Thoughts on health care, government programs

Just curious ...
What if the federal government came out and said "crime is such a problem. It's costing citizens and cities so much money every year, and we don't have enough police to protect everyone so they can feel safe and secure. So we're going to pass a law that everyone has to buy a gun. If you have a gun, you can keep it of course. But if you don't have one, you should buy one. If you don't buy one, one will be provided for you and you'll just pay for it when you pay your income tax."

Maybe a gun is too radical. What if the government just decided every house should be required to have an alarm system? There are mortgage companies that won't give homeowners a mortgage in certain high-crime areas unless they have a working alarm system. What if the government just decided that to cut down on crime and the residual cost crime has on individuals, communities, local police, insurance companies, everyone should have an alarm system. Would you accept that?

Maybe you think those are extreme. But I saw a story on CNN where, because obesity has become such a serious problem in this country, South Carolina has voted to approve a government-paid for weight-loss surgery program it would make people healthier and save millions in medical costs every year. If you do a search, you find this isn't so far-fetched; that similar appeals are being made in Australia and Canada and Great Britain, and already you can find ways to apply for government grants for weight-loss surgery here.

So is it really that far-fetched that the government might order us to eat spinach, because it is good for us? And if we don't eat it, could the government fine us, the way it will if we don't have medical insurance under what is popularly known as "Obamacare?"

Or that the government order us to have alarm systems on our homes?

I was discussing President Obama's healthcare law with a few friends. It was pointed out that many people come to emergency rooms for what should be routine office visits and those people don't have insurance, so they can't pay for the visit. I have been in the emergency room at Children's Hospital with what we considered a legitimate emergency and seen some of these people, whose children simply had colds or fevers that could have been handled in a pediatricians' office. When I asked the nurse, I was told that the emergency room had, for a certain segment of the population, become their "doctor's office." And, no, they usually didn't have insurance.
The cost of those visits had to be absorbed by the hospital, and of course passed on in higher costs to other patients who do have insurance, which in turn means insurance companies have to pass on greater costs or higher restrictions to businesses and people who buy insurance.
That's wrong at both ends.

On the other hand, everyone seems to agree there is a shortage of general practice doctors in this country, a serious shortage. A guy I know who is in medical school said he believes its because the cost of medical school is so high, people who want to become doctors are drawn into the specialty fields where the chance to make the money to pay off the loans is greater, rather than the old concept of the general practitioner, which apparently doesn't pay as well, or at least not as quickly.
Which led me to wonder what happens if 20,000 people who don't currently have insurance are suddenly brought onto the insurance roles through government mandated insurance? Will we have 20,000 people suddenly making appointments for check-ups and fevers and the routine things the rest of us already go to our "family doctors'' for?
And will that tax a system that is already strained, further reducing the quality of health care because those doctors are going to be stretched even further to see these people? How hard might it become to get an appointment (that might already take months if all you want is a routine physical)? How rushed will those doctors be to see as many patients as possible? How much of their work will be passed off to nurses or physicians' assistants - which are a great option, but still, if I'm paying to see a doctor, I should be entitled to see a doctor.
So while this makes health care affordable to more people (in theory), without enough doctors to meet the new influx of patients, will the quality of our health care system decline?

Again, not that I think people who can't afford it should go without regular medical care so those of us who can afford it have a higher quality of care. I'm just pointing out a potential consequence.

Another friend believes that health care is a "right." I believe we should do our best to make health care available to everyone. Christian missionaries have done that for centuries, laying the foundation for modern organizations that are dedicated to bringing health care to people in need. I support those efforts, and believe it is a responsibility of those who have been blessed with "more."
But a "right?" I think we throw around that word "right" to include anything we think would make our lives better, rather than the basics that allow us to have a chance to achieve that good life for ourselves - particularly because too often we think of "rights" as things it is the responsibility of our governments to provide.
Is it a "right" that we be thin and healthy, and government should pay for us to be that way because it would save the government money in health care?

