No Payment For Prayer: Christian Science and Health Care Reform

With the historic passage of sweeping health insurance reform, Americans have reason to rejoice this week. For the first time, and despite hysterical opposition from the party of conspiracy nuts and theocrats, our government has enshrined in law the idea that every citizen has a right to affordable health care. Even if the law is far from perfect, it’s still a huge advance over the alternative of doing nothing – and history shows that most major pieces of progressive social legislation, including Social Security and Medicare, started out flawed and were improved over time. With this bill now signed into law, we have a foundation to build on.

Atheists and freethinkers have another reason to celebrate (in addition to the removal of the noxious, theocratic Stupak language on abortion). Namely, one of the worst provisions of the bill – a clause mandating that health insurance companies pay for prayer – was removed in committee and didn’t make it into the final legislation. This clause was originally inserted at the urging of the Christian Science church, the cult which shuns all modern medicine in favor of faith healing delusions and would rather see children suffer agonizingly and die slowly than take them to a doctor.

Or at least, that used to be the party line. In the last few decades, Christian Scientists’ numbers have been in steady decline, and there are signs that the church may be giving ground on its absolute stance, as the New York Times reports:

Though officials do not provide membership statistics, scholars estimate that the church’s numbers have dropped to under 100,000 from a peak of about twice that at the turn of the 20th century…. In New York City, falling membership forced the Christian Science church on Park Avenue to lease its building part time to a catering service in 2006. Another Manhattan church remains open; a third closed in 2005.

It’d be easy to snark that the reason Christian Scientists’ numbers are dwindling is that so many of them tend to die. But I don’t think it’s sheer attrition that’s the cause. In the past few years, there have been more and more cases of parents prosecuted for letting their children die of completely treatable illnesses. I think it’s the onslaught of bad publicity and the church’s public intransigence that have been turning people off – not to mention the fact that, as scientific medicine gets better and better and its benefits become more and more apparent, there are increasingly few people willing to give it up.

Like most churches in decline, Christian Scientists have turned to the state to prop them up. The healthcare reform bill was a perfect example, where church lobbyists pleaded with the government to force insurers to pay them for praying. Christian Science practitioners charge $25 to $50 per session, but since their “treatment” of the sick consists of nothing more than babbling superstitious gibberish, anything other than zero is far too high a price to pay. And if every sect or cult under the sun could demand payment in exchange for carrying out their own magic rituals, where would it end? Why should the rest of us have to subsidize, through higher insurance premiums, the religious nonsense of modern-day witch doctors?

The American Academy of Pediatrics deserves commendation for their strong stand against treating prayer as the equivalent of medicine:

“Given the complete lack of scientific evidence of the efficacy of prayer in treating any illness or disorder in children,” academy officials wrote Senate leaders in October, “mandating coverage for these services runs counter to the principles of evidence-based medicine.”

But, as I said, there are signs that the Christian Scientists have started to relax their absolutist stance – the pronouncements of their lunatic founder, Mary Baker Eddy, notwithstanding. Though Eddy demanded that believers forsake medicine under all circumstances, some modern members are taking a more tolerant stance and starting to push prayer as an alternative, rather than a replacement, for conventional, evidence-based treatment.

The faith’s guiding textbook forbids mixing medical care with Christian Science healing, which is a form of transcendental prayer intended to realign a patient’s soul with God…. Mary Baker Eddy, who founded the Church of Christ, Scientist, in 1879 in Boston, wrote in the church’s textbook, “Science and Health With Key to the Scriptures,” that anyone inviting a doctor to his sickbed “invites defeat.”

But faced with dwindling membership and blows to their church’s reputation… Christian Science leaders have recently found a new tolerance for medical care. For more than a year, leaders say, they have been encouraging members to see a physician if they feel it is necessary.

…”In the last year, I can’t tell you how many times I’ve been called to pray at a patient’s bedside in a hospital,” said Philip Davis, 59, the church’s national spokesman, who has been tending to the sick for three decades as a Christian Science practitioner.

This may end up being one of the very rare cases where a religion is forced to change by the sheer weight of the evidence against it. The Christian Science church is still going through a process of smoothing out the rough edges, and as the benefits of modern medicine become increasingly obvious, their leaders may no longer be able to persuade the rest to forsake it. We may wind up with a situation like modern Roman Catholicism, where the bishops and the Pope continue to preach against contraception, but the official teaching is almost universally ignored among educated followers. And the happy fact that payment for prayer was removed from the health care law – a rare triumph of rationality in Washington – can only speed that outcome.

About Adam Lee

Adam Lee is an atheist writer and speaker living in New York City. His new novel, Broken Ring, is available in paperback and e-book. Read his full bio, or follow him on Twitter.

  • penn

    People could be choosing to leave, but honestly how many people do you know over the age of 60 who haven’t needed live saving medical care? I’m willing to guess the average age of church-goers is right around 60 (I only found stats for the Anglicans in the UK where the average is 61), so there is a good chance that they are in fact dying off.

    I personally would have died from appendicitis as a child without medical care. Not to mention the untold number of infections that have been staved off through the simple use of antibiotics. There is a reason the average lifespan in the U.S. went from about 40 years to over 70 years over the course of the last century.

  • FuzzyDuck

    “Alternative medicine, by definition, has either not been proved to work, or has been proven not to work. Do you know what they call alternative medicine that’s been proved to work? Medicine.”

  • http://theperplexedobserver.blogspot.com/ TPO

    It boggles the mind that language which mandated “health insurance companies pay for prayer” made it into the bill in the first place but thank reason for its removal.

    The passage of this bill is indeed a reason to rejoice but as you say, it is far from perfect and hopefully legislators like Kuncinich and Grayson will continue to push for further reform.

  • http://stevebowen58.blogspot.com Steve Bowen

    This is good news. We are getting a rare outbreak of rationality in the U.K as well. Currently you can get homeopathy on the National Health Service, but there is a growing lobby of M.P’s trying to put a stop to that

    FuzzyDuck: Oi! I do the Tim Minchin quotes around here :)

  • Zietlos

    See? Obstinate fossil meet intense heat and pressure. My pun-point from a few weeks back is proven.

    It ain’t perfect, for sure, but I’m happy for our Southern friends. Ours wasn’t the best at the start either, but no one, not even the most fundamentalist extreme conservative, would dare remove it since it would be political suicide (ignore our complaints, complaining is a national Canadian pastime).

  • Katie M

    The health care reform is certainly welcome news. I didn’t even KNOW about the Christian Science provision. Glad to see that there’s at least SOME sense in Washington.

  • http://www.ooblick.com/weblog/ arensb

    In the past few years, there have been more and more cases of parents prosecuted for letting their children die of completely treatable illnesses.

    This, by the way, is also noteworthy: it means that the US legal system treats prayer as having no significant medical value. In the last of these cases that I looked into, the parents were charged with negligence.

    Imagine a parallel situation: a patient has cancer; one doctor recommends radiation therapy; but the doctor in charge prescribes chemotherapy. After getting chemo, the patient dies. I can easily imagine the second doctor being sued for not administering the chemotherapy properly, or for not taking important factors into account, but not for “you idiot, you should know that chemo doesn’t work!”-type negligence.

  • TommyP

    My Grandmother is a Christian Scientist, and she’s married to, of all things, an internal medicine specialist. Go figure. She has no qualms about taking medicine for back pain, or even undergoing surgery. Always was a bit confusing to me though. Guess being married to a doctor has it’s advantages for changing people’s minds about medicine. Go grandpa!

  • Bletchley Park

    Why are you so thrilled about this health care legislation? This is an atheist website, and I dislike how partisan you are in your comments. This new bill costs way too much, and we taxpayers are getting higher and higher percentages of our income sliced away by the government. The government is inefficient when they try to run things. Similarly, those who don’t work and haven’t saved are sponging off of those of us who do. Homeowners who didn’t overextend themselves on mortgages are ticked off when they’re paying to help out those who have.

    Our opposition is not “hysterical”, it is thoughtful and based on real concerns. We think you might look back on this bill’s passage with regret, not rejoicing. Atheists are not necessarily liberal democrats like you. I wish you’d stick to No Payment for Prayer.

  • http://uncyclopedia.wikia.com/wiki/User:Modusoperandi Modusoperandi

    Bletchley Park “Why are you so thrilled about this health care legislation?”
    Because, while it’s not nearly as good as it could’ve been (lacking Single Payer and significant cost controls, for two), it’s better than the status quo, which wasn’t working and was getting worse.

    “This new bill costs way too much, and we taxpayers are getting higher and higher percentages of our income sliced away by the government.”
    1. Even before the bill, you were already paying for it.
    2. There is no 2.

