Wednesday, July 29, 2009

Is Opposition to a Public Healthcare Plan a Sign of Miserliness?

Recently several friends and I were having a discussion about whether people with medical conditions (specifically obesity) should be charged more than other people for healthcare coverage plans. In response to my opinion that people's premiums should be proportionate to the amount of services actually used, someone wrote:

I didn't take you for the type who would rather keep that little bit of cash per month instead of helping your fellow man. Is a relatively insignificant amount of money really that important to people when it's going towards the good of everyone?
I certainly believe in giving money to help my fellow man. However, I think that the government is horribly inefficient and ineffective at actually helping people in need. More specifically, I am convinced that paying the government to help people results in less help for people in need at a higher cost than contributing directly to the needy or through a non-profit organization.

If the government were skilled at determining who to help, and actually put a large percentage of the money towards helping people, then I would be in favor of such a thing. But, when I know for a fact that a large percentage of the money I give is going to line the pockets of corrupt politicians rather than actually helping people, I feel disinclined to give (through that means) at all.

Addditionally, I don't believe in the "good of everyone." "Everyone" is not some single entity like a corporation or a nation. Everyone consists of a large number of individual people. Paying money for a public healthcare plan or making a donation to a research group that seeks a cure for cancer does not benefit everyone. It benefits a few specific individuals (or for a larger group, a specific subset of individuals) at the expense of everyone else. For example, in the case of a public healthcare plan, if I am giving money, my money does not directly benefit you. My money does not benefit people who are denied access to the program. My money does not benefit healthy people who have no need of health services. It only helps the subset of people who are eligible to receive benefits and who actually utilize those benefits. Therefore, even things that are for the "good of everyone" only benefit a select few.

The raises the question of whether more benefits are granted or costs are incurred. Since with a mandatory public healthcare plan, all citizens are required to pay into the plan, even if they can barely afford it, every single contributor directly incurs a cost. Each person who puts in more than they receive is being harmed by the plan, proportional to the difference between contribution and services received. Each person who receives more than they put in is being benefitted by the plan, proportional to the difference between the services received and the amount contributed. Given the fact that any administrated solution necessarily involves inefficiency, it is clear that out of 100% of the monies put in, even with a highly efficient system only 95% percent (at most) of the monies actually go towards the desired result. Therefore the total benefits received by society is only 95% of the costs cumulatively incurred. Though a few individuals will be better off, society as a whole finds themselves collectively worse off than if no public plan was enacted.
(The 95% efficiency figure is deliberately a low-end figure. Here are a couple of studies on the current administrative costs of the Medicare system: Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance, Medicare's Hidden Administrative Costs)

Let us contrast this with personal giving or giving through non-profit organizations. For example, let us suppose that I have a friend who needs an expensive medical operation and has no insurance. If I give him $100 to help him cover the expense, 100% of that $100 goes directly toward helping him cover the cost. This is a maximally efficient system since there is no loss due to administration. Also, I know for a fact that whoever receives the money that I give will actually spent it to cover their need, because I know the people that I give money to. For this reason, I love giving anonymous gifts to people who need help. I know that all of my money is going directly towards a good purpose and benefits society a maximal amount. If I give $100 to the government to help someone out, I have to wonder how much of it will really help those in need.

Likewise, if I give to organizations whose values I admire, I can be sure that even though some administrative inefficiency may be involved, that they will have a better selection process in determining whom to help. The government will never go and hand out bagged lunches to homeless people. If I give money to CrossStreets, I know that 100% of the money goes directly to helping the homeless. Since all of the members of CrossStreets are unpaid volunteers who willingly give their time and resources, I have assurance that they will go and find people who are truly in need, give them food, offer them clothing and tell them about the gift of salvation that Jesus Christ offers, which is a power that can break the devastating cycles of addiction and irresponsibility that most of them face. The government isn't going to help those people. They aren't going to offer friendship, love and spiritual support.

Because of this, I believe that helping individuals directly (or through more efficient means) provides society with a greater benefit than a public healthcare plan. The necessary government inefficiency guarantees that a percentage of resources are lost in the process of providing healthcare. As the study from the Heritage Foundation shows, when you have something as vast a public plan, not only is there a higher administrative cost per person, but there are many times more dollars being funneled through the system, which guarantees millions and millions of dollars of waste. Additionally, when giving is more personal and directly, there are relational benefits to society that the government can never hope to provide.

Lastly, I am strongly opposed to any form of mandantory "giving." The whole point of giving (and the joy of giving) stems from giving something completely out of the goodness of your heart. That which is mandatory neither has the same value to the recipient, nor provides the same joy to the giver. The beauty of giving is that you are freely contributing to the well-being of another person just because you want to. That makes it special. Personal giving is relational in nature. Contrarily, when you are forced to contribute to something, the obligation strips the joy of blessing someone with your gift. Whether you want to give or not, you have to. You have no idea who is going to be benefitted by your contributed. You will probably never see the happiness of the person receiving your gift. The giving is reduced to a mere mechnical process, devoid of any heart-to-heart emotional connection. Also, in the case of government-mandated "giving" it is much more akin to robbery, since there is a material threat to your well-being if you don't comply. If you don't contribute to the mandatory public plan, then you are subject to prosecution, fines and possible jail time. How is this different than a mugger threatening you with violence if you don't "give" him your money and possessions? The method is intrinsically one that dehumanizes the process of giving and is enforced by a method that has more similiarity to organized crime than it does to a benevolent organization looking for generous donors.

As you can see, I am not at all opposed to giving and to helping people in need. I typically give about 20% of my income to charitable organizations. However, I don't think that the government is very skilled at helping people, and I certainly believe that they have no right to demand contribution.

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