Eugene Cho

health care reform: what should we do?

from the NY TimesI’ve been meaning to write a post or two about health care but my own personal thoughts have been so jumbled as I’ve sought to process some information amidst all the heckling, shouting, screaming, finger pointing, and demonizing.

While I have these forming thoughts, I also have questions [perhaps like many of you]:

What did you think of President Obama’s speech?
Did it clarify your questions and assuage any concerns?
Health care reform: What should we do?  How does our lens as Christ followers inform that decision?

Here are some highlights of President Obama’s speech [cnn article]:

“First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have. What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.”

“My health care proposal has also been attacked by some who oppose reform as a “government takeover” of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare. So let me set the record straight. My guiding principle is, and always has been, that consumers do better when there is choice and competition.”

“Under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. “

“I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I’ve already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance.”

Saw this video several weeks ago and thought it provided a good general overview of some of the issues at hand.

I think it’s time we move beyond vilifying and demonizing one another as people who monopolize compassion or completely lack it. No one wants anyone to die or to go broke. But we have a system that can be improved, right?

My perspective is simple [while I acknowledge the situation is complex and the solutions even more so].  As a country and government, I don’t believe we have to provide universal health care. While I personally acknowledge it is a moral issue from my worldview, I have to understand that people have fundamentally different views about the role and purposes of government.

So, while we don’t have to, it is amazing to consider that as a country and as the people of this country…

We can do this.

We don’t have to but we get to. Doesn’t this contribute to our collective idea of liberties and the pursuit of happiness?

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21 Responses

  1. chad m says:

    right to life, liberty, and pursuit of happiness. it would be interesting to see how people define the right to “life.” does a right to life include health and well-being, access to health care, etc?

  2. franksabunch says:

    As a physician, I believe that we should have universal health care, with the following stipulations:

    1) Coverage for illegal immigrants (not in this proposal)
    2) Tort reform (not enough in this proposal)
    3) Ability to supplement your care (i.e. not having to deal with increased waiting times, etc. that result from rationed care) by paying for additional insurance/self-pay options.

    If you ask physicians on the front line (internal medicine, family practice, emergency medicine), you’ll find that most of them would agree that the addition of a public option without coverage of illegal immigrants would be inadequate, because the issue of escalating health care costs from emergency care, difficult disposition (discharging from hospitals), etc. will still occur and account for billions annually. Costs that will still be passed on to those with insurance.

    Health care is not the Bellagio Buffet on Bill Gates’ wallet. We cannot have everything, and we must be honest to ourselves in what we are willing to sacrifice for what we will gain.

    Anyway, I won’t make a suuuuuper long comment (too late!), so here’s what I wrote a while ago:

    http://franksabunch.xanga.com/710478864/item/

    One more thing…don’t believe the hype…Delivery from the Medicare, Medicaid and VA systems are inadequate and do not provide the best care possible.

  3. elderj says:

    I am in some way very much in favor of universal health care coverage BUT, I have little confidence in the government’s ability to effectively, and in a cost efficient way to deliver such service.

    Any service, health care included, must be rationed. The market system is the usual way that services are rationed or provided, usually using money. It is impossible to provide universal health coverage without very high costs (either through taxes or through limiting service or access to service). In other words, we can’t get something for nothing and that’s what is not being honestly talked about in the current debate. There are trade offs that must be considered.

  4. RV says:

    Elderj has a point that the gov. isn’t going to do a perfect job of offering health coverage, but I think it would be better to have an imperfect option than no option at all for those who are currently uninsured. From what I understand, the reform would not effect those who are currently insured.

    As Americans we don’t like change (non metric system, the way our currency looks, etc.), so making a step toward fixing this enormous problem is going to be met with a lot of fear and skepticism.

    Fraud within the current gov. system is rampant, but I know for a fact that the gov. is addressing this issue (personal friend is a U.S. Attorney currently prosecuting people for this in LA) Whether public or private, these problems exist. I hope we can at least give this a chance to succeed.

  5. Kacie says:

    i struggle to grasp all of the debate, but I do know that I am not opposed to the Canadian or British system. Although they have flaws, I think they have less flaws than our current system.

  6. Well, I’m afraid I don’t have all the answers. I’m personally in favor of health care reform, but I’m still skeptical about whether or not Obama will actually deliver on everything he promised last night. But I do know that we, as Christians, should pray for God’s wisdom, and to be able to discuss the issue with civility and respect.

