Saturday, May 23, 2009

Not-For-Profit in the Arena of Needs and Single Payer Health Care

Not-For-Profit in the Arena of Needs

Who should profit from a person’s need for medical care or disability maintenance? Should anyone profit? Why should the gross-charge for medical care include a profit above and beyond the actual cost of production-distribution-administration and prorated training, design, and development and be a part of the economic model for the provision of our essential needs? Are food, water, energy, shelter, provisions for health/safety, and transportation essential need? Are these rights or privileges? Is survival of the fittest the our operating paradigm, or is compassion?

Specifically – health, medical, pharmaceutical, and prevention - businesses and services which comprise a 15 percent of our present GDP are essential to each individual’s life. Is the idea of profit for these services exploitive, if not a form of extortion? The brokers and middlemen that are now interjected between the consuming individual and the service provider/product should become unnecessary, with the improved levels of - communication, automation, and education – available today. Could an enlightened, educated, and responsible citizenry be self responsible for maintaining accountability for the efficacy of the administration of these services, and the acceptance of risk? Do we now have a model on the internet, AngiesList, that attempts to accomplish this? Is this not the place for litigation, but instead a place for the ‘free marketplace’ to weed-out, or entrust, where individuals’ actions to purchase and use are the judge and jury? If we and our educational institutions work correctly, we can dramatically improve our own oversight of medical care, and if we are individually conscientious, we can exercise higher levels of preventative medicine as well as preliminary diagnostics and even treatment prescription. If we individually fail to assume responsibility that fault lies individually with us. What defines a non-profit business? Who or what agencies monitor those not-for-profit businesses, define the policies appropriate of non-profits, and enforce those policies? Why would anyone want to establish and run a non-profit business? Could true not-for-profit health care related products and service significantly reduce the cost of health care? Or, on the other hand, are health care and the insurance management/access industries currently mainly operating as not-for-profit, thus making this argument moot? Is this truly and issue of individual responsibility, and if so how do we foster greater individual responsibility?

Another take of the problem of health care costs was developed by the CATO institute in 1994, in which the primary premise is the over-use of medical services because of ‘ease-of-access’ to the system. You can follow the link here to the article Cato Policy Analysis No. 211. In addition, Cato argues that ‘third-party’ payments (government/medicare/medicade, and insurance companies) are paying the bills, enabling the patient, and thus encouraging higher costs. Is it a combination of these observations? Are we trying to provide for the delivery of too much health care? What is too much? Too much for whom?

Last, how do these arguments relate to the other essential needs of food, water, energy, and shelter?