Reframing The Health Care Debate

Last month, the Wall Street Journal published and editorial by Andrew Klavan entitled, "The Panel." It provided a hypothetical appeal to one of Wonderboy's planned 'death panels' by an older consumer for treatment he had been denied.

As a preamble to the piece, Klavan quoted the First Rookie in this passage,

"It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance."

Here's what is really curious about that quote. And how it omits the acknowledgment that such a statement necessarily involves reframing the debate about medical care in America from its historic perspective.

Why should "the country" be making any medical decisions through "the normal political channels?"

Only the polity, or the state, assumes to itself the right to determine health care decisions would such methods ever be contemplated.

This is why people don't want single-payer, government-provided health care. Only a single-entity payer would behave to minimize costs.

Each individual payer, left to sort out her or his own medical situation, would determine, with their insurer, what care made sense, on a number of dimensions. The patient might even elect to spend her or his own money, were their insurer not to cover some procedure, because they believed it was a reasonable decision.

We know that giving any governmental entity a sense of total power over health care spending will result in rationing, to manage total medical spending.

Individuals don't actually care about total US spending on health care. Why should they?

Do you know, or care, what total US advertising spending is? Or grocery spending?

How about spending on sporting event tickets, media and related goods?

If these are not subject to examination and caps, why should health care be so arbitrarily treated?

There is a bald-faced, incredibly arrogant assumption in Wonderboy's quote, which was provided in a New York Times interview. It is that any person or entity, besides a patient and the insurer with whom s/he has contracted to pay for certain medical expenses, has the interest in, or right to affect any decision regarding that person's medical care.

Let's be clear. The entire reframing of the health care debate by Wonderboy has been, as you'd expect from a lawyer, has been done without calling attention that it is a reframing. And that is very important.

Like all Socratic arguments, the devil is usually in the initial hypotheses and statements. Failure to carefully read, understand and debate them leaves one open to arguing on the opponent's terms. It is key to challenge every single contention in the debate, beginning with the first one.

And in this case, the first contention of Wonderboy's entire health care dream is that the state has any business whatsoever "making those decisions."

They do not. Individual health care decisions are for individuals to make, subject to their economic resources. And no one else, nor any other entity with whom they do not have a non-coercive contractual relationship pertaining to the medical expenses.