Health care – a complex issue

The provision of health care in contemporary society is almost as complex as the human body.  As the economy continues its decline health care will probably become an even more emotional and difficult issue.

There are three things that make health care complicated.  The consequences of poor health are generally pain and discomfort, a lot of us expect the government to take responsibility for our well-being and there are lots of other claims on scarce resources..

We all know that eventually we are going to die, but that does not stop most of us from trying to prolong life as much as possible, even if it means living in pain or as vegetables.   Some years ago The Economist stated in an article that 80 per cent of health care spending is in the last six months of life.  If this was true, if it is still true, then there is a lot of potential to reduce health care spending without sacrificing much human enjoyment of life.  But how is one to make the decisions to terminate health care. One has to note doctor assisted suicide is becoming more prevalent.

Medical  care is ideal for insurance although who should run it is open for debate.  We never know when we may face a medical crisis which could bankrupt us.  Sharing the risk makes a lot of sense.  A problem with most insurance schemes is some people have higher risks than others.  We all have to cope with the stresses of living and sometime the coping mechanisms are detrimental to our health and increase the risk we will need medical attention.  To what extent should we be responsible for other people’s lifestyle issues?  There may be no satisfactory answer to that question.  Maybe insurance should be for people with equal risks.  For example people who smoke could be in one insurance pool.  That sounds like a can of worms.

Some people believe governments are better at providing service than private businesses as they do not have the profit motive.  I disagree because there are no profits when one has a truly competitive market and because people in government have lots of other interests which override the interests of their customers – like staying in power.  I believe the best way for health care would be private coverage with lots of competition.  Governments can ensure everyone is covered by making it mandatory.

Health care is further complicated as it involves the allocation of resources.  Most of us make a variety of demands upon the resources available to us.  As well as health care we want education,  housing, defense, environmental protection, vacations, libraries, entertainment and cultural activities.  All of these compete for resources with help of powerful lobby/marketing groups.  As a lot of us expect government to help with some of these, governments have difficult decisions to make.  This writer would prefer most of these to be provided via competitive markets so that most of the decisions could be made by individuals.  A guaranteed income scheme would ensure everyone has the opportunity for the same standard of living as most other people.

Health care is a highly emotional issue which touches on human existence.  This writer tries to live a balanced life – some things which are good for my health and some things which are less good.  When my turn comes I hope I will be able to accept it gratefully.

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