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I am not a medical doctor nor do I understand all the complexities of health insurance, but I have spent time in a hospital as both a patient and as someone who visits hospitals to comfort friends and those whom I care about.  I also believe that there are several common sense principles that we are not following as a nation.  Here are a few of my observations:

1. Health insurance, whether through one?s employer or through a government entitlement, does not force the consumer to even consider the cost of health care.  When one presents the insurance card to a provider, there is often a co-pay cost but one has no idea of the total cost.  Discernment, comparative information from other health care providers never enters into the decision.  Most of us are never even aware of the total cost of the health care we receive.  It is the only major part of our decision-making as citizens that involves money where we do not consider the cost.  It seems reasonable to me that any reform of our health care system must force American citizens to be wise consumers.  Somehow we must reform the health care system so that those who consume health care begin to view it like any other decision they make:  Consider costs, benefits, quality of care, various options, etc.  Currently, nothing like that is even a part of health care decisions we make.  To me that seems silly!  Common sense tells me that I should view health care just like any other major purchase I make.
2. Marvin Olasky recently observed that ?Instead of uprooting our entire medical system, we should expand local clinics:  Patients would save time and taxpayers would save money.  Last year, according to the National Association of Community Health Centers, clinics?including Christian ones?cared for more than 18 million patients (70% of them with low incomes by federal standards) in more than 6,300 communities.
3. Recent reports have demonstrated that US medical schools are not graduating enough primary care and emergency physicians to fill needs.  Olasky writes that ?rather than moving towards the organizational and financial constraints of socialized medicