Humanism and Health Care

August 25, 2009

Is there a humanist position on health care?

Yes and no. (Don't you just love lawyers' responses?)

As my colleague Reba Boyd Wooden points out in her perceptive blog post (see entry for August 19), humanism does not embrace any particular economic doctine or political ideology. Provided basic human rights are respected, humanism is compatible with a market economy with minimal regulation, a market economy with significant regulation, a mixed economy (that is, one with a private sector but also a significant public sector) or even socialism. Humanism, per se, simply does not dictate how large a role the government should play in regulating economic activities. Humanism's compatibility with a wide range of economic and political positions makes it impossible to say that all humanists are obliged by their principles to adopt a specific position in the current health care debate raging in the U.S. I do not see how anyone could logically claim that humanism entails support for a single payer system, or a system that combines public and private options, or some modification of the current employer-based system of health insurance. 

However, that does not imply that humanists have nothing to contribute to the health care debate. It seems to me some form of universal health care should be supported by humanists. Note that I intentionally use the hedge words "some form" because I do not believe that providing the exact same level of health care to all is mandated by humanist principles -- no more than providing the exact same level of housing to all is mandated by humanist principles. What humanists should support is some sort of system that ensures everyone receives at least a decent minimum of health care, just as everyone has a right to basic housing and a basic education.

Those humanists who are libertarians may disagree, but I believe this position is justified both by empirical evidence and humanist values and principles.  With respect to empirical evidence, a number of studies indicate that early treatment of health issues prevents more costly problems later.  As we ultimately bear the costs of others' serious health problems, at least indirectly, reducing the frequency of these serious health problems is in our own self-interest. 

 But we can and should go beyond conclusions that can be drawn from empirical studies.  Humanists do not share a detailed moral code, but we do have a commitment to certain core values.  Among those is a commitment to the dignity of each individual and, insofar as possible, a commitment to ensuring that everyone can participate and pursue similar opportunities in the life of the community.  What those commitments imply will change with our social conditions.  In 1700 it would have been difficult to make the case that everyone had a right to a basic education or a right to basic health care.  In contemporary Western democracies, however, access to certain social goods, such as education, housing, and health care, is essential. 

People often contrast compassion with reason.  But sometimes a position is supported by both compassion and reason.  I believe that ensuring a basic level of health care for everyone is such a position. 

Comments:

#1 Jeremy (Guest) on Wednesday August 26, 2009 at 6:01am

I disagree, but no surprise, since I’m a libertarian.  First, my problem is the straw man created by implying that being against a public option is being against everyone having adequate medical insurance.  Unfortunately, the media has largely encouraged this false dichotomy: either you are for a mandated minimal care level or you hate poor people.  That’s just silly.  The issue is how.  Should an inefficient, large-scale government program be issued?  Judging from the track record of Medicare and Medicaid, I’m not really optimistic that such a solution would work.  I’m actually kind of surprised that the government would consider expanding these programs.  And regardless of the White House might say, these are expansions.  At least, that is the goal since the majority of rhetoric is aimed on people who cannot afford insurance.  But that’s the problem isn’t it?  Medicare and medicaid are so inefficient and awful, that the government has to justify this by providing a public option.  I wish this were just a weasel word for expansion of Medicare/Medicaid.  But unfortunately, any public option would drive any private insurers out because (a) the government is not limited by a need for profit and efficacy (it just drive up debt), (b) it can mandate what care under their program costs, and (c) it can mandate what other insurers (and exclude themselves) must cover.  Of course, given these factors, it’s hard to imagine a public option actually being fair competition with the private sector.  It’s not and it will resort in a government monopoly on health care.  Once that happens, taxes have to go up or rationing start since Americans have no where to go and the government does not pay enough to make it worthy for the skilled people to go into medicine (hell, that’s why I’m an engineer and not in medicine despite my dad, mom, uncles, and aunts all being doctors, nurses, and radiologists).  And yes, those taxes will hit the middle worst.

#2 Randy on Wednesday August 26, 2009 at 7:58am

My view is that since most of us are born into a society that we don’t choose, and one that makes it close to impossible to actually live off the land on our own, society owes us something in return for our forced involvement in it.  Health care is not an unreasonable thing to expect in this situation.  Also, when we’re all healthy, we tend to all stay healthy, because there isn’t a permanent “diseased class” circulating among us.

As far as how you provide health care, there are a few different models ranging from public health insurance (like the Canadian system or Medicare) or public health care (like the UK system or the VA).  I don’t think the particular implementation is important, except that individuals must be able to at least have access to government health insurance.

I’m no economist, but regarding the public health insurance option, I would say that it is an essential part of any health care reform.  Without it, private insurers will simply blame reform for ratcheting up prices, people will complain to their representatives about it, and it will all come undone.  The public option provides much-needed competition to the health care oligopoly.  It will take the costly cases out of the private system, which should lower costs for customers of private insurance, increasing their profits.  If the public insurance is still able to be competitive with that burden, private insurers will have to stop feasting off the continued illnesses of the nation, and start delivering actual health care at reasonable prices, or risk losing customers.  If private insurers fail, it will only be because customers CHOOSE the public option because it works better for them.  If government health insurance is as incompetent as certain people claim, it’s hard to see people switching to it.  There’s not really a good argument against public health insurance that I’ve heard.

