Health Care Reform: Philosophical and Other Observations
Central to any meaningful reform regardless of the object being reformed is an establishment of an intellectual foundation, which gives meaning, context and a roadmap to guide its development. The tendency to disregard the role foundation plays in politics and instead substitute opportunistic slogans and soundbites goes a long ways towards explaining the dysfunction of American politics. Nowhere is this more apparent than in the debate over health care, which crystallized during last year’s presidential campaign with the popularity of Bernie Sanders.
Fascism drawing many of its ideological tenets from thinkers on the left and the right may at times have ideas with a surface resemblance to its liberal counterparts, while sharing the patriotism and values of the right. Unfortunately, neither left nor right are able to break out of an ideological box first constructed in the 17th century, which aims to liberate man from any social or religious attachments. An ideological box, which cannot address the problems of the 21st century.
One of the consequences of enlightenment thought is the idea of human rights. The belief that because someone is born a human he is therefore endowed with certain inalienable rights, which cannot be abrogated, with governments existing solely to protect. The evolution of this idea has led us to a point, which would most likely be inconceivable to those that first created it. Anything resembling a human need or want has now come under the cover of being a human right, and once instituted as such becomes almost impossible to eliminate or change, becoming a permanent part of the social fabric. The problem with rights is that there is no sound foundation for their existence. Their promoters justify their existence through an abstract mind game which ignores any kind of context which surrounds man, while others use God and the bible as justification ignoring the fact that nowhere are “rights” mentioned in the book, conveniently ignoring though its emphasis on duty and obligation. Rights as theoretical constructs have consequences, and as any observer of the contemporary west can see, their effects, the selfishness, the mental illness epidemics and the overall decay of society, those effects have not been good.
This leads us back to the issue of health care. Amongst liberals and conservatives, the idea of the health care debate being about rights has taken center stage, with the left advocating its universal implementation as a fundamental human right and Conservatives countering that its enforcement would restrict the rights of individuals and doctors to manage their own care. Our position has always been to support Universal coverage not as a human right, but as a social obligation and just good public policy. Establishing coverage as a human right opens a Pandora’s Box, which would cause innumerable problems, leading to an open-ended number of conditions and disorders, which would gain a status of normalcy. This is seen with the normalizing of mental conditions such as transgenderism, and hormone treatments being offered to minors. If there is one thing that modern society has shown us, is the connection between an issue such as health and the social context, which surrounds it. Even the best doctors and the most efficient delivery systems are meaningless if the social context creates incentives, which lead to drug addiction, diabetes, and altogether unhealthy lifestyles. This is where the danger of a rights centered approach comes in. Rights require nothing; ask nothing of those receiving them. Their mental acquisition by individual’s leads to selfishness and disregard for others. Rights have a tendency to exist for themselves. Speech is no longer valued for its content but for its own sake as the exercise of a fundamental right. The act of getting an abortion is not judged by its effects but of the act itself as the fulfillment of a right. In a society where neighbors live so close to each other that they can listen into each other’s conversation; the idea of their being separate spheres of a private and public character no longer apply. The neighbor with a drug addiction is no longer the problem of his family but becomes a problem for the community, which must be addressed.
By framing health care as a duty to fulfill by both society and the individual, the first stage can begin to be addressed. Instead of justifying a lifestyle by its connection to a so called right a society built upon duties and obligations would be structured so as to cause the individual to think more about his obligations to society and the effects of his actions on others. Drug addiction and obesity from the standpoint of the individual would no longer be viewed as detrimental to himself but the harm he causes by his actions to family, and community.
All of this begs the question, how does this spiritual transformation of the populace translate over into the field of health care. If the current system is maintained and the costs keep rising relative to wages then the current predicament that many people have between having quality coverage and staying financially solvent will continue to get worse and spread to more and more people. Getting sick should not cause someone to go into bankruptcy. The very fact that often times it does works to devalue the Nation as a reality.