    “The government is inefficient when they try to run things.”
    Did you hear that? That was all the countries that have proper socialized healthcare doing a spit-take (also, the VA and Medicare)*1.
    Health is a poor area to practice Social Darwinism*2.

    “Similarly, those who don’t work and haven’t saved are sponging off of those of us who do.”
    I know, right? It’s like when your neighbor loses his job (and, with it, his insurance), gets cancer and loses his house. Or when your other neighbor can’t get insurance for his kid because his kid’s got a congenital heart defect which eventually needs an operation and so they lose the house. Or when someone with insurance has something bad happen and, even with insurance is still wiped out. Or when you get [insert disease] and your insurance company drops you because treating it would reduce their profits (and you can’t get new insurance because your condition is now pre-existing) and your savings gets wiped out and you lose the house.
    Leaches! Every damn last one of them!
    And why should I pay for schools, libraries, roads, police and firefighters for poor people to use, anyway?! Pah! Let them fight their own fires, I say!

    “Our opposition is not ‘hysterical’, it is thoughtful and based on real concerns.”
    Three of you have real concerns. The rest are yelling “SOCIALISM!!”. While you can’t pick the people that argree with you, look that the party you keep. The ignorant and the greedy. The worst from “my side” thinks that leasing a new Prius every few years is somehow good for the environment.
    Next time, get a voice at the table and your concerns will help to make the bill better. You’re going to have to take back the GOP first, though. Good luck with that, the social conservatives and the plutocrats are tough to fight (one doesn’t use reality and the other’s got the money to make sure the former is both fed talking points and given airtime).

    “We think you might look back on this bill’s passage with regret, not rejoicing.”
    I think it’s a start; a foot in the door.

    “Atheists are not necessarily liberal democrats like you.”
    Shorter Bletchley Park: “Some atheists don’t have empathy.”

    1. Make no mistake, while socialized medicine has issues, it’s not like the US system, which has issues.
    2. Remember to warm up before practice, or you’ll strain something.

  • Eurekus

    I can’t believe payment for prayer was even asked for by these religious nuts. Don’t they realise it was inevitable that the rationally minded would object? Damn they’re dumb. What is perplexing is the gall of these people.

  • http://steve.mikexstudios.com themann1086

    Bletchley is either misinformed or lying. The bill reduces the deficit, for starters, and the government isn’t running anything (sadly), this was “merely” a massive regulatory overhaul of the health insurance network.

    The U.S. also has the lowest tax rates in the Western world, and the vast majority of people will see no change or a decrease in their federal taxes due to this bill.

    I’d also note the irony of an atheist complaining about another being “partisan” on his own blog. I mean, really Ebon, how dare you have opinions representative of a large majority of atheists!!

  • muema wambua

    I must say that the so called ‘christian scientists’ dont sound as Christians at all. Jesus himself did not shun medical attention. In several instances, he healed and recommended that the healed people see the priest (now the priests doubled as medical practitioners!). It is therefore not fair at all for anyone to call people who obviously deny Jesus teachings ‘Christians’. They are the weed that is planted by the Devil so as to confuse the ungodly, and non-believers. I am not sure where the atheists fall.

  • Kaltro

    Themann– “The bill reduces the deficit, for starters,”

    How does it do that?

  • Jerryd

    The amazing thing that both atheists and religious people overlook is that the 1,100 Christian Science churches are being subsidized by federal, state and local tax exemptions. And that is but a tiny portion of the tax money our government fails to receive and have use of due to the exemptions and other perks religions are given by a government that supposedly sits on one side of the wall keeping religion out of government and government out of religion. Amazing to me that the people crying the loudest about paying taxes are the religious right, and their churches are doing the most to cause all of us to pay huge amounts of extra taxes every year to make up for the religious tax exemption money our government never sees. And to think those exemptions are going to the most irrational and evil of religions as exemplified by Christian Science is beyond belief.

