The strategic health-care reform not being debated

Posted 8/21/2009 03:01:00 PM

© 2009 by Michael Swickard, Ph.D.

Most Americans in these town-hall meetings are, metaphorically, just waxing deck chairs on the Titanic. They argue health-care tactics while ignoring the profound change in health-care strategy. The unexamined and unchallenged change is from a philosophy of social contract to one of social justice.

When I was born in 1950, health care was predicated on a long-standing social contract we citizens had with our government in which the government’s role was to enhance our lives in both longevity and quality. Government-sponsored medical advances were greeted enthusiastically by Americans.

My cardiologist started in the early 1970s when it was uncommon for heart patients to live robustly past 70. With the advent of new procedures and drugs, patients now live actively past 80. Likewise, there were worldwide celebrations when Polio was defeated and then Smallpox, Measles and Rubella.

Many people are alive today because of that social contract with our government. This increase in longevity, a source of pride, is now at the core of our reform debate.

The social contract also had researchers working on eradicating cancer and heart disease; however, the prospect of the changing health-care strategy brings that into this question: Should society be curing cancer and heart disease, since that results in people living longer? This extends the society’s obligations to these survivors for medical treatments and Social Security. That is the reform strategy not being debated.

Instead, there are long-winded debates about the minutia of what is on page 420 of a bill that has multiple versions. Americans are standing on a whale fishing for minnows.

A radical change in philosophy

The health care reform is not about saving money for consumers of health care, and it is not about whether citizens use the private option or non-profit co-ops. Rather, it is the supposition that the government should change how it uses health-care resources based upon a radical change of philosophy similar to the progressive health-care changes in Europe and Canada.

The new philosophy is social justice which, operationally, never takes from the young to give to the old. Under a social-contract philosophy, our government provides resources so citizens live longer and better. Social-justice philosophy says to oldsters, “You have lived long enough; we cannot expend resources on you that could go to the young.”

Other countries have made that change. It is the core of health-care decisions in England. Their health-care motto is: In with the young, out with the old. It is like some strange New Year’s Eve party where the elderly are shuffled off to the cemetery for the good of the country.

If America adopts a social justice philosophy, that changes who gets government-controlled health care resources. Countries making this switch experience unreasonable delays or outright prohibition of resources for people considered too old or of not enough use to the society as a whole.

Social justice says the collective good of the society trumps individual benefits. As a cancer survivor I regularly see the effect of my having had cancer on the current health-care system that endeavors to hold me at arm’s length. But I see even worse outcomes if our country adopts the new social-justice yardstick, which will reason that keeping me alive is good money after bad, since I could re-acquire cancer at any time, thereby wasting money that might go to the young.

So it will be out to the trash heap for me.

Missing the strategic change

Further, the new social-justice government will view my survival of cancer differently from the government of social contract. Surviving my bout with cancer required quick action on a five-hour operation and follow-up radiation. The government that sponsored the research leading to procedures that were successful in my survival was happy. However, a social-justice society would not be happy and would say, “Shuckins, if he had died we would not owe him any Social Security. Hope he dies before we have to pay him anything, despite his 40 years of paying into Social Security.”

The town-hall debaters do not see the beast in belly. They think this a political rather than ethical issue that is a battle over which political party wins. Like the rest of our country, they will be quite surprised by the extent of the governmental betrayal.

With no scrutiny by the media or citizen debate, the congressional leadership and President Obama are set to install this new philosophy of social justice, which will remake us into a New Order Progressive Nation. They are enabled when citizens and the media miss the strategic change and only debate tactics.

We need not debate private options if our government no longer supports longevity and quality of life for older Americans. Those details do not matter in the least if our leaders, using social-justice reasoning, betray and then discard older citizens.

Swickard is a weekly columnist for this site. You can reach him at michael@swickard.com.

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6 Comments:

At 3:30 PM, August 21, 2009, Blogger Dr. J said...

Well, I certainly have not read any of this in HR 3200, and you have to believe that HR 3200 (or similar) is but the first step into socialized medicine to get to this conclusion. I fear it could be true, but the Obamanaics would strongly deny this the same as they denied the "death panels" issues and that this is a takeover of all health insurance. Other than the "public option" being the nose of the government's camel in our private rights tent, I don't see much of HR 3200 that indicates old people will be discarded and ignored due to cost in favor of the young. This could be an outcome, I agree, and having lived in 2 countries with socialized medicine (Canada and Norway), I can assure people that is what happens. But how do you convince people that this is the underlying scheme of HR 3200 (or similar) if they can't read it in the bill and their Democrat representatives, unions, and other activists say it is nonsense?

 
At 4:14 PM, August 21, 2009, Blogger mjh said...

Remember: When drinking political kookaid, don't use a lead cup. I won't even ask for a 'rational' explanation -- or evidence -- for why evil Liberals want old people dead. Soylent Green? peace, mjh

 
At 6:45 PM, August 21, 2009, Blogger wedum59 said...

Don't know how long Dr. J lived in Canada and Norway, but if he is still peddling the "death squad" lies, his credibility is shot with me.

Come on, pp 423-428 in HR 3200 are confusing for those of us that are not lawyers, but all that has been clarified (for those who will listen, see MT 13: 3--9).

AARP writes: "There is no provision of any piece of legislation that would promote euthanasia of any kind.

The rumors out there are flat out lies. Right now Medicare does not cover [pay for] counseling for end-of-life care. The portion of the bill in question would simply provide coverage for optional end-of-life consultations with doctors, so that the patient can be aware of all of the treatment options on the table. It is not mandatory and it has nothing to do with euthanasia."

Further clarification was in an excellent article I saw in the Washington Post by reporter Ben Evans, see http://www.washingtonpost.com/wp-dyn/content/article/2009/08/14/AR2009081401976.html?hpid=moreheadlines?hpid=sec-politics :

".... Just a year ago, Congress overwhelmingly approved legislation requiring doctors to discuss issues like living wills and advance directives with new Medicare enrollees. And the government already requires hospitals and nursing homes to help patients with those legal documents if they want support, under a 1992 law passed under Republican President George H.W. Bush. Supporters say the current House proposal just goes one step further by paying for the counseling, with the idea that doctors and patients would spend more time on it instead of just having a cursory discussion in an initial Medicare visit. The counseling is voluntary. .... The current bill specifies that the counseling would be covered [paid for] only every five years to prevent people from overusing it ...."

And finally, from Sara Robinson's 'Mythbusting Canadian Health Care' articles,
"One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb [which Kaiser Permanente has been caught on video doing to indigent patients]. In fact, they live longer, healthier, and more productive lives because they're getting a constant level of care that ensures small things get treated before they become big problems.
"The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren't working 60-hour weeks trying to hold onto a job that gives them insurance."

Seems to me that our Social Security system has the young taking care of the old. The proposed system in HR 3200 will require all those healthy uninsured young Americans to get health insurance and that will help pay for the old. So I don't see a "social justice" issue here at all.

 
At 6:55 PM, August 21, 2009, Blogger Thinker said...

Jesus preached social justice. Just sayin'.

 
At 6:59 PM, August 21, 2009, Blogger Stephen Jones said...

Once again Michael Swickard invites us into his fever-dreams.

In this particular inverted vision, conservatives are somehow the champions of the well being of old and young alike. The trouble is nothing could be further from the truth. Conservatives have fought against every program ever enagted to protect well being and health of the elderly and children against the raw cruelty of the unbridled market. Social Security and medicare, just to name two eaxamples, were passed over the shrieks of conservatives.

Conservatives still fight to abolish both programs. Has anyone ever heard of Newt Gingrich or Dick Armey? Ronald Reagan warned us not to pass Medicare, it would lead us down the primrose path to "socialism" he said. If medicare was passed into law, Reagan warned us in 1961, America's senior citizens would lose their choice of doctor and face government rationing. Sound familiar? Learn to play another note on the piano, already!

Reaching back further progressives enacted legislation abolishng child labor and passed laws mandating universal education and worked to fund public libraries. Conservatives fought against schools and libraries, warning us of the dangerous ideas they might spread. Abolishing child labor was an intrusion on the family, they said. State Universities? Conservatives opposed them. Municipal water standards, fire departments and pure food and drug regulation. They opposed that too.

I have a history background, but anyone who purports to know a little something about mathmatics would tell you to check your numbers. According to the CIA World Fact Book, life expectancy in Canada ranks 6th from the top and the United Kingdom comes in at 25th. The United States? We weigh in at number 50, way behind every other industrial nation and some not so industrial. It's just a hunch here, but considering the similarities in diet and lifestyle between us and Canadians, the difference in rank of #6 versus our #50 might have something to do with universal access to health care.

"Are there no prisons, are there no workhouses?" Conservatives have been shrieking for a century and a half, "Do you need health care, just go to theemergency room!"

Progressives applaud and encourage the free market, but when corporate bean counters overstep and begin rationing care to those too old, to young, or too weak to meet their preferred market demographic, we will support the right to life, liberty and pursuit of happiness of all Americans and demand reform!

 
At 7:51 PM, August 21, 2009, Blogger Bob Sanchez said...

I am deeply suspicious of those who use stock phrases like "socialized medicine" or "death panels" and pejoratives like "Obamaniacs." These words add zero to intelligent discussion and understanding. As for the phrase "social justice," what kind of perversion of language allows "justice" to be used as a negative? And since when is asking the young to help the old an injustice? I paid into the Social Security system for over 40 years and hope that people working today will do the same and eventually receive support in retirement. The social justice is not in minimizing taxes for the young; it's in allowing everyone a chance to live out their lives in dignity.

There is no earthly evidence that the current administration wants old people dead so they can save money. When we make claims about other people's actions or intentions, we should be prepared to cite verifiable facts.

Bob Sanchez
http://bobsanchez1.blogspot.com

 

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