Ask most people who have public health insurance or public health care whether they would give that up for the current US system of privately-funded health care.  I think you’ll find the answer is overwhelmingly in favour of keeping their government-funded coverage.  No system is perfect, but we do know which ones provide healthier outcomes for the money.

#3 Ronald A. Lindsay on Wednesday August 26, 2009 at 10:13am

Both Jeremy and Randy make some good points. I think this type of discussion illustrates humanism in action:  a rational, factually supported, respectful exchange of views.
Let me clarify one thing in light of Jeremy’s comments. In my post I intentionally stayed clear of endorsing a public option, if by public option one means government-run health care. Government can mandate a basic level of health care for all whle allowing private companies to administer the care. Something like this is done in the housing sector. Since the 1930’s, the federal government has subsidized housing for millions. Under the so-called Section 8 program, the housing is provided by private apartment complexes, with the government paying a portion of the rent. The amount of the subsidy varies depending on the tenant’s income. Are these apartments palaces? No, but they do take care of basic housing needs.
I am not saying we should not have a public option, but I am also not saying we should. Frankly, I am undecided about that myself. And, in any event, I do not believe adherence to humanism requires one to take a particular side in that debate.
Two other quick points: I am familar with the argument that a public option will eventually work to eliminate private insurers. I can’t say that prediction is without any economic fiundation, but I do believe our experience shows such an eventuality is not necessarily inevitable. The quasi-governmental monopoly in mail service did not eliminate private couriers or UPS or FedEx. Heck, even the government’s near monopoly on lawful deadly force and trained combatants has not prevented the flourishing of private security companies such as Blackwater (now known as Xe or something like that)that are used by the government itself to replace our armed forces in certain situations.
My last point goes to the affordability of health care, something that as rational individuals we cannot overlook. There may be some proposals that we simply cannot afford. In this regard, I believe the comparison often made between the U.S. and other Western democracies that have universal health care and/or public health care is misleading and unfair. Because we are the most powerful democracy in the world, and because other countries look to us for protection, we have special commitments and incur far higher defense costs, percentage-wise, than these other countries (unless you count Israel as a Western democracy). We spend about 4% of GDP on defense. Britain spends about 2.5%; Germany and Sweden about 1.5%. Even if we raise taxes, we may not have sufficient funds to adopt the same type of health care system found in some other countries.

#4 gray1 on Wednesday August 26, 2009 at 3:03pm

I’m not familiar with how things work in other States, but the State of Louisiana has long operated a statewide healthcare system which is free of cost to those unable to pay and offers a graduated scale of fees to those who might be somewhat more able to pay but still fall short of being able to afford the corporate hospitals and doctors, etc.  Would this already working “free” system be supplanted by the proposed federal takeover of medical services?  This would amount to total unnecessary nonsense and must be viewed as a pure power play for the people currently in charge to see that they remain in charge of an ever increasing “say so” in the lives of average Americans.

If the existing “charity” hospital system which works with the LSU School of Medicine in Louisiana might be criticized, it would be for some lines and waiting for service which has already been predicted in spades for any federal system which would also create a new enormous administrative load on the taxpayers before any services at all become evident.  And yet the news is strangely silent on such “free” healthcare which already exists in the U.S.A.  So who’s pushing what agenda here?

Why fix something that isn’t broken?  Does this boil down to some ideology that the existing State “charity” system somehow isn’t “good enough” for those of us in Louisiana who either have in the past or currently benefit from free medical care? I have used that already working system in the past and have friends and family who have as well for some major operations, regular medications and care and I dare say that what we currently have available to those who really need it is a lot better than what might well replace it!  Strangely enough, I didn’t feel embarassed to be receiving free care, just grateful.

#5 Jerry Schwarz on Sunday August 30, 2009 at 11:37am

For the record,  I’m a strong supporter of heath care reform and of the principal health care should be a right of all citizens.  Politically I am a liberal without much sympathy for the libertarian position.  So personally I agree with most of the blog entry.

I don’t identify myself as a humanist so I won’t express an opinion on what it implies about health care.  But I am bothered by the possibility that CFI might take a position on this issue which I think it is basically political and economic..  For me CFI is about reason and opposing irationality.  There is a lot of work to be done there without becoming a political organization.

#6 Vaginal Herpes (Guest) on Friday September 18, 2009 at 1:44pm

People were encouraged to think beyond their own world..It helped society in that man was thought more of a good person instead of just a person who will always sin,so unless he received the sacraments from the Church,he was destined to go to hell..Vaginal Herpes

#7 Resveratol (Guest) on Saturday September 19, 2009 at 2:52pm

Hi,
  The health professions can pay high salaries, and there is nothing wrong with considering compensation levels when you’re exploring the career of your dreams.  However, the best health professionals are those who feel it’s not about the money. 

              Thank you…

Resveratol

#8 Vitamins Supplements (Guest) on Tuesday September 22, 2009 at 11:16pm

Hi,
At we ultimately bear the costs of others serious health problems, at least indirectly, reducing the frequency of these serious health problems is in our own selfinterest.
  Thanks…

Vitamins Supplements

#9 gray1 on Wednesday September 23, 2009 at 9:05am

Just cull the “problems”? - Yet another benefit (besides the tax money) from the widespread legal use of tobacco, alcohol and caffeine.  Is this a Mormon conspiracy or what?

I personally suspect that caffeine and excessive refined sugar is responsible for the majority of mental problems in this country, particularly as seen in children.  Some education might be in order except that some pharmaceutical companies and doctors are fat and happy the way it is.

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