  7. Andy M says:

    Because of the healthcare issue, and the stimulus issue, I just had to do a little bit of research, because there is such a fear of socialized healthcare and government power, and the false idea of Obama wanting socialism to take over our economic system. The discussion about healthcare has many nuances, but the very premise of most discussions is the conflict between capitalism and socialism.

    What is interesting to me is that socialism (as it is meant to be, am not referring to communistic countries with bad dictators), has its roots in fighting against corporate injustice and an unhealthy inequality of wealth. Capitalism is the opposite. Capitalism is fighting against government corruption and injustice. The problem is that we can’t truly trust either the government or corporations to rule over us, because they are both inherently human and flawed. So at the very least we try to have them control each other, but even that can leave some people out in the cold.

    I have read many articles lately talking about the healthcare of European countries, and I honestly cannot see what people are so scared of. Every system has its problems, but those healthcare systems make a fair bit of sense to me. It is interesting that our private healthcare system which doesn’t cover everybody, costs twice as much as several public, or part public/part private systems that do cover everybody. It makes financial sense to take a bit of advice from other systems that accomplish more with far less money. But I would guess that there is where an American arrogance pops up and assumes that we know best and everybody elses way of doing things just can’t work as well as ours.

    Anyways, as for your questions. I haven’t heard his speech yet, so I don’t know. As for how my faith affects my thoughts on healthcare… I agree with many that we should not just rely on the government to help the poor, needy, and the sick, and that we should actively engage in taking care of those people and each other. That should be our primary concern, really. But we live in a country that gives us a voice, and if we as Christians are loud enough in supporting system reform, we can change a system that currently favors the rich.

    My simplest answer is that it is obvious that the current system isn’t working, so I’m all for trying something else.

  8. Grady Bauer says:

    I proposed a solution this week on my blog, let me know what you think.
    http://missionalspace.com/?p=353

  9. Joe says:

    I spent a year living in the Soviet Union under Gorbachev, and additional time living in nations with socialized, government-mandated health care. I have direct experience with both communism and socialism.

    I have had periods in my life when I have been incapable of accessing health care, and I still oppose the course proposed by this administration.

  10. […] not the only crazy pastor who is thinking along these same lines, here’s an excerpt from his recent blog post (damn liberals :- […]

  11. attgig says:

    YOU LIE!

    just kidding…

    It would’ve been interesting if all the health insurance companies went under during the recent financial collapse, and obama bailed all of them out. Then, all those companies could’ve become government run agencies….
    oh well.

  12. This is a tough issue, and I appreciate the thoughfulness and quality of the debate in the comments here. My own beef with our system is how impersonal medical care has become as managed care became the norm these last two decades. I expand on this issue at http://www.jcwill5.wordpress.com

  13. Tony Lin says:

    The following is peer-reviewed journal article (not an op ed) about the state of national health care:

    From the article:
    “Americans already pay for national health insurance — they just don’t get it. In this 2002 Health Affairs paper, David Himmelstein and Steffie Woolhandler point out that the standard accounting miscategorizes two major public health expenditures as private: the tax credit for private health insurance and the cost of the Federal Employees Health Benefit Program.

    When these costs are accounted for, it becomes evident that Americans already pay the world’s highest health care taxes. In fact, the amount of public health spending in the U.S. is greater than the combined public and private spending of nations which provide universal comprehensive health insurance. A single-payer system could provide such coverage to all Americans with no need for additional health dollars.”

    http://www.pnhp.org/single_payer_resources/60_percent_of_health_spending_is_already_publicly_financed_enough_to_cover_everyone.php

  14. Jeff says:

    I agreed with all the president has said until he brought out the public option, I leave it at the Post Office and Amtrak as examples of what his public option will most likely turn into. Healthcare Reform/Tort Reform, regulate and bring about consumer protection, allow Insurance Companies to compete in all states. We are not a complete free market economy we are a regulated market economy….

  15. Jjoe says:

    Exactly what is wrong with the Post Office? It is a good thing for our society to be able to put a letter in a box outside my house and have it go to the opposite coast in a couple of days for less than 42 cents or whatever it costs.

    Subsidize it? Why sure.

    Why does everything in the world have to be oriented around profit?

    If we have to wait on the free market to bring us a train system comparable to those in Europe — something that would save our country untold billions of dollars besides reducing our dependence on oil — it’ll never happen.

    What is next? Library admission charges? Insurance to pay for police protection? Closing the public schools? Putting condos in National Parks?

