Bioethics, government medicine, health care funding, insurance, medical economics, medical finance, Medicare, medicine, politics, public policy

Healthcare lottery

When you buy a lottery ticket, do you choose the cash option with its immediate payout of half the winnings or do you choose the payment of the full amount, doled out over 20 years?

I’ve found this question to be a good way to help other people understand the difference between conservativism and those who think that someone else can take care of them or the “totalitarian mamas” who believe that they can take better care of us than we could ourselves and for our own good. (Of course, someConservatives tell me don’t gamble, so they never buy lottery tickets.)

It’s amazing how many people tell me that they always buy the “cash option.” Some say they worry that their families wouldn’t get anything if they die before the 20 years is up. Some tell me that they believe they can manage and invest the money to earn more than they would if they wait out the smaller payments. A few tell me that they would rather not have all the money at one time, preferring the guaranteed income over the years or fearing blowing the money.

The latter group never understands why I suggest that their health insurance should be something that they own and control, rather than something doled out by government and their employers.

A “right” is something that we each have without conditions and which we can call on society and government to enforce or punish if someone infringes that right. The right to life is actually the right not to be killed. We expect our fellow citizens to protect us through providing armies and law enforcement, a militia and by allowing self-defense. If another person infringes our right not to be killed, we expect society to punish him.

Last night, Democratic Presidential Candidate Barack Obama stated that health care is a right. I strongly disagree.

“Health” and “health care” are difficult terms to define. Instead of people and their actions, health is threatened by disease, age and injury. If I’m not well, how will society protect my health – and who or what will be held responsible as I inevitably age? If I have a “right” to health care, then I want everything possible to maximize my health. Rights can’t be rationed.

What we’re really talking about is health care funding. Funding certainly can be rationed. Take a look at Medicare, Medicaid, and the Veteran’s Administration.

These systems work fairly well most of the time. However, they rely on limiting the costs of health care. The limitations fail when demand for cutting edge, expensive treatments or emotional arguments override them. That’s why Medicare won’t pay for a tetanus shot after a dirty wound, but will pay for annual physicals, screening mammograms and prostate specific antigen tests, although there’s no evidence that these prolong life.

Or why Oregon Health sends notes telling patients that they won’t pay for cancer treatments, but they will pay for assisted suicide.

For more on this subject, here’s another opinion.

About bnuckols

Conservative Christian Family Doctor, promoting conservative news and views. (Hot Air under the right wing!)

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