The Realities of American Health Care
This musing starts with proposing a concept of what constitutes good government. For this musing good government will be defined as that form of government which maximizes the contentment level for the maximum number of citizens under that government. Good health care is certainly one of the factors which enable individuals to be more contented.
A right to good health care fits in nicely with the ethical mantra called the Golden Rule: Do unto others as we would have them do unto us. It is not possible to earn good health care, especially in the formative years. A child in their formative years either receives good health care or they don’t. When a child, I had just about every conceivable communicable disease around except polio. Fortunately, the antibiotics to cure most of them had been discovered less than ten years before. My parents were able to afford the doctor bills which came with this endless medical care. I did not, in any way, earn my survival from these diseases. I was lucky.
The American mantra for health care is partly based on a survival of the fittest mantra and the notion that everyone can earn their level of economic independence and good health. “I earned my success the old fashioned way—I earned it.” This may be good for our ego, but most often, has little connection to reality.
The Golden Rule, as the basis for human ethics, is an inherent genetic factor which is universal, and which is independent of what religion inherited. No one ever claims the Golden Rule is not an ethical principle. Unfortunately, this universal principle is only invoked when convenient, as we have other goals which are more quickly gained via more self serving means.
The Golden Rule is also the basis for every child or adult to have access to good schools, good teachers, a safe environment, good job opportunities at livable wages, a protected natural environment, basic civil rights, and a healthy tolerance for individual diversity. But we will stick here to the American need for a right for all citizens to have access to good health care.
The intense political debate now taking place falls well short of a comprehensive package which will meet the needs of all our citizens. Let’s start here with all the realities involved. First of all, for all citizens to have good health care, a huge increase in the number of doctors, nurses, and health care involved employment will be necessary. In a country striving to provide good jobs for its own citizens, how can any government refuse to provide enough educational support to supply us with doctors, thus requiring a high percentage of doctors must be imported from other countries? That is not fair to our own young people and does not ensure providing the best health care professionals. To provide good education for more health care personnel will cost a lot money and more medical schools with revised, more sensible curriculums. However, once the money is found, it increases income for thousands upon thousands of employed citizens who then spend money with their purchasing power. If we want more good jobs for American citizens why would we import doctors and other health professionals from other countries? We have met the enemy and it is us.
Next, it need be understood that a single payer system is the only way to provide good medical coverage for everyone. Letting some people have their own separate option enables those more affluent to create options in which the best doctors and best health professional providers will create their own system. This is already happening as more and more doctors charge upfront costly fees before they will accept a patient. This ensures the doctors will make more money and the patients will get appointments faster, and get treatment by the best doctors all using the same facilities as the less fortunate citizens. The rest of the citizens, less affluent, not able to pay the upfront additional cost, will have to wait longer for an appointment, more likely get the least competent doctors, and in many cases most of their contact will be with Nurse practitioners, Physicians Assistants, and other assorted titles which are popping up. Thus, the system is returning to what we are trying to avoid—the affluent getting good health care, the less affluent getting 2nd class health care. We already have that. With any effective single health care provider, it would be illegal for such private care alternative programs to be established. Period. When politicians argue that some union members have good health care insurance, and should be allowed to keep their old plans, we then are once again letting some workers get better health care than others. Same old, same old. The goal should be to raise the health care so that everyone gets good health care, in which case unions, along with everyone else, get the good health care that now just union members get.
Next the government need establish a value system for careers and begin to use taxes on wealth/income/inheritance as once done back early in the 19th Century which enabled all economic classes to flourish like they never have since. Once this kind of steeply progressive taxation was eliminated, 2-5% of our citizens sequestered 90% of our nation’s wealth for themselves. There is this conception that the Golden Rule tries to level all people to some common level. This is silly. People, via diversity of their genetics, environment, and luck, will never be equal. What the Golden Rule does is try to level the playing field, and recognize that like with most everything in life, enough is enough. On what basis can any society really claim that it is just for any kind of Government to allow 3 individuals to own as much of that societies wealth as the bottom half of the citizens? It would be like a parent allowing the smarter, stronger, better looking, more social of their children, to use all these advantages to determine just how much of a families’ attention, financial assets, and privileges the more fortunate child can receive.