  • http://stevebowen58.blogspot.com Steve Bowen

    1,100 Christian Science churches are being subsidized by federal, state and local tax exemptions. And that is but a tiny portion of the tax money our government fails to receive

    Maybe Obama will follow the Greek Government’s lead

  • Roy

    “In 1894, Democrats in Congress passed the Wilson-Gorman tariff, which imposed the first peacetime income tax. The rate was 2% on income over $4000, which meant fewer than 10% of households would pay any.”-Wikepedia
    Look at ANY other government program and compare the promise to the reality. “This great legislation will only cost XX billion dollars” (and reality says XXX TRILLION).
    If you dare operate a private business like the government operates, you would be in jail (ponzi scheme for Social Security, barely legal bribes for votes, political chicanery by BOTH partes, etc.)
    And one of the biggest outrages: MOST LAWS PASSED ARE NOT APPLIED TO THE TOP OFFICIALS IN EITHER THE LEGISLATIVE OR EXECUTIVE BRANCH.
    Now, another first for government. Forcing a private citizen to buy something (health insurance). I wish they had found this authority last year. It would have helped all the car dealerships to have people buy the new cars on our local lots. (last paragraph sarcasm)

  • http://www.whyihatejesus.blogspot.com/ OMGF

    Now, another first for government. Forcing a private citizen to buy something (health insurance).

    Um, most states already have required insurance for vehicles, which is forcing a private citizen to buy something – so long as they have a car (which is necessary in most areas since we don’t tend to invest in public transport in this country). Massachusetts already has mandatory health care as well, which is provided to those who can’t afford it. If you can afford it and don’t buy it, you pay a fine. It seems to work out pretty well. The idea is to get people health care that can’t afford it.

    The real problem would be if this bill turns out to simply be a vehicle for health insurance companies to make money by forcing people to be customers instead of focusing on making sure the health insurance companies are being good providers.

  • http://stevebowen58.blogspot.com Steve Bowen

    Living as I do in a country with a fully funded national health service and compulsory national insurance, you guys don’t know what you are missing. Don’t be fooled by the bad press and horror stories, (we Brits like to knock anything down given the chance). The NHS is good value for money, it pays less for drugs than private hospitals do and you can walk in off the street with anything from a splinter to a heart attack and get it fixed without worrying about the bill.

  • http://steve.mikexstudios.com themann1086

    Kaltro,

    Check the CBO for details, but it’s a combination of various factors, including lowered costs for medicare/medicaid (and medical care in general; it won’t be enough, but it’s a good first step) as well as a tax on both so-called “cadillac” insurance plans and people who can afford, but refuse, to buy health insurance. Again, check the CBO for details, but the total decreases in the deficit are $200 billion over the first decade and $2 trillion over the first two decades

  • Thumpalumpacus

    The real problem would be if this bill turns out to simply be a vehicle for health insurance companies to make money by forcing people to be customers instead of focusing on making sure the health insurance companies are being good providers.

    And therein lies the rub. While I’m supportive of this effort, the skeptic in me cannot help but worry that the mandate to carry insurance, combined with the subsidies for those who need help, will interact with the lack of price controls to effect a massive transfer of public wealth into private hands.

  • Rebekah Dekker

    The only sad thing about the Christian Science church dwindling away to oblivion would be the loss of their news arm, the Christian Science Monitor, which actually publishes many well-researched and interesting news articles. Other than that, meh, let ‘em disappear!

    My family has excellent insurance coverage, but I support the new reform bill because I have friends who do not, a grandfather who sometimes has to decide whether or not he can afford his prescription refills, and a son who will be struggling with several pre-existing conditions once he gets out on his own.

    That said, I agree with Thumpalumpacus’s worry that the insurance companies will simply turn the new requirements into their own cash cow. I was strongly for a public option and/or a single-payer system.

  • Zietlos

    Ahh Rebekah, you are naive! (joke mode starting, just FYI)

    A public option only kills people. After all, when people think of Canada’s health care, their immediate thought is that no one, no one at all, ever gets treated. Britain is the same way: the doctors are too busy killing old people to help anyone! I’d say some doctors must kill several hundred people a day! Heck, the documentary Logan’s Run was based on Canada’s healthcare system, bet you didn’t know that! Anyone over 30 in Canada? They’re killed. And turned into soylent maple syrup. And sold to the States as “alternative medicine”.
    [/joke]
    [tl;dr below]
    Canada has one of the worst health-care systems, when compared to Europe. However, it has the absolute best in North America. For pretty much free, if you’re feeling bad in any way, you can get treatment. Public option is awesome.

