3.23.10-RE Facebookers: Healthcare Reform in America

I am a student of healthcare. I have studied the fundamentals of medicine and of global health, I hope to study at medical school the practice of medicine, and I am working on a life dedicated to health and healthcare. Those are my humble credentials. Take it or leave it.

That said, my blood has been boiling since Sunday night, for reasons very different, perhaps, than your own. Part of this comes from some of the blatant lies and false information spread by the media. Mostly, however, it is due to the reaction of so many of my peers over the healthcare reform signed today by President Obama. (In this regard, Facebook is a most dangerous platform for political argument, and makes even the smartest, nicest, most open-minded people look like complete dirt bags and selfish morons--on BOTH sides of the argument.)

Now I want to start with validating some of the arguments I’ve heard against the reform, adding some of my own issues about it:

Yes, it is expensive, at a time when we don’t have a lot of money floating around (that isn’t borrowed!).
Yes, it was a break from President Obama’s promise of bipartisanship.
Yes, I am confident that there were backroom deals.
Yes, it is imperfect. Very imperfect, as far as the actual reform goes.
Yes, it does mean bigger government.
Yes, some people will freeload off this, and you will have to pay for it.
Yes, some people will have to pay more, and never receive any ‘benefits’ from it.

Yes, I hear all of that, and agree. But I don’t sympathize with your comments on how it screws the healthcare system, how it screws the American people, or how it takes away our freedom. I don’t understand your tears of sorrow. I don’t sympathize with your selfish sentiments on how it is going to screw you. Oh, and I DON’T think you should run for office. (Sorry, I am trying to avoid sarcasm as much as I can, but really? Why do you think you’re so smart? This one gets old real quick.)

At the risk of doing the same (thinking I am so smart), here are some of my developing opinions. Here are some of the reasons why THIS healthcare reform is good, and right, and necessary—now.

1. Because the system is very broken. It is ineffective, it is expensive. It is corrupt, it is unfair, and it is burdened. (All agreed, say “I”)
2. Because, however burdened and broken the system is NOW, it will only get a lot worse. We will have a rise in the number of elderly, like never before seen. My generation, which probably won’t make as much as my parents’, will try and care for this large population. If our system is broken now, it will be obliterated then if we don’t act. I think most people can agree on that, too.
3. Republicans cannot fix this issue. They are broken, they are divided, and they simply will not take the initiative. McCain joined in late on the healthcare debate, copy-catting Obama (a fine example of leadership) in the presidential election. Republican tightwads don’t believe in big government reform, and they don’t believe in big government spending. So, how are we going to get big healthcare reform from a party with Sarah Palin vowing for leadership, that sympathizes with tea party radicalism and has no soul? (Every republican, please fill in the missing answer).
Now, I don’t mean to bash Republicans too far. Most of my friends are Republicans, my parents are, and I sympathize with much of their thinking. But they truly became ‘the part of no’. And that is not reform.
4. Because it is a step forward. Everyone can agree the reform is imperfect. That does not mean it is better than nothing.
5. Because now that an imperfect reform is in place, Republicans in future office will hopefully improve it, make it fiscally more responsible, and socially more appropriate. No piece of legislation was perfect on the first attempt, not the Constitution, not anything to my knowledge. So what—the reform has started, now let’s improve upon it. Trying to kill the bill (still) may be political suicide for Mitt Romney, and it certainly seems like a step backwards. If you do kill it, do you really think you will be elected in 3 years and then reform the system? Yeah, right.

This healthcare reform is also good because:

