by HowardLake
Those pushing the need for health care reform spend a lot of time talking about the uninsured and the many unfortunate people who cannot or will not afford to pay for health care. (Mostly they talk about the “cannot pay” people except when they are proposing to have individual mandates, then they start talking about “freeloaders” who don’t get insurance even though they can afford it.) These people claim that health care is a right and (although they don’t use the word) they are proposing that the government can and should provide charity care for those in the “cannot pay” camp. The only problem is that government has been trying to do that for a long time through medicaid and medicare. The fact is that government cannot provide charity care – government can only take from those it chooses to burden and give to those it chooses to help. This warps the system even when it is meant to level the playing field.
In health care, the government must either take money through taxes, fees, and penalties, or else it must demand that health care providers go uncompensated. Neither of those situations equals charity. Charity is the voluntary donation of goods and services for the benefit of others. Anyone may donate money, time, or equipment that are theirs to give. Additionally, doctors may donate expertise that is theirs to give. The resources thus donated are given freely for the benefit of those who need what is given – to the limit of those resources – without the warping influence of force. Thus charity is able to make the playing field more level without warping the system.
Many who favor true free-market health care argue that if government would step back society would pick up the slack with charity care that is more efficient. I have heard some who are dependent on government assistance with extreme medical bills – the kind that are not the fault of any person – who respond that if they felt they could depend on charity care to pick up the slack for their enormous costs they would be happy so see government step back, but they are doubtful.
[quote]It may sound callous of me, but I will not argue that charity care will pick up all the slack if government steps back – I only contend that government is incapable, by its very nature, of providing charity care because government can only operate through force of one kind or another. I also argue that the only way to successfully meet all the needs of the hungry, naked, sick, and afflicted, is through real charity.
There are no guarantees that there will be sufficient charity offered to meet all needs. Two things are guaranteed – first, that if the amount of charity given is less than the need it indicates a problem in society; second, that such a problem, when it exists, cannot be solved through the powers of government. Where society is broken such that charity is insufficient to meet demand government can only do those things which are the proper role of government – specifically by ensuring justice for all by prosecuting fraud and abuse. If government oversteps its proper role it may aggravate the underlying social problem, but it cannot fix it.
Great post. The whole point of charity is voluntarily helping others with our own resources. Government HAS no resources of its own (which is probably news to many people in & out of government), and there are no warm fuzzies for being generous with *other people’s* resources…
Having no resources of its own is precisely why government is incapable of giving charity. The only real thing that government has independent of the population at large is a microphone. There is nothing wrong with government encouraging people to be charitable, but they can;t force it.
I do have to disagree with you on one thing – I’m sure that there are warm fuzzies from being generous with other people’s resources. On the other hand, there is no virtue in being generous with other people’s resources.
Take government out of the equation of providing social services altogether. Government also has limited resources to allocate, but government does not allocate those resources rationally or logically, nor do they do it efficiently–in fact, government is probably the single most inefficient resource allocater. In order to do this, the tax code should be changed to allow 100% charitable contribution credit (not just a deduction). The “People” would then allocate their resources to those charities that would provide appropriate social services, healthcare, education, and all the other things that government has targeted. In all cases, political ideological issues would be mitigated as conservatives and liberals, reds and blues, republicans and democrats, etc. would allocate to their social service of choice. Leave the decision to all the “People”. I recognize governemnt will never allow this infringement on their collective “right” to do this, nor will they ever allow us to make such decisions with “their” tax dollars.
Government has no financial resources of their own – not just limited amounts.
Because government has legitimate functions to perform (common defense being a prime example) I fear that a 100% tax credit for charitable contributions could lead to serious problems as functions that are the legitimate role of government go unfunded due to minimal charitable contributions. Imagine if $2000 in charitable contributions eliminated all my tax liability rather than just reducing my taxable income by $2000. That sounds to me like a system begging for people to take advantage of it. (On the other hand, I don’t think that we should have an income tax to begin with.)
I agree to your points: government has no financial resources of their own (but don’t tell that to Congress of the Executive as they all think it is their land and their money), and, government does have legitimate purposes for which we, as citizens, have a moral obligation to provide funding: justice, domestic tranquility, the common defense, the general welfare and the blessings of liberty. I also concede up front that my proposal has significant potential for abuse. Nonetheless, the underlying points are: (1) citizens, in their local communities and states, would be much more apt to allocate those limited resources appropriately, and (2) somewhere between the extreme of my concept and the current state of government-allocated social program expenditures is a better answer.