    Oh, of course, we have much higher taxes than the states, gotta admit it. I laughed so much when I heard the complaints about the States’ tax rates… Whoo, and I’m not even in the most taxed provinces. But it makes things friendlier, in a way. Deep down, people realize they’re looking out for each other. I go to a classy restaurant, and see my waiter, and yes, I’m paying more in taxes than he is, but he pays what he can too. And if he spills boiling oil on his arm, yeah, I’m subsidizing his injury, that he got trying to make money, and I know if I’m injured I’ll also get subsidized, even if the costs are more than I ever put in, because there are a lot of people out there working who don’t abuse their privilege. Basically, everyone(IE regardless of income) is subsidizing MY health care, both the CEO I spoke with last week, and the server at the restaurant. And I help theirs in turn.

    It’s like putting aside a bit of money in a community fund, and whoever happens to have misfortune befall them can take use of it, but when they’re better they’re expected to contribute as well… I think this was called “insurance” before people took the term as a for-profit measure. The only people who should profit off death are morticians, not insurance salesmen.

    tl;dr: An open love letter to Canada’s Healthcare. Don’t ever change.

    As for the American system, corruption is a part of Stateside’s corporate culture. There will be abuse of these rules to get some profit, or even abuse of what most think are the rules, but really aren’t, until they get sued. You’re not being paranoid Thump, you’re being realistic.

  • http://steve.mikexstudios.com themann1086

    There actually are some decent price controls in the new law. My personal favorite: 85% of premiums must go towards health care; if it falls below that, the insurance company must rebate the insured to get back to that level. My only concern there is enforcement and regulatory capture.

  • http://www.daylightatheism.org Ebonmuse

    I agree that the public option, or the expanded Medicare buy-in, would have made this law much stronger. (I don’t know why Congress doesn’t just go back and pass the public option through reconciliation – there should be no reason why they can’t, it’s a straight-up deficit reduction according to the CBO.) But the medical loss ratio, as themann1086 pointed out, is the next best thing.

    Of course, the insurance companies are already trying to figure out how much they can get away with reclassifying as medical expenses. But it was always to be expected that they’d spend as much effort as possible trying to game the system, no matter what ultimately passed. This law is obviously going to need further changes and improvements, but I think we at least have the impetus now. My hope is that health insurance will ultimately end up like utilities: privately run, but strongly regulated.

  • IThePerson

    As an atheist, I’m a bit disappointed. Who would have thought that supposed “rationalists” would have been such dogmatic left-liberals! For too many atheists, the sentiment “only God can produce good social outcomes” has been replaced with “only Government can produce good social outcomes.” Sad….

  • http://uncyclopedia.wikia.com/wiki/User:Modusoperandi Modusoperandi

    IThePerson, I know, right?! It’s like they won’t even let the free market continue to profit by being a middleman in their misery! If denying care isn’t “added value”, I don’t know what is! Further statement of some description!

  • http://stevebowen58.blogspot.com Steve Bowen

    Can one be dogmatically liberal?
    Whatever there are plenty of things in life that can be left to the free market, but really health care isn’t one of them.

  • Thumpalumpacus

    My son’s mom has had an off-and-on battle with cancer over the last decade. After her co-pays and deductibles wiped out her savings, she was dropped. Now state insurance isn’t all that bad, but a month’s delay in the case of an agressive tumor isn’t good either.

    Having said that, I like the idea of healthcare not being driven by profits. In this case, I’ll side with bureaucracy over avarice.

  • IThePerson

    What’s wrong with profits? Profits are just signals that allow entrepreneurs to channel scarce resources toward their best uses. When the profits of an industry are high, other entrepreneurs are enticed to join, which drives down economic profit (as opposed to accounting profits) toward zero. When losses accrue, this is a sort of punishment meted out against incompetent entrepreneurs (losses indicate that they have put the resources to a lower value use than they could have otherwise been put).

    Unfortunately, self-styled humanists often seethe with hatred when the dreaded “p-word” is used, especially with ostensible “positive right” goods and services such as health care. Never mind that the health insurance industry has lower-than-average profit margins, or that government will, a priori, fare worse than private industry at allocating scarce resources, because it does not have the profit-and-loss system with which to contend.

    We DO NOT have a free market in health care. What you all are seeing is something I like to call corporate socialism, a state of affairs that CANNOT occur in a truly free market. Under corporate socialism, well-established companies actually WELCOME and CLAMOR for market regulations, because they artificially increase the cost of starting up businesses, which discourages potential competitors from opening up shop. In general, in this state of affairs, companies gain an unfair advantage by leveraging the coercive power of the state and using it against other businesses.

    Of course, I’m sure I’m just going to hear another screed about “greedy,” “evil” insurance companies “driven by the bottom line,” where they are “heartless” and “cut-throat,” reasoned argument need not apply.

    As far as I’m concerned, the best epistemological basis for understanding economics is rationally, not empirically.

  • http://www.daylightatheism.org Ebonmuse

    …or that government will, a priori, fare worse than private industry at allocating scarce resources, because it does not have the profit-and-loss system with which to contend.

    IThePerson, your argument implies that medical care should be allocated based not on the individual’s need, but on their ability to pay. Is that a position you wish to defend? If so, would you also defend the logically implied corollary that wealthier people’s lives are more valuable?

  • Katy Tan

    I am looking into Christian Science because it fits with my beliefs. I am not a Christian and I do not need to be one to be part of that church. I like the focus on the positive and the denial of the negative. It’s very non duality only with more of an emphasis on the self. If I want to go to the doctor I will. I was told by my friend who is also dabbling in it that you only don’t go to the doctor if you have built up a certain level of consciousness that you can see faith healing is the better choice. I’m really surprised Christian Scientists would let their children die vs going to get medical treatment because the people I have met all seem pretty grounded and level headed and would probably encourage a doctor’s visit. I know one practiioner encouraged my own to take the pills the doctor ordered for her during labor. But there are always extremists who aren’t in touch with reality and I think it’s kind of sad because there’s a lot of good there. P.S. Yeah for the Health Care Reform. Obama is awesome!

  • IThePerson

    You’re setting forth a false dilemma. It’s not about individual need vs. ability to pay. Scarcity–the condition in which the material needs and wants of individuals exceed what is FREELY available from nature–is a fact of reality; it’s not a social construct, but rather it’s the immediate consequence of the boundless desires of human nature coupled with the finite resources of the natural world.

    When you have scarcity, resources (and the goods of services that come from them) MUST be allocated in SOME way. There are many potential mechanisms through which this may occur. For instance, goods and services could be allocated through a first-come-first-serve basis (where you “pay” by waiting in line); through an egalitarian rationing mechanism (everyone gets exactly X amount of a good, no more, no less); through a might-makes-right approach (if you can muster the power to take it, it’s yours); or, in the case of the free market, the pricing mechanism. This doesn’t exhaust all possibilities, but these are some major ones.

    What I’m getting at is that health care services are scarce. Therefore, they MUST be allocated in some manner. I think you are advocating a mixture of egalitarian allocation and pricing (everyone gets at least X amount of health care, and additional services can be paid for thereafter).

    I think many people fail to understand that prices are NOT arbitrary. They are an imperfect proxy for scarcity (which, again, is based upon the reality of human nature and the natural world), although they are the best proxy we have. In that sense, they reflect a fundamental fact about the good or service in question. Health care IS expensive, precisely because it requires a vast amount of scarce resources to function effectively. When you take away the pricing signal, you introduce inefficiencies, because then health care is not directed to those who value it most highly (again, the proxy of which is price), but to those who want to wait in line the longest, or are best at lobbying political bodies, or whatever.

    I don’t know why you want to put forth these specious straw-men, as though people who are against mandated health insurance get their jollies from seeing poor people suffer. Moreover, your “corollary” that wealthy people’s lives are more valuable is a non-sequitur. One’s economic wealth is (in most cases) a reflection of the extent to which a person has satisfied the needs and wants of consumers in the marketplace. In that sense, the wealthy HAVE materially benefited their fellow human beings to a greater extent than have poorer people, although that is a completely different consideration from one’s “worth” in a metaphorical, humanistic sense.

  • http://uncyclopedia.wikia.com/wiki/User:Modusoperandi Modusoperandi

    IThePerson “Never mind that the health insurance industry has lower-than-average profit margins…”
    Should I cry crocodile tears? Should I be fighting to pay the insurance middlemen more to compensate them for the less-than-ideal margins?

    “…or that government will, a priori, fare worse than private industry at allocating scarce resources, because it does not have the profit-and-loss system with which to contend.”
    I know, right?! And I’m all “Why should my taxes go to some socialist program to fight other people’s fires?”