  16. Jeff says:

    My point on Amtrak and the Post Office is that they are both set up to be fully self-funding, but can’t, so they are subsidized, the President said he can insure 30 million people just through the premiums under the public option, but the numbers don’t add up…

    Police and fire and Libraries are all funded at the local level, the Post Office was a purely government run program at one time…no one ever said they have to make a profit, I’m for 501(3)C Health Coops. I have zero confidence that the government a run this program effectively and efficiently.

  17. Andy M says:

    A government run program, and/or a non-profit I would think as well, would have more interest in preventative healthcare than any insurance company would. As things are, there are tons of people who wait until they are sick enough to go to the emergency room before getting treatment, and that costs way more than if they had gotten treatment when they first got sick. In our current healthcare system, primarily concerned with profits, has no real motivation to push preventative care. That alone would cut costs immensely.

    And changing our healthcare system will change things in the long run. If the changes made this year eventually get us down to the point of spending relatively the same as most of the European countries with universal healthcare, then that will save tons of money. But if the system stays as it is, our costs on healthcare will only go up.

    @Jeff, you said, “I’m for 501(3)C Health Coops. I have zero confidence that the government a run this program effectively and efficiently.”

    I would, for the most part, agree, and I am all for non-profits, or coops, as a way to change the system if they work. You say you have zero confidence in the government to do it well, well while I understand strongly your feelings there and even agree to a fair extent, I also have zero confidence that private insurance companies can do it effectively and efficiently, mostly because they have proven that all they care about is profits, not the care of people. If they cared about people properly, then there wouldn’t be so many problems with our current system.

    Many times when we rail against government control, which I admit often is poor, we too often go to far and give too much control to private corporations who rule over us all the more poorly. And vice versa.

    My personal comparisons between leaving more control to the government, or to corporations, I would probably rather give more control to the government, because the typical Americans have more say in who is controlling the government and how they run it, than they do in who and how corporations run their businesses. You can vote people out of public office, you cannot vote a CEO out of his. Now, that is my opinion from my basic observations, and I leave it up to the strong chance that I could be wrong, but it makes sense to me.

    @Joe, I’m just curious what countries you have been in, and what reasons you have for preferring our current system. I have read articles by people in various European countries, (not the Soviet Union), who don’t mind their countries healthcare system, and prefer it over ours. I would be interested in hearing your thoughts on this.

    I will say, I rather enjoy this kind of conversation about this subject, rather than the craziness that has been going on in the last month or two. Thank you everyone for being very civil with a topic that can create such great divisions between people. Sorry my post is so long again though, I have lots of thoughts about this subject, as it has been on my mind quite a lot lately.

  18. Jeff says:

    Andy you say that you have more confidence in the government because we can vote them out, I would say that once something is established with-in the government, elected officials have very little say or control. Most programs are run by career government employees who not exist to perpetuate their job, we call these people GS 13 and 14 (just joking as someone whose father was a career fed and I worked in local government). But once these programs are set in motion very little will stop them or turn them around.

    At least in the private sector, allow for competition, most states only allow local/regional Insurance companies to sell insurance. The government’s core competency is creating laws and regulations and providing certain services. National Government Programs by their very nature become bloated and unruly.

    Let the government create the regulation with teeth that the President spoke of in the first part of his speech with Tort-reform. Allow for real competition for companies and set forth personal responsibility.

    My family has catastrophic coverage that includes preventative, we pay for it ourselves and we make decisions on health care based on cost and service. We don’t run out at every fever or sniffle. We use cost effective treatment options when we need care, such as the Minute Clinic, where you see a PA or Nurse Practitioner. The problem with regular insurance or government plans is that those covered go at the slightest feeling of sickness and because of the threat of lawsuit the medical facility orders way too many tests (just in case) and too often prescribes medicines that mask the symptoms. This drives up the cost of health care.

    I wish that employer covered healthcare would end, and just like auto insurance it would be the responsibility of individuals with some form of government safety net but not government run. If this was in the hands of the consumer I think we would see costs drop.

  19. Steven says:

    I must admit a little frustration at Obama’s claims…

    The bill won’t affect those with current plans?

    This may be ‘technically’ accurate, but it is far from true. There is tremendous debate over what effect the bill would have on current plans, and to shrug that entire debate off without even a reference is quite dishonest. The simple fact is that this bill may well incentivize your employer to drop your current plan. Kind of like saying, ‘I didn’t do X,’ while secretly hiding the fact that I advertised on craigslist to pay someone else to do X.