This discussion however deviates from your original post on charity provided by the government. There are and always will be situations that require people to help others in difficult situations. It is oxymoronic to speak of mandated charity. Government programs have been thrust upon us because citizens in local communities did not step up and take care of people who legitimately needed care. Unfortunately, those programs grew and created individuals who are now either dependent on the state for survival out of their own greed or because they don’t know how to survive without assistance. If we want the government out of these programs, then we, as citizens, must step up and take care of are fellow citizens ourselves. That will require a titanic paradigm shift among the citizens; but, if we don’t, we will be destroyed by such things as ObamaCare.
There is no right to healtcare, although the rhetoric sounds quite appealing. There is, however, the right to be able to purchase healthcare and medical treatment and nobody should be denied this right. A problem with the current cacophony on healthcare reform is the supposed need to lower costs. If we are going to have the best healthcare in the world, then it will, and should, cost money. However, because of the way insurance has become etched in our culture over the past 60 years, most Americans really do not understand the underlying economic transaction to purchase health and medical treatment. Those who have insurance believe it is a plan that covers all things and thus they take no thought nor responsibility of the economics of the underlying transaction to purchase treatment. Insurance is really nothing more than the mechanism to spread the risk of the cost we could never pay individually over a group. But this has been forgotten, and the healthcare debate buys into this concept–that is, everyone should be in a position to just pay something and have it all taken care of by the “insurance” company. If people were moved back into the reality of and into the middle of the transaction of purchasing health and medical treatment as a service–not dissimilar to paying for legal or other professional advice–then costs would go down. Insurance could still be there, but would be for the catastrophic event that we could collectively absorb. Once again, the people need to become involved rather than abdicating the issue to another–be it the government or the insurance company. My argument has some holes in it because there are times when people, by the nature of the disease or injury, are not capable to make a “purchasing” decision. Moreover, health and medical treatment can be incredibly complex and is not like getting an accountant to prepare a tax return. I do believe that in a significant majority of the health and medical treatment transactions, patient involvement at the time of purchase would drive down costs and ensure better overall results.
AMEN! The idea that we can or should artificially drive down costs through some government involvement is misplaced. Costs will be reduced organically if people begin taking the costs into account as they make their day-to-day health care decisions. As a general rule, if we cannot afford a health care choice without insurance (speaking of the standard care such as regular checkups, minor illnesses and injuries, etc.) then we should not expect to afford them with insurance.
As for where we should be between your proposal and the current reality – we should definitely be much closer to what you proposed than to what we currently endure.
Fantastic discussion. I must disagree with Scott Miller on one point. He writes, “Government programs have been thrust upon us because citizens in local communities did not step up and take care of people who legitimately needed care.”
While there were certainly tragic cases, they were never as broad based as claimed by the promoters of the various centralized ‘charity’ schemes. Nor did the schemes achieve a better situation than was had prior to their implementation, when all factors are considered. Some have been better taken care of, while others have not. Ostensibly, those that have been negatively impacted are invisible to the political class. They are the forgotten Americans.
In reality, each and every government ‘charity’ scheme was pursued so as to increase state control over the lives of individuals. The fact that these programs could be sold as a way to help the less fortunate was simply a marketing feature. This may seem cynical, but I believe it to be the most accurate representation of the truth.
There are those that honestly believe that centralizing control will achieve a more utopian society. They may be sincere, but they are woefully misguided, and they are not benign. Then there are those that are simply avaricious and have an unquenchable thirst for accumulating power. They are evil. It requires a coalition of misdirected idealists, evil power gluttons, and sufficient gullible citizens to achieve each new piece of centralized power. That is the only way government ‘charity’ systems develop.
To Reach Upward-We may be actually discussing opposite sides of the same coin, but it is still the same coin. My main argument is that government programs have been put in place because the Anointed think they know better, and the local citizens have either not taken the responsibility to care for their own, or the local citizens have been overwhelmed by federal and state designation as to who needs to be cared for. Thus, local involvement is imperative; otherwise, the Anointed from their perches in Washington, D.C. will impose their will on ours.