    “What you all are seeing is something I like to call corporate socialism, a state of affairs that CANNOT occur in a truly free market.”
    As long as you have government, there’s no such thing as a “truly free market”. Big Business tries to use the State to serve its interests, rather than the peoples’. The closest we came recently was probably the Gilded Age, which ended up (because of the, um, excesses of the Gilded Age) with the New Deal (most of which has been erased by the relentless deregulation from Reagan on up), if memory serves.
    The State is bad. No State (or a toothless one) is worse.

    “Of course, I’m sure I’m just going to hear another screed about ‘greedy,’ ‘evil’ insurance companies ‘driven by the bottom line,’ where they are ‘heartless’ and ‘cut-throat,’ reasoned argument need not apply.”
    *Greedy – If a company can make more money by raising your rates, then dropping you when it has to pay out, what is that, exactly?
    *Evil – Not evil. Fundamentally amoral. A for-profit corporation’s highest fiduciary duty is to “act in the best interest of the beneficiary”. The “beneficiary” isn’t the customer, it’s the investor. The ideal corporate business model is one where customers pay in but get nothing in return.
    *Driven by the bottom line – Well, yeah. Since the 80s, they’ve tended to be for-profit companies (still exempt from some anti-trust regulation from back when they weren’t for-profit, to boot).
    *Heartless – Again, amoral.
    *Cut-throat – Sure, but they insist on a co-pay for the throat cutting. Then they double your rate. Later, if you apply for, say, a de-pantsing or a trickle-downing, they drop you. Then you can’t get insurance, due to the now pre-existing cut throat.
    I have no problem with profit. I do have a problem with profiting from and by misery. Healthcare is not a place to practice Social Darwinism.

    “As far as I’m concerned, the best epistemological basis for understanding economics is rationally, not empirically.”
    So, either way, Single Payer then?

    Ebonmuse “If so, would you also defend the logically implied corollary that wealthier people’s lives are more valuable?”
    Obviously. If they weren’t, they’d be poor.

  • IThePerson

    Modusoperandi,

    did you read my post above yours (#32)? I really don’t feel like explaining from square-one again. I also like that you just continue with the knee-jerk, derisive, emotionally hysterical diatribes, as I thought you would. Please consider relying upon someone else besides James Carville and Keith Olbermann for your entire worldview (and no, I don’t watch or read Fox news or listen to any talk radio, in anticipation of your predictable comeback).

  • IThePerson

    Make that response #33, not 32. I don’t know what’s up with this comment board; it’s poorly designed.

  • http://www.daylightatheism.org Ebonmuse

    Scarcity… is a fact of reality; it’s not a social construct, but rather it’s the immediate consequence of the boundless desires of human nature coupled with the finite resources of the natural world.

    Agreed.

    I think many people fail to understand that prices are NOT arbitrary… they reflect a fundamental fact about the good or service in question. Health care IS expensive, precisely because it requires a vast amount of scarce resources to function effectively.

    Agreed.

    What I’m getting at is that health care services are scarce. Therefore, they MUST be allocated in some manner.

    Also agreed. This is all basic economics, which I don’t object to. The question is, what means of allocation are you proposing?

    I’ve already given my answer, but let me expand on it a bit: to the greatest extent possible, medical care should be allocated based on need. If a donor kidney becomes available, the person who should get it is the one who has the most urgent need of it. I define “need” as a combination of two factors: who’s in the greatest danger of death or permanent disability if they don’t receive treatment, and who has the greatest expectation of a long and healthy life thereafter if they do receive treatment. These decisions should be made by doctors, in accordance with the best evidence we can obtain (e.g., through clinical trials of what works and what doesn’t) to guide them. The costs of providing this should be spread across society via the risk-distribution method of insurance.

    What I do not advocate is allocation of scarce medical resources based on individual ability to pay. If a donor kidney becomes available, we should not give it to whoever can afford to pay the most for it. To do that would, as I said, be implicitly judging a person’s value based on their net worth, which is something I find abhorrent. You seem to be saying that this isn’t the allocation model you support. So, again I ask: What are you proposing? How do you think we should decide who gets medical care?

  • IThePerson

    If a donor kidney becomes available, we should not give it to whoever can afford to pay the most for it.

    Well, I personally agree with that. Let’s go through an example. Let’s say there are two people in need of a kidney, where one of the people will survive years without one, while the other person will die in a few days without it. Furthermore, the person who is near death has no ability to pay for it, while the person with the lesser need is a millionaire who can easily afford it. What kind of doctor, aware of the entire situation, would take the money and give the kidney to the millionaire and let the poor person die?

