Exciting New Method of Health Care Finance
posted by Frank Pasquale
The hearts of consumer-directed health care advocates will surely be gladdened by one innovative Georgia family’s effort to pay for care for their two disabled children:
Facing snowballing medical expenses for their two young disabled children, Gregg and Brittiny Peters quipped they might need to sell everything they owned to stay solvent. As the bills tipped $10,000, however, the idea was no longer funny. So on Thursday, the Georgia couple accepted a winning $20,000 eBay bid for all their belongings minus their house.
As John McCain said in the campaign, eBay can be the answer for many woes–especially if you don’t mind living without furniture.
Seriously, as we endlessly debate the stimulative potential of various proposed government interventions, Paul Krugman’s moral clarity on the matter should be our lodestar:
There’s a populist rage building in this country, as Americans see bankers getting huge bailouts while ordinary citizens suffer. . . . Barney Frank, the chairman of the House Financial Services Committee . . . argues that — as a matter of political necessity as well as social justice — aid to bankers has to be linked to a strengthening of the social safety net, so that Americans can see that the government is ready to help everyone, not just the rich and powerful.
The bottom line, then, is that this is no time to let campaign promises of guaranteed health care be quietly forgotten. It is, instead, a time to put the push for universal care front and center. Health care now!
I couldn’t have put it better myself. A state that coddles clueless capitalists while neglecting the parents of disabled children is on its way to a legitimation crisis.
January 31, 2009 at 8:45 pm
Posted in: Health Law
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Responses (4)
MDTrussell - January 31, 2009 at 9:10 pm
Why call out consumer-driven health care advocates in this post? Last time I checked consumer-driven health care was formed out of the backlash from people rebelling against managed care (i.e. the HMO telling us all what would, or would not be covered.)
While no one wants to conjure up a picture of a family selling all their belongings to pay for their health care, at least they were able to buy it when they needed it.
Will a government-run system give us the same choice? Probably not. Then the story will be, “Couple sells belongings to travel to India to get treatments denied by US HEALTH PLAN.”
We need to find a better way.
Frank - January 31, 2009 at 10:17 pm
A fundamental tenet of CDHC is that if consumers have more “skin in the game,” they will demand that providers cut costs more. In this story, the consumers have more skin, furniture, etc. in the game–and it appears to me that the vision of CDHC is that as more people get in straits like this, eventually a critical mass of cost-reducing pressure will improve the market for health care. Of course, along the way, lots of people will be bankrupted.
Another way to accomplish the same objective is to follow the path of neary all other industrial countries, and to collectively demand cost-discipline and quality improvement. If it’s good enough for the VA and government employees, it’s good enough for the rest of us.
Patrick S. O'Donnell - January 31, 2009 at 10:44 pm
I think we should have patient-driven health care in the first instance. The predominance of a consumer model distorts what goes on in the clinic and medical care, as well as what *should* occur in medicine generally. Consumer-driven health care prices some patients out of the medical marketplace. Social insurance schemes provided by the state that assure compulsory “risk-pooling” also provide for “cost-pooling” and serve to remedy the many and varied forms of market failure (the state having access to revenues beyond insurance premiums and trust funds fed by them). The redistributive function of social insurance schemes are essential when it comes to the provision of health care in a modern nation-state so patients can avoid the sorts of (harmful, life-threatening or deadly) risks associated with being priced out of private markets.
Like the welfare state itself, social insurance schemes should be seen not so much as “a grand plan for social organization writ large as…a modest principle of interpersonal ethics writ large” (Robert Goodin). The interpersonal ethics here pivots upon a duty of care involving the protection of the vulnerable as both an individual and collective responsibility.
The ethos of the marketplace entails the respect of people’s choices but, as Goodin reminds us, a fundamental reason behind such respect is our desire to respect people qua people, including their dignity and self-conceptions. And that is why, for instance, we recognize nonfungible rights of various kinds. The meeting of material necessities and basic needs is inextricably connected to our dignity if such dignity is to be more than nominal.
Patrick S. O'Donnell - January 31, 2009 at 10:55 pm
Erratum: “a grand plan for social organization writ small as…a modest principle….”
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