Monday, August 17, 2009

Doctorin', Part 1

Very, very few of us are competent to doctor ourselves. Doctoring is one of those things we "hire done." But it isn't the only such thing. Your typical Americano has no business doing his or her own plumbing, or wiring. Car repair is a specialist job. Made your own clothing lately? Made any shoes? Written a web browser? Raised (and slaughtered and butchered) your own beef cattle?

For how many of these functions, which you count on skilled others to perform, do you have, or need, insurance?

The doctoring seems unique in this way. I believe the problem is supposed to be that many Americans can't afford to get medical attention when they need it, and the alleged debate over the solution is framed in terms of obtaining insurance (not doctoring) for those Americans. If a poor man goes naked to his government, crying out for help, he'll presumably be given clothing, or maybe money to go and buy clothing. No one thinks he needs garment insurance. If he's homeless, someone may invite him indoors to a warm place to sleep; it probably wouldn't occur to them that what he really needs is a shelter policy.

Yes, we're told, but medical care's different. It's really, really expensive. True, it is. We should think about why that is; and there are, I think, several reasons, which I'd like to consider in subsequent posts here. For now, though, let me suggest that "perverse incentives" to all of us, as consumers of medical services, abound. In my own case: I have a job, one benefit of which is pretty good medical insurance. That means I make a number of choices about whether to consume a given service or not, in which my out-of-pocket cost is not a factor; that is, my "coverage" costs me the same amount whether I use such-and-such service or not. The contingent or optional cost is, from my point of view, something that Someone Else pays.

Do you suppose that my arrangement, multiplied by the large number of people like me, might tend to increase the total money being spent on medical matters?

Relative to what?, one might ask.

More about this tomorrow, I hope.


Craig said...

You're on to something. It's called the "health care industry" for a reason. We're just cogs in the machine.

Thinking Mama said...

And it seems as though the elite's plan is that we forget how to do for ourselves. Isn't it convenient for people control when doctors, who must be certified by the state, are the only ones who can doctor us? And then we buy our store-bought clothes from China and we pay somebody to mow our yard and we forget that vegetables don't grow in the crisper of the grocery store, et al. Could it be that we're getting dumber and dumber all the time?

akaGaGa said...

From your list, I can only claim sewing clothes, which I haven't done in a while, and even when I did, I never, never did underwear. Underwear is really tough, especially men's briefs.

Another side note: How sad it is that naked, homeless people turn to the government in the first place.

To your larger point, insurance is simply another form of gambling masquerading as business, much like banking and investing. It's played with a deck stacked in favor of the insurer. When the insured starts to win, the government re-stacks the deck.

Ready for the next hand?

Mort Chien said...

Insurance is simply a way of managing financial risk so that potential creditors for expensive commodities have a reasonable expectation of being paid for their services. Life and liability insurance is a little different in that no service is being paid for. The risk being managed is someone's future ability to pay living expenses. Health insurance "guarantees" that doctors and hospitals will be paid. Car and mortgage insurance allows the banks to assume some risks they would not normally be wise to assume. It is all about spreading risk around. Not inherently evil (I know you did not say this) - but, like anything else in this world in rebellion against God, easily corruptible.
Other arrangements have been tried throughout history - many assume a level of community existing that does not exist today except in small isolation - the Amish come to mind. The history of insurance is interesting and probably has fewer villains and more saints than many other activities.


akaGaGa said...

@Mort: "not inherently evil"? I'm not so sure. I think God is supposed to be our insurance policy, and a couple scriptures come to mind.

The Lord's prayer says "Give us this day our daily bread." It doesn't say "give me a guarantee for tomorrow." And Jesus directly states, "So do not worry about tomorrow; for tomorrow will care for itself. Each day has enough trouble of its own." (Matthew 6:34)

As an example of this, when God sent manna from heaven to the Israelites, each morning they gathered only enough for that day. If they had any leftovers, it grew worms and became foul. Conversely, they gathered two days worth before the Sabbath and it kept until the Sabbath rest was over. (Exo 16)

I think the lesson here has to include faith that God will care for us tomorrow.

Rebecca said...

I much prefer to do things myself. I rarely find anyone who is as meticulous as I am in doing it correctly.

As far as the insurance issue, the government wanting to get involved is not so as to "provide" but to "control." Because this is more than government meeting a temporal need (such as a garment or a meal)-- government intends to completely control the long-term health care of its "subjects." I think most people fail to realize this-- all they see is that their dentist bill will be paid for, or their wellness checkup will be paid for... but what the government sees is every soul subject to their system of health care control and management.

And truly, the Gubment has no business either providing or controlling, in my book! lol

I liked your analogies. Good post, I look forward to more.

Jim Wetzel said...

Thanks to all of you who commented, and who continue to look in on this poor neglected blog from time to time.

I think Mort and Gaga both make good points, and I think I pretty much agree with both despite the apparent conflict, because I think it's pretty much only apparent. I don't see an inherent problem with the economic strategy of risk-sharing, which offers the individual sharer economic efficiencies that allow him to "reward" the adminstrator of the risk pool (the insurer) with a reasonable profit while still receiving good risk-reduction value. What I think Jesus was teaching against in Matthew 6 is the human tendency to try to combine illusory independence with illusory security, and also to indulge in anxiety. To imagine ourselves "secure" as a result of our own arrangements is, I think, a species of the sin or presumption. The purchase of some kinds of insurance is, or can be, an element of planning, rather than of presumption; but how easily planning can slip into presumption, and the seeking after self-security! So much depends on motivation and degree. I can think of very few human activities that we can't pervert, somehow, into sin if we try hard enough; likewise, very few activities that cannot be done innocently and with thankfulness to God. There's just no security anywhere in this life.

Or so it seems to me.