I believe in self-determination. I believe in responsibility.
At the same time, I am sympathetic to those in need, who have less, who are not as fortunate. Unfortunately, 50 years of "The Great Society" has not done much to alleviate poverty. And the truth is, what we call "poverty" has become more and more like middle class in most other cultures around the world.
The benefits given to help people who find themselves in tough situations can become very difficult to free oneself from. The conversation was with a man from Great Britain who argued that people on unemployment didn't want to be on unemployment because there was not enough money on unemployment to provide a basic standard of living. And he is right, if you just draw unemployment which, in Alabama, is capped at $260 a week.
However ... let's say you and your wife/domestic partner each get $250 a week in unemployment (I pick 250 because the math is easier). That's $24000 a year - still not much.
But then if you get food stamps to pay for basic food needs. And you live in Section Eight housing, where the government pays someone to allow you to live in their house like a renter (except the government pays the rent). And you qualify for a free cell phone and internet access (through an FCC tax the government passed a few years go because someone decided cell phones and internet access were a "right" the poor should not be denied) ... suddenly, if housing and food and communication is free, that $24,000 a year (tax free) becomes very livable.
Particularly if you compare it to what happens if you get a job basic, minimum wage job. While studies have shown that adults who take a minimum wage job and stay with it are rarely still at that job a year later but instead have gained skills and connections to move up to a better-paying job, once you go on the ranks of the employed it becomes much more difficult to continue to receive food stamps, live in government-subsidized housing, with free cell phones and internet service. You quality of life actually can decline by getting a full-time job.

Here's the tough thing: we haven't learned that by giving people what we perceive them as needing, we actually can condemn them to a life of dependence. That's what 50 years of government programs to help the "poor" have proven.

But because we have entire government bureaucracies that exist to help "the poor,'' those people have to keep finding ways to help the poor or else risk losing their jobs. They are part of massive government agencies with huge budgets, and if they don't spend to the level of their budget those budgets are reduced, and salaries are cut, and people are laid off. So the very act of creating a new government agency to address some "need" becomes a self-fulfilling prophecy: whatever ill your agency was created to address will continue because of the existence of the agency created to address it.
If my job depends on helping the poor, then I  need to continually find news ways to help the poor, and redefining what poor is, so I keep my job and my relevance continues.

In an earlier blog, I defined "poverty" as "the lack of choices -real or imagined."
If you feel you no longer have a choice in the direction of your life, then you are "poor," or suffering from poverty.
The reason I make this my definition (at least for now, until I arrive at a better one) is that it seems to encompass all the sub-elements of poverty, as well as has the ability to transcend location.
In other words, if you are trapped into place or position, you are poor.
We look at the people we consider to be "poor," and I don't think they necessarily have chosen to be poor - to live on government welfare and food stamps or whatever subsidy they live on. But they just don't know any other way. That's how everyone they know lives.
While some would say "they" need to get a job, "they" would ask - and I believe in all sincerity - "why?" To get a job means you have to start paying rent and paying for food and paying for the things that right now are given to you.
(And I wonder if those people look at the "rich'' who lives in their big houses and don't assume that somehow those people live for "free," too, but just somehow got a better subsidy. That is, those people have a "company'' that gives them money in the form of a giant salary. But come on - putting on a suit and sitting behind a desk all day isn't work. It's money for nothing (and the chics are free - to quote Dire Straits).  They got it because they were born into a different form of subsidy.)

My issue is not really about healthcare, which is certainly a problem that needs to be corrected.
My issue is that the more responsibility we give government to care for us, the more we abdicate our responsibility to look out for ourselves.
I know there will be those who disagree with this, but I do believe that neighbors will help neighbors in need. In a first-hand way, I've seen a Christian service organization help re-build houses in areas ravaged by tornadoes (in areas both urban, suburban, and rural), and do it much more quickly and more efficiently than government agencies. I've heard people who have been promised a new home by a government agency lament that they didn't take up the Christian service organization's offer to build their home, because they've watched as their neighbors' homes were rebuilt while they are still waiting on the government.
But those who demand that government 'fix' their problems - or the problems of others -ignore the work that is going on all around them, being done every day, by volunteers who are compassionate and are stepping up to help rebuild houses, provide job training, conduct after-school reading and homework classes, distributing food, opening up health care clinics ... and in the majority of situations, those are working far more cost-effectively and efficiently than government-run programs.
The problem is they often do those things in the name of "Christ,'' which  is anathema. Too many people would rather see people suffer than see them receive help in the name of "God" or religion, particularly Christian religion.
(And, to be far, sometimes those things are done "in the name of Christ" but with expectations attached).


Meanwhile, we do know that if the government creates an agency to run a program to solve a problem, the people who run that agency and are employed by it have a vested interest in seeing that problem never go away, because to solve the problem means an end to their jobs.

And while the free market has a way of doing that for a company that no longer sells a product or provides a service people want, the government is not run on free-market principles.

So I worry about how rulings like the Healthcare ruling by the Supreme Court will be interpreted in the coming years in other situations, like weight-loss surgery or spinach or home security alarms.

However, I don't worry about the government every mandating that all citizens own guns.