    Although this is a simplified example, what I’m getting at is that, perhaps unlike insurance companies, I can’t imagine a doctor worthy of being considered a human who would refuse to treat a dying person in exchange for receiving some money for his services. I guess I trust that doctors on the ground have enough compassion to, as you say, order his patients by need, and also offer reduced or free services to those who cannot afford them and are also in dire need of them.

    I think the difference in our opinions is that I believe that the allocation you advocate would happen naturally anyway, especially in true emergency situations; on the other hand, you seem to imply that it should be required by law in some sense, although I’m not sure how such an allocation would be enforced.

    Now, a problem I could see with this is that the bureaucratic nature of hospitals could hinder the ability of doctors to choose the need-based allocation, but ultimately I think it would happen more often than not. Just because health care COULD be offered for a price doesn’t mean that it HAS to be all the time. Certain emergency situations could (and probably would) be ameliorated through charitable acts on the part of doctors.

    I don’t know, maybe I trust people to do the right thing too much.

  • http://www.daylightatheism.org Ebonmuse

    Although this is a simplified example, what I’m getting at is that, perhaps unlike insurance companies, I can’t imagine a doctor worthy of being considered a human who would refuse to treat a dying person in exchange for receiving some money for his services.

    I can’t either, and I’m glad to see we agree on that much. But my question for you is: why should society rely on every doctor altruistically doing the right thing? Why shouldn’t we set up the system so that there are incentives for them to do that, so that they can be compensated for their good work and not have to repeatedly treat the needy at a loss?

  • IThePerson

    Ebonmuse,

    why should society rely on every doctor altruistically doing the right thing?

    Unfortunately, I don’t have much time to do justice to this question, as I’ll have to go pretty soon. I’ll just say that it is ultimately an issue of what our “rights” are, or should be, and how they should be assigned in society. The positive vs. negative rights dichotomy (which I realize some see as a false one) implies an irreconcilable conflict between property rights on one hand (using your labor as you see fit being a subset of such rights), and positive rights on the other hand (the right to health care).

    Making the need-based allocation voluntary fulfills the property rights claim while neglecting the positive rights claim; on the other hand, making the need-based allocation mandatory violates the property rights of health care providers while satisfying positive rights.

    If you take as an example the “right to life,” this could be used as justification for absolute property rights (property acquisition is a product of one’s own physical and mental abilities, and so it is an extension of one’s life), or for justification of positive rights (health care is often necessary to sustain life, and therefore people should be able to access it regardless of other considerations).

    It would take a much deeper philosophical justification for either position to be viable; in that spirit, I think Rawls’ A Theory of Justice in contrast with Nozick’s Anarchy, State, and Utopia elucidate this sort of dichotomy more deeply than either you or I could here.

    Well, I’ll have to go now; it was good talking with you, and I’ll conclude by saying that I enjoy both of your sites; in fact, it was your other site, Ebon Musings, that helped to propel me towards atheism. Take care…

  • http://www.whyihatejesus.blogspot.com/ OMGF

    Why would we put the onus on doctors to do what is right and not on health insurance companies? Health insurance companies are disincentivized to give out health care because it hurts the bottom line. Is it really the solution to put the onus on the doctors instead (and really simply pass the buck?) Why do ins. companies get absolved of their moral responsibilities?

  • Thumpalumpacus

    Why do ins. companies get absolved of their moral responsibilities?

    Well, they’re only people when they’re contributing to political campaigns. I thought everyone knew that.

  • http://www.daylightatheism.org Ebonmuse

    Just a few more thoughts:

    Making the need-based allocation voluntary fulfills the property rights claim while neglecting the positive rights claim; on the other hand, making the need-based allocation mandatory violates the property rights of health care providers while satisfying positive rights.

    I don’t see how instituting need-based allocation of health care violates anyone’s rights to anything. Are you under the impression that doctors will be forced to treat people? No one is arguing for that (except perhaps in the limited sense that doctors have an ethical duty to treat anyone in need of immediate care), nor does the health-care law require that.

    Even under my proposal, doctors would be free to choose their patients as always. If anything, this reform gives doctors more freedom than before: they can now freely choose to do the ethical thing and treat the sickest people, and still have confidence that they’ll be compensated fairly for doing so. The old system gave doctors the choice of either working for a loss or turning away people they might have wanted to help.


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