goods such as food, clothing, shelter, or health care. As defined in the U.S. Constitution and in traditional philosophy of government, the State's role is to care for the common good — the "general welfare," not each person's "individual welfare." The common good, of course, is that network of institutions within which the human person, as an aspect of his or her personal sovereignty and individual human dignity, acquires and develops virtue — "pursues happiness" — as a "political animal." Our natural rights to life, liberty, and access to the means of acquiring and possessing private property in the means of production support our acquisition and development of virtue.

Putting power over individual welfare in the hands of the State leads directly to a totalitarian order. This is either through the establishment of socialism outright, or through its bastard cousin, fascism. Totalitarian States do not, as a rule, respect life in any form, to say nothing of liberty, property, or pursuit of happiness. They were, in the twentieth century, responsible for an estimated 90 million deaths:

Stalin: 1.5 to 2 million (purges), plus 5 to 10 million (famine)
Hitler: 13 to 14 million (death camps, execution of POWs, ethnic cleansing)
Pol Pot: 7.1 million
China: 58 million (ROC, Nationalist, Japanese, and Communist, cf. R. J. Rummel, China's Bloody Century. New Brunswick, New Jersey: Transaction Publishers, 1991).

Perhaps you could be more specific in addressing which of the principles or applications of principles embodied in the "Doctors' Plan" with which you disagree, either from a moral or an economic standpoint. We did not see anything in your remarks offering a way to keep the choice over health care in the hands of citizens, preserve the doctor-patient relationship, or grow the economy — including the health care delivery system — in an ethical and sustainable way that would allow people to afford the means to sustain their lives in a manner befitting the demands of human dignity and respect for personal sovereignty.

Your suggestion that we, or anyone else concerned with basic human dignity and personal sovereignty "stay far away from the Health Care Reform debate because it is not your fight," displays a certain lack of political acumen. On the contrary, it is everyone's fight. As Edmund Burke has been paraphrased as saying, "All that is necessary for the triumph of evil is for good men to do nothing."

Ultimately, there is only one thing that you can "guarantee" if we or anyone else let you persuade him or her that he or she "will rue the day that you ever heard of health care financing reform." That is that the State will step in unopposed while people stand idly by, hoping vainly that the bureaucrats in charge of determining who qualifies to receive State-controlled health care will not deem them, in the words of Karl Binding and Alfred Hoche, Lebensunwertes Leben — "Life unworthy of life." You will then have an answer to your demand regarding the value of human life. As far as the totalitarian State is concerned, the answer is, "nothing."

You might find the analysis of Dr. Leo Alexander, Chief Medical Examiner at the Nuremberg War Crimes Trials of interest in this context. His article, "Medical Science Under Dictatorship," from the July 14, 1949 New England Journal of Medicine, examines the politicization of the practice of medicine in the Third Reich.