Make Docs Pay for Healthcare

I find it intriguing that no one is asking this question: why, when doctors choose to give away their services, are the rest of us forced to pay for their largess?

The Regan era law requiring ERs to treat the uninsured sure doesn't help.  But that law feeds upon the medical profession's ethic that drives docs to give free medical service to those who can't pay.  I'm not saying they shouldn't treat people who can't pay.  But if one of my advertisers (I sell ad space for Newsweek Daily Beast) asked for an ad in the magazine but said they didn't have the money to pay, I'm fairly sure management wouldn't raise every other advertisers' rates by 1% to cover the cost.

Advertising isn't healthcare.  But somewhere along the line docs who are duty-bound to give away their services successfully passed the buck to me and everyone else who pays for health insurance.  Let's ask the medical profession to back up their ethics with action.  Rather than forcing consumers to buy health insurance let's force medical accreditation boards to allocate X% of doctors' time to serve the uninsured.  Remember Northern Exposure?  Kinda like that.  But on a national scale.

With the exception of legal defense against a criminal charge, I can think of no other profession in which services provided for those who can't pay are underwritten by everyone else who can pay.  Since healthcare is a unique service with limited price elasticity, a universal potential market, and morally freighted in every dimension, it has to be treated differently than other markets.  Turning our legislative guns to the root of the problem -- doctors who have to give away their service -- will lead us to a more just and effective solution.

People die in war

The mess in Afghanistan over the civilian victims of Robert Bale's shooting spree got me to thinking about some basic facts we seem to have forgotten about war.  People die in war.  War is horrible, unpredictable, and must be avoided if at all possible...but not at all costs.

2,551 civilians were killed in the 9/11 attacks.  That's when this war started.  Don't be fooled, we are at war with the people who launched those attacks.  The problem is that this is a modern asynchronous war with an enemy that doesn't hail from a sovereign nation or wear a uniform.  If the people, nay the government, of Afghanistan hadn't given harbor to our enemy we wouldn't be there.  But they did.  So we are.

So, this is a war and we are in it.  I'll go a step further.  We should be in it.  And we should finish it...or, as hawks like to say, win it.  And that means more people are going to die. But since our enemy won't wear a uniform or follow any international laws of war (a term that always brings a wry smile), we are going to kill civilians.

All we can do now is prosecute the offenders and keep fighting the war.  An NPR headline asked whether Robert Bale's shooting spree will alter White House policy in Afghanistan.  I hope not.  Bale is, at best, a troubled soul who should've been removed from the field of battle sooner.  But my suspicion is that hundreds of "Bales" went undetected in Vietnam.  Thousands probably went undetected in Hitler's army (and I'm not talking about the ones who were following orders when they murdered millions upon millions upon millions of Jews, Catholics, gays, Poles, and anyone else who was unlucky enough not to be born with the right stuff).  And in the history of peoples at war I'd guess hundreds of thousands of "Bales" have gotten away with murder.

The good news?  We're still a nation of laws, not men, so Bale will be punished.  We're also a nation that hates war so we're likely to end this one as soon as we restore some level of pre-9/11 security to America and our allies.