    So, while it is accurate to say the bill doesn’t touch your current plan, it is dishonest…

    And the same is true for other important aspects of this bill, ie abortion, end of life care or lack of…

  20. elderj says:

    A lot of insurance companies are currently non-profit. The biggest issue (other than the libertarian argument) is that we can’t afford it. The country is broke and paying bills on borrowed money. To create another entitlement program when the ones we have tremendous unfunded liabilities is unwise and to “trust” that Congress will be responsible with money is irresponsible. It will be our children and grandchildren who pay for this one way or another

  21. Andy M says:

    @Jeff,
    Just to be clear, I don’t really have that much confidence in the government, but in comparison to corporations, government gets more of my trust than they do. I’m not even saying that it is much, but I still have more say over the government than I do about CEO’s.

    Honestly, much of this will come down to a difference in opinion. It is my opinion that corporations cannot be trusted any more than government, in America maybe less. Many people I know would trust a free market corporation far more than the government. But I have serious doubts that competition alone will fix the system.

    You could say that I am choosing the lesser of two evils, because I don’t like either side.

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One Day’s Wages

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As I soaked in this breathtaking sunrise this morning above the clouds, I felt compelled to pray for so my places in America and around the world that are experiencing such pain, heartache, injustice, and violence. At times, it feels so overwhelming but in prayer, I was reminded of these words from John 16:33. As we keep striving, working, hoping, preaching, loving, truthtelling, reconciling, repenting, forgiving, dismantling, peacemaking, Kingdom building...may we fix our eyes on Christ: “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” - John 16:33 Grateful for a very full weekend of ministry and preaching in Toronto, Canada (GTA). Such a privilege to partner with @worldvisioncan @wvcollective to advocate for the most vulnerable around the world. God is so gracious. A true honor to meet and encourage local pastors, lecture at Tyndale University & Seminary (photo), and preach at Richmond Hills Community Church, Compass Point Bible Church, and New City Church. Thank you, Lord, that you use broken and imperfect people like me to speak of Your love. Today, Minhee and I dropped off our eldest child at her college. We have been thinking and praying about this day for many years. On some days, we hoped it would never come. On other days, we couldn't wait for it to come. On some days, we prayed for time to stop and other days, we prayed with anticipation. 
After an entire summer of laughing it off, it hit us...hard...this week. Seeing all of her stuff laid out on the basement floor was the catalyst to a load of emotions.

After unloading the car and taking her stuff to her new home for this year and mindful that she might never live with us again; helping sort out her stuff, saying hello to her roommates...I wasn't sure what to do or say.

A flood of thoughts rushed my mind.

Is she ready?
Have we done enough?
Have we taught her enough? 
What if this? What if that?

And so we shared what we have shared with her the moment she began to understand words: "Remember who you are. Remember WHO you belong to. Remember what you're about. God loves you so much. Please hold God's Word and His promises close and dear to your heart. We love you so much and we are so proud of you." And with that, we said goodbye. Even if she may not be thousands of miles away, this is a new chapter for her and even for us. I kept it composed. Her roommate was staring at me. I didn't want to be that father. I have street cred to uphold. Another final hug. 
And I came home.
And I wept.
Forget my street cred.
I miss her. I love her.
She will always be my little baby.

I'm no parenting guru. I just laughed as I wrote that line. No, I'm stumbling and bumbling along but I'd love to share an ephiphany I learned not that long ago. Coming to this realization was incredibly painful but simultaneously, liberating. To be honest, it was the ultimate game-changer in my understanding as a parent seeking after the heart of God.

While there are many methods, tools, philosophies, and biblical principles to parenting, there is – in my opinion – only one purpose or destination.

Our purpose as parents is to eventually…release them. Send forth. For His glory. Met a friend and fellow pastor who I haven't seen in over 20 years. In him, I saw a glimpse of my future. While only 10 years older, his kids are married and he's now a grandfather of 3. His love for his wife and family were so evident and his passion for the Gospel has not wavered. It was so good to see someone a bit older still passionately serving the Lord with such joy and faithfulness. Lord, help me to keep running the race for your Glory. Happy wife.
Happy life. - Eugenius 3:16

I still remember that time, many years ago, when Minhee was pregnant with our first child. She had left her family and friends in Korea just two years before. Her morning sickness was horrible and when she finally had an appetite, she craved her favorite Korean food from certain restaurants in her neighborhood in Seoul, Korea. I had no way of getting that food from those restaurants so I actually said, "How about a Whopper? Big Mac?" Sorry honey. Eat away. You deserve it. I don't care if it sounds mushy but sunsets are one of my love languages. Seoul, Korea was amazing but WOW...what a breathtaking welcome back sunset by Seattle. Not ready to let go of summer.

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