6. Someday you just may need it, and benefit from it. Yes, you. I hope not, but if so, how will your uncompromising, unforgiving attitude towards this piece of ‘socialistic’ legislation hold up when you get a $12,000 bill from the hospital and you are below the poverty line, but actually have insurance!?
7. Giving health and life to the uninsured is a lease on life, with great economic dividends! Thank you Adam Smith for your first (less famous) writing entitled Theory of Moral Sentiments, which spells out how beneficence is part of the capitalist equation. I am finishing this book up, and I feel I have so much the advantage on those who have only read Wealth of Nations. Any great individual is a product of environment (Malcolm Gladwell, right?). Why do we assume that this money will be ‘wasted’ on the poor, and that it won’t promote opportunity and enterprise?
8. The poor, sick, uninsured, are not necessarily the lazy, handout taking, irresponsible. That’s just unfair. YOU know someone that is uninsured, for one reason or another. Try your sarcastic arguments on them. I saw this on Facebook a couple days ago, when someone who spoke out against healthcare reform obnoxiously was quickly curbed by one of his friends, who needs it. That must have been embarrassing for both parties involved.
Taking away their opportunity for health? That is going to end up coming out of your pocket in the long run if you don’t take care of them now. I don’t sympathize with this argument at all. I know that some are lazy, irresponsible, handout-takers. Of course there are. I don’t think that is uniformly or uniquely a trait of the poor, though! Even if it is, in some respect, it’s a creature of habit, not of nature.
9. Government is for the people--all the people. We kill the American dream when we refuse to allow people healthcare that really want and need it, and will be so productive and useful and industrious if and when they have it. For those 15-30 million that might benefit from this reform, I doubt they would say that their ‘freedom’ is being robbed from them.
10. We elected this presidency. This is what they vowed to do, and they did it (there’s a surprise, no sarcasm intended!). You may disagree with it, but ‘the people’ elected them. You cannot say that it was a loss for the American people. Take responsibility: we voted these people into office, as a nation.
11. Avoiding a decision and beating down imperfect legislation is more dangerous than starting a solution. That’s what I think we are doing with this reform—starting a solution. We are already behind the ball to fix it, and if we were to wait four or eight years until a better president that could somehow create bipartisanship, we would just have wasted so many years of potential progress, and would have continued in a downward spiral.
12. The money will not fund abortion. Thank you, Bart Stupak, among others. I don’t think Fox News has reported this fact yet…
13. Our doctors, as a collective, support it (see AMA statement on healthcare reform, as of yesterday). It doesn’t ruin their system. In the end, the coverage and spotlight on their profession has potential to make their lives so much better.

Finally, two personal thoughts on the morality of healthcare as a human right.

14. We shouldn’t discriminate based on health. Plain and simple. Health may or may not be a human right, but it is certainly a human privilege, and certainly an aspiration of any just and good government (big or small!).
14. We are all children of God, and maybe that is the only respect in which we are equal in this life. I’ve been thinking lately about a speech given in the Scriptures by a King Benjamin, who taught about how all of us are beggars before God, and how we should not judge the merit of the petitioner (Mosiah 4:7-19 in the Book of Mormon). It’s an incredible speech. I am certain that some of you are familiar with it, and I have no intention of ‘playing the religion’ card on anyone. I am certainly no philosopher, great thinker, or religious source. But this is part of my equation for why healthcare, and why this healthcare reform, is good. Christ clearly gave life to the sick, the dying, the defeated, and the emotionally/mentally ill. He didn’t make them pay. He didn’t ask them if they were going to take advantage of him.

I am excited, as a future physician, by the opportunity to help lift others out of sickness, to be a part of their healing. Health is vitality and life—the base of a long and prosperous existence. In this respect, differentiating between the poor and the rich, the insured and the uninsured, the lazy and the quick, seems unimportant. Let them live their lives! I look forward to a system that can hopefully do that better.

I know I’ve missed the point here on at least several levels, as I am sure you are quick to point out. The reform may seem unconstitutional, on some level, or it may make you queasy about your wallet. You may not like giving to poor people because maybe you see some buy booze with it, and thus you feel you are merely supporting an addiction. I’m sure your arguments have validity.

But overall, this reform is a step in the right direction, for America as a people. As the richest nation in the world, we currently spend the most on healthcare, but are not in the top 15 countries as far as care goes. Today we start climbing those ropes toward a healthier, more prosperous future.

I know this is a very imperfect reform, and that many fear the consequences of it. This whole thing reminds me a little of the war in Iraq—of our ‘good intentions’, our lofty ideals, and our hasty move forward. With my tail between my legs, I admit that I voted for Bush, and that I originally supported the war. Ignorance played a part of that. But so did execution. In the end, putting healthcare reform into action, and seeing how it comes to life, will dictate the efficacy of the reform, and really determine how well this argument I’ve made plays out. I hope I am not like one alternative music artist, who wrote a song about how “I believe in this war because the cause is good…We don’t fight ‘cuz we have to but because we should.” Looking back on the aftermath, he probably kicks himself for writing that.

Motives alone are not worthy of our approbation—we care about actions. Unlike the war in Iraq, healthcare is a different kind of battle, with the potential for radically different results: less lives lost, less costs long-term, and less danger (sickness, illness, death among others) to our people. I am satisfied that the reform legislation passed, and hopefully await its successful implementation.



I recognize that I don’t understand your argument as well as you do, and probably missed so many points of view. I would appreciate your insights, criticisms, thoughts, and ideas, either via email at markmiller21@gmail.com, or by way of comments.