The debate over costs too often is framed within a strict construct, which fails to veer outside of the present system, and relies upon an empirical analysis of outlays, which fail to address the root problem. To arbitrarily reduce services, cut payments to doctors and hospitals and ration care may cut expenses but they also reduce the supply of care needed to meet the demand of a sick populace. The first step to fixing this problem of reducing costs while still being able to meet demand is to reduce demand.
Too often, the medical profession in this country is afflicted with tunnel vision. A patient seeking medical attention for diabetes, and heart disease is given medication, which is successful at relieving the symptoms of these conditions, and the patient walks away, with both doctor and patient considering the problem resolved. This is a symptom of a system, which is broken. In this case, the patient still is in very poor health and is a candidate for subsequent diseases related to his original medical conditions. This is not to deny the value of medicine. Many people are very sick that without the recourse to medication would die. The problem is that medication is often considered a first line of defense, with standard medical practice often failing to look into the root causes of illnesses.
Holistic medicine operates by a different set of standards than standard medical practice. It aims to resolve health issues by addressing the root causes of illnesses instead of treating just the symptoms. This includes looking into the whole person, body, mind, spirit, and emotions. As it stands now not enough research has been put into this medical practice to recommend it as a complete alternative to standard medicine, but there is evidence of it succeeding in some areas of people’s health. When successful it comes at a much lower cost than medications and surgeries often performed by standard doctors and hospitals. However, the problem exists that the supply of holistic medical practitioners is not sufficient and because of bad publicity, the demand is not where it should be, so the funds have not been forthcoming to do the research needed to expand this medical field to cover more people. Any reform serious about reducing the cost of health care would have to address this issue. A good place to start would be to allow holistic practitioners membership in the American Medical Association to give them the same status as regular health care givers. In addition, there would have to be a concerted governmental financial effort, which would involve putting more money into research and establishing Holistic clinics and practitioners across the country. Ideally once established this system would create a two tiered approach to health management, with Holistic medicine providing the first line of defense against illnesses and conventional medicine treating maladies which have progressed beyond the point where natural medicine would be effective. This approach is complementary with both tiers working together to keep the people healthy.
There still is the issue of costs to talk about. Even with the complementary approach described above many doctor visits would still be prohibitively expensive. So insurance and which way to go with it still is an issue to consider. The current system is untenable. An industry, which by nature that is designed to maintain health and treat illnesses is incompatible with an industry whose sole concern is profit. With health care being centered around insurance companies the values which those companies are composed of leak into the practice of medicine slowly transforming it into a money making venture. The Health Insurance Company intermediary has no place in what we are constructing. Acknowledging that the structures, which compose any system, are made of multiple layers each being influenced by the idea, which gave them life and existence and in turn influencing the individuals who fulfill and compose the whole.
It is imperative that the healthcare industry be reconstituted to reflect Fascist ideology and values. With private insurance companies no longer having a role, the State becomes the default insurer. Along with being more cost effective by eliminating the need for marketing, and profit, government insurance programs can more easily restrict the abusive lawsuits, which have plagued the system in recent years, and the amount of bureaucracy is much less, than the current private system employs. Working through the Corporatist model, having doctors, hospitals, and consumers work together to create prices the trap of having a top down system where all the terms are dictated by State fiat can be avoided. Instead, the cooperative structure of the corporatist system itself would produce outcomes suitable for all parties involved.
Any new construct involving health care reform is a job, which goes beyond just one article. What has been attempted here is a starting point from which we can erect a foundation to build upon. Fascist Italy while making inroads in the field of national health does not give us a comprehensive model from which to use. Therefore, it is up to us to take Fascist values and extrapolate from them a system, which can best reflect those ideals. We started out deconstructing the current philosophical basis of health care and building up a new one from which to build upon. Then we introduced some new approaches to health care and integrated them into the present medical practice to create a new structure. All of this eventually being tied together through the Corporatist structure. This picture is far from complete but it does give us a new approach from which to build upon.