As you point out, government programs are the creation of those individuals who believe that government is the best solution to solving any of society’s woes–and as you so elegantly stated, some of these individuals are, well, simply evil!
Point 1: a community is much better at taking care of it’s own citizens–the Forgotten Americans–who, for whatever reason, cannot fully participate in society. These include those who have challenges (I don’t dare say handicaps or disabilities) and need the assistance whether it be with learning disabilities, the elderly, those who are suffering from other conditions that may temporarally get in the way of their full participation in society. Reaching out to these Forgotten Americans is a moral obligations of the rest of society. But this sort of “charity” does not go to those who lack the motivation or inclination to face life’s challenges when they clearly have the capacity–if they so choose to use it–to overcome those obstacles. That is not a community issue, that is an individual moral obligation.
Point 2: Without local community involvement, the Federal government, led by the Anointed, will always seek to interject their “reality” into the situation and dictate the ends and the means of their noble “charity”. If we citizens become more involved, we have a better chance of fighting off the invading hordes of federal regulators. Thus it is our responsibility to reach out and help others, to reach down and pull others up. And in agreement with you, the number of those people who do need help are significantly smaller than the Anointed would statistically claim. In short, and if I dare to be so blunt, some people need to get off the couch, quit complaining about all the reasons they cannot do something, and take responsibility for their own life!
Point 3: The market system is the best method to do this. If there is a need, someone will find a way to serve that need. Furthermore, I believe that many–as you say honest and sincere people–will continue to identify those individuals who legitimately need help. And if someone makes a profit doing such things, so be it. Americans are a collective group of people who will take care of their own. Look at our country and see all the wonderful things that people do, in spite of government intervention. Look at hospitals, doctors, nurses, researchers, and yes, even drug companies, who have created a healthcare system second to none in the world. Look at businesses whose employees have organized and participate in programs to help the elderly and the youth in the inner cities. Reflect upon all our teachers in grade school, remember the sacrifices of those young men and women on the shores of France and other places. The private sector works because Americans work. It may not be perfect, and there will always be those who try to exploit that goodness.
Point 4: Remember how much the Founding Fathers warned us of the danger our large and unchecked governments. I can only imagine John Adams, Thomas Jefferson, James Madison, and others weeping as they look down and see the threats on liberty being made by the collection of the Evil Anointed in the land today.
At the risk of over-simplification of the root problem, I conclude that the the collection of our current leaders, at all levels of government and in corporate boardrooms as well, are seeking their own individual glory by stealing and outlawing our collective individual agency to choose the course of our lives.
I was in the mountains over the weekend and couldn’t respond earlier. Indeed, I’d say we have achieved a meeting of minds on this matter. Thanks for expressing your views so well.
The thing that saddens me the most about our current situation is that voters, in large measure, have either bought into the views expressed by government and corporate leaders or else abdicated their responsibility to be discerning about who they choose as leaders and who they support in business. Those who seek to curtail individual agency only succeed as far as society allows.
Politicians and political observers have known for millennia that co-opting the masses is a relatively easy chore, especially when security is promised. Co-opting the opposition is much more difficult. A vocal opposition requires those at the margins of the masses to actually give some serious thought to the issue at stake. This can slow the progress of usurpation of individual liberty; although, history suggests that it rarely halts that progression until the public gets fed up with all of the byproducts of state sponsored security.
Those that seek to expand power over others know that to achieve their fondest goals, they must silence the opposition. The more that power is centralized, the easier it becomes for them to do that. But it eventually requires rather ruthless measures.
In some ways the real question that we have to ask ourselves (as a society) is whether the time has come when we are fed up with the current level of usurpation and ready to no longer be silenced.
We often hear conservative and libertarian types making allusions and comparisons with the American Revolution. Some people argue that things are worse now than they were then or that the colonists at the time were rebelling over measures that were too mild to warrant their actions. What we should probably realize is that how severe the reaction is depends more on the mood of the opposition than on the actual offenses against them.
The question we should be asking ourselves is not – “are the offenses severe enough to warrant a change”, but rather “am I ready to stand against today’s offenses against my liberty?” The fact is that there is always some usurpation of liberty to be found – the question is if we are willing (not simply if we are able) to live with it.