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Is profit appropriate in health care?


While reevaluation of the profit motive in health care is appropriate, that does not portend a legitimacy for its abolition in other endeavors.

Perhaps this is  a time when believers in freemarket principles, me among them, should question the appropriateness of the profit motive in  health care. Some priorities in human activity are higher than others. Since Life precedes liberty and the  pursuit of happiness, we reason that the use of resources for preservation of life ( as through health care) outweighs the use of those same limited resources for other purposes. Life itself trumps profit.

But of course it's not really that simple. When talking about the three basic human rights (listed above), the public (constitutional) assurance of the numero uno--life--also includes something even more precious than notions of inherent liberty. In the minds of some townhall contrarians, an extension of that right to life  requires protection of life (23+23=46 chromosomes) from its inception. Maybe those disrupters are being manipulated, as Wendell Potter suggests, by the wizards of insurance, but they are nevertheless real people with real values, and not as stupid as you think. It is possible that every one of us is manipulated in ways we do not discern. 

Some of those angry people are looking for an assurance that their tax dollars will not be used for abortions. If you could spell that out for them in the proposed legislation, it would help them to accept the public option.  Let janedoe pay for her own procedure of choice.

This popular resistance to governmental planning is not just about the insurance industry secretly prodding the rabble to disrupt public meetings, although I'm being convinced that that probably is happening. (And I despise the rudeness.) There are, nevertheless, real philosophical issues at stake, and they are no less than: life, liberty, and the pursuit of happiness . We Americans are not just pawns in a game;  the human struggle for dignity arises from much more than just exploitation of the proletariat by some capitalist roader puppeteers who hide within their insured fortresses.
 
Pursuit of profit, while arguably not as noble as other human inclinations, is a subset of the "pursuit of happiness."  It therefore falls within the category of constitutionally protected activity. In the midst of reevaluation of a profit motive in the health care industry , freemarket advocates are not willing to sacrifice their endorsement of the profit motive as a legitimate basis for other endeavors. The profit motive seems to be enduring, in many quarters, a fundamental attack these days. This provokes knee-jerk-conservative reaction against the  "socialist" bogeyman.

 And it doesn't help matters that the HFT traders and default-swappers have absconded the public image of capitalism. The force of hyper-technologized greed--running roughshod through operation of perpetual-motion HFT money making machines--does not represent the face of true capitalism. This is very frustraing for advocates and practitioners of true capitalism.

That real face--that authentic representative of true capitalism--is found on the main streets and behind the storefronts of every town and hamlet and city in America. And some of those visages are found on insurance agents.

On the other side of the coin, neither is Kevorkian the face of the public option. So this is a case of public care advocates educating their fellow-citizens about the real issues involved, in order that we might collectively dispel the hysteria.

The sustained effort will require something like the persistent gradualism that Ted Kennedy epitomized.

Let's take care of the American people. Let's find a way to get everybody covered. But we need not extinguish the pursuit of profit while doing so. And surely we don't need to throw the baby out with the bath water. 

 

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No.

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throw the baby out with the bathwater

No just those requiring more care then our mighty profit margin will allow. Here ask disgusting Hypocrite Senator Tom Colburn:

http://www.youtube.com/watch?v=e3jwhLcW_c8&feature=player_embedded

Nonsensical Reagan talking points are more important then truth or compassion. These people just disgust me. Like her neighbors can help her train her husband to eat again, they're working hard to make ends meet too. Jesus all he has to do is advocate changing the law to force insurers to actually cover. They are smart they will find a way to keep making money. (see private insurers in France, Germany, Switzerland, Holland- all of which would cover this and all cost about half what we pay).

But no, Let her eat cake. Go beg your goddamn neighbor. You don't pay taxes to help the community. Beg bitch. I mean He's an ordained deacon for god's sake. Yeah Jesus would tell her to get stuffed too, gotta protect the profit motive, gov ain't the answer.

(p.s Sorry Carey, on quite a tear on your blogs lately- don't know why, nice work though.)

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Health insurance is different from auto or property insurance.

If you wreck your car, you can take other means of transportation. In the case of auto insurance, the company bets you won't wreck your car and earns a profit when you don't. That they earn that profit does not strike me as immoral since you have those other transportation options.

If a hurricane decimates your home, you can move in with relatives, pitch a tent, rent a room, etc. You have other options. The insurance company bets a catastrophe won't befall your home and earns a profit when it doesn't. Again, since you have other options, it's not altogether immoral for them to earn a profit when you're lucky.

HOWEVER, if your body fails you, you can't rent or borrow another one. It's all you have. For that reason, it is, in my view, patently immoral for insurance companies to enjoy profits when you're healthy and engineer ways to deny your claims to continue their profitability when you're not. Even if they paid the claims without question, the fact that they profit from your good health is wrong.

Auto insurance companies offer safe driver discounts. Homeowners insurance carriers offer discounts when you weather-proof your home and install smoke detectors. Health insurance companies offer no incentives that I'm aware of.

Rather, they do everything possible to avoid giving up profits, routinely forcing the sick and recovering to spend hours haggling on the phone and rifling through confounding paperwork to get a claim paid.

If people want to have health insurance through profit making entities, they should have that option. However, people who want coverage through non-profit entities should likewise have that option. That would satisfy both camps.

Thanks for the post, Carey.

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Thanks for your productive comment. Morality is important here, I believe. Although personally I don't mind a company profiting from my good health, because they assumed a risk in me.

It's the profiting on bad health that bothers me; it seems exploitive, maybe even cruel.

Your conclusion, addressed to satisfying "both camps," makes great sense to me. I'm just mystified that the insurance companies would feel so threatened by the public option, because affluent people will probably continue to enhance their coverage with private plans, like older folks now do with Medicare Advantage policies.

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Not sure what 'baby' you're talking about. If my insurance rates are to high on my vehicle, I can purchase a less expensive vehicle to insure. If I develop an expensive cancer to treat, I have nowhere to turn. Sure. Let them make a profit. A tightly regulated profit. Based on costs which the public sector controls/regulates as well.

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Miguelitoh2o, it seems if there were no profit in health insurance there would be lower premiums.

With universal care, in a for-profit system, premiums of people who earn too little to pay all or a portion of their premium would have to be subsidized by the government. Doesn't that mean the government ultimately subsidizes the insurance company's profits? That's not acceptable. I want taxpayer dollars out of corporate profits.

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I agree. The only way that is going to happen is with a single payer system. Barring that, if the insurance cos were truly competitive, and healthcare costs were regulated, either directly and/or through modifying payment from 'fee for service' to 'fee for outcome', they could potentially provide what would amount to a billing service for a reasonable price as opposed to the money giveaway we have now.

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Here's a good Q & A on healthcare in Japan, which has a tightly regulated healthcare market, and different payment incentives, and is not a single payer system, yet has the lowest healthcare costs of any OECD country as well as some of the best health outcomes.

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So, miguelitoh20, this "fee for outcome" sounds like an idea with real possibility for saving some money. Is it a part of the current proposal?

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To my knowledge, no it isn't. The presence of a strong public option, allowed to pay medicare rates, or minimally negotiate lower rates will be a key to instituting these kinds of structural changes in our healthcare delivery system. I believe this in tandem with IT protocols for treatment, and standardization of billing procedures will be round two, (or three), of healthcare reform in the US.

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