The reality is that democracy in America is no longer even remotely being governed by the people via elections. The 2-5% of the citizens who own 90% of the wealth now control all three branches of government. They do this via bankrolling politicians who will vote for their interests or not get any funding and that often means they can’t get elected. Money, which is the most popular American object of worship, is seen as the key basis for contentment in their lives. Numerous studies have shown that monetary wealth is a component of contentment only up to about a $70,000 range and after that it often actually becomes a negative. Those who tend to accumulate vast amounts of wealth are often obsessive, addictive, and compulsive about money. None of these three behaviors can ever generate contentment, except on a momentary basis, since enough will never be enough. When the amassment of vast amounts of wealth become addictive, obsessive, and compulsive then ethics becomes a smaller and smaller force in their lives. Our government is no longer able to remotely set limits on how much of our national wealth these 2-5% of its citizens can accumulate, and seldom holds these bandits for the consequences of their unethical or criminal behavior. It is not uncommon for billions of dollars in unethical/illegal behavior to result in fines only of several hundred thousands of dollars, plus it is rare for white collar criminals, no matter how many millions of people are hurt, ever receiving jail time. Jail is apparently more appropriate for the more helpless poor, and minorities.
At any rate, good health care, good schools, good teachers, living wage jobs, safe environments for all citizens, all require a massive input of money and a huge change in social and governmental priorities. Religion plays a significant role here in the situation. People have been taught that God will listen to their prayers, and therefore, if the less fortunate citizens will pray to God for help, or the affluent pray for God to help the less fortunate, then all will get better. There is no evidence that God ever intercedes and saves anyone from God’s laws which govern the evolutionary process. What our species does have, which no other species has, is the ability for the affluent to help the less fortunate by living their lives according to the innate ethical nature of the Golden Rule. Of course it is easier to pray than sacrifice for the greater good of the whole, so too often, not much happens other then endless praying.
In theory, governments are supposed to prevent monopolistic behaviors which enable some citizens to gain an amazing amount of wealth at the expense of other citizens. What could possibly be an ethical government if it allows certain citizens to amass so much wealth of that society, which is the real reason why so many less fortunate citizens have poor health care, poor schools, the least competent teachers, poor job opportunities, non living wage jobs, unsafe communities, etc. Politicians invariably say we cannot build better schools, pay teachers attractive wages, pay more citizens livable wages, take better care of the environment because there is no money to do that. Of course there is money to pay for all of this. Really? Where is it? The 2-5% who own 90% of the wealth have grabbed all that money, often via special loopholes, tax breaks, tax shelters, etc. to manage the feat. Then there are the three individuals who own as much wealth as the bottom half of our citizens. We know where all the wealth is sitting.
It was pointed out earlier that for most everything there is a point where enough is enough. For there to be enough money to provide good health care to everyone, limits have to be put on the accumulation of a nation’s wealth by any individuals. The greater good of the whole tops the individual good of a few, which is not to say that people should not be allowed to become wealthy. Jeff Bozo of Amazon.com is worth 144 billion dollars. If someone were to make $50 million dollars a year, it would take them 2,880 yrs to reach 144 billion dollars. It makes far more sense to limit wealth by a few. I, as an individual, am not the one to determine the best limit. Given all the better uses of such vast sums of money, it seems to me that we might force the limit to be say $10 million per year. If a person makes $10 million per year it just seems they can live a wealthy life style. If they scream they need more, then they have no understanding about the basis for human contentment. Remember, compulsive behaviors, addictions, and obsessive behaviors cannot, by definition lead to contentment.
There is no way for me to attempt any precise figures here since I am likely to screw up, but just use common sense here. If the top 2-5% of our citizens, instead of owning 90% of our nation’s wealth, owned only half of our nations wealth, that would free up 40% of our nation’s wealth for excellent health care, to protect our environment, to pay livable wages to all our workers, to have the best infrastructure in the world, etc. At $10 million dollars a year maybe we are talking 60% of our nation’s wealth to use for these other needs mentioned above.
There are other needed changes too. In 2108 CEO’s made 287 times more money than their workers. In the 1950’s, the average CEO made 20 times the salary compared to their workers? What exactly has changed in our society to justify this? It has nothing to do with inflation since these are ratios. CEO’s are important to our society in that they are in a position to make us competitive with foreign markets. They certainly are more important than actors, athletes, financial speculators, mega church preachers, etc. Thus, perhaps it is more important to peg ‘enough is enough’ salary caps for CEO’s, medical doctors, and national politicians higher than others. These are examples, not any actual list.
One might ask, well how do we cap salaries for different professions? Once we understand that past a certain income, people do not reap increases in their contentment levels— we simply go substantially beyond the already determined level of $70,000/yr and past this level, let’s say arbitrarily here $150,000, and we tax the income so steeply that it will not allow an individual to earn more money without like 90% of it going into tax money for the Treasury Dept. Instead of a small percentage of citizens getting all the wealth, all citizens would have their basic needs met. This is real justice and ethics, not the religion of money as so well entrenched in our society today. Organized religions actually shelter the rich from their obsessive worship of money. No religion, to my knowledge, ever throws out members who use Government loopholes to further their wealth. I always tend to think of the biblical rule that “it is easier for a camel to pass through the eye of the needle than for a rich person to gain entrance to heaven”.
All this is that follows here is what should go down. None of it is likely to go down. It is a mystery to me why Bernie Sanders and Elizabeth Warren keep letting the other candidates harp on letting other competing medical care systems be labeled a good thing “allowing individuals to keep their current health plans”. In other words, other medical plans for the affluent will ensure that the affluent continue to get good health care while the vast majority of people will get poor or no health care. No change at all.
So what will likely result after the election? Without enough doctors, most citizens will deal with Physicians Assistants, Nurse Practitioners, and Technicians. Soon, most patients will talk to computers to diagnose their situation and come up with treatments. This is not all bad and will be the only way to get quick treatment. These computers will probably diagnose and provide treatment plans that will rival the best doctors. In fact computers can do so much now that there is really no need for a 40 hr week. We should reduce full time work hours to 30 hrs. Any additional money via overtime and more than one job will be taxed heavily, which will prevent many from going in that direction.
What about tax rates on the average citizen. It is hard to be precise here. The amount of taxes coming into the government will soar, the number of people on welfare will decrease exponentially when all people working 30 hrs per week get a livable wage, unemployment will be almost nonexistent and the happiness polls conducted across the globe will find us at the top or near the top instead of buried far behind on such polls. We will once again have good schools for all kids, good teachers for all kids, good pay to draw more scholastically competent people into teaching, good health care for all, good job opportunities for all, increased vacation days with a 30 hr wk, assistance with parenting for those whose kids have chronic high levels of stress hormones in their system, etc. And, our infrastructure will be the best in the world.
And lets be honest, here. Let’s say our taxes go up 20 percent, which I doubt, all the stresses which most people have about health costs, livable wages, good education, unsafe neighborhoods, sometimes poor job opportunities, etc will all be nonexistent, and whatever money is left, all citizens can then spend on whatever they want. This is exactly why those countries who provide basic needs for all their citizens (to varying degrees) never vote this ‘socialism’ out. They don’t have all these basic worries that so many Americans have. Socialism has become a useless term. And capitalism without proper regulation and limits is a disaster. With proper government regulation and limits, it is a great system.
Finally, without getting a grip globally on responsible reproduction, protecting the environment, reducing the global accumulation of wealth to a few very wealthy citizens, and preventing climate change, the end result, no matter what we do in the matters above, will be disastrous in the not too distant future. There is to date no indication that any of the above is about to happen globally. No nation can save itself—all the major problems are global. That spells global disaster in the short run but means nothing in the long run for God’s evolutionary process governed by the laws God created to insure progress on global time, not human time. Those who worry about the future for their grandchildren should worry. However the evolutionary future via evolutionary time will likely continue as it has for billions of years with reversals which can last millions of years. But eventually the process rebounds with amazing levels of progress via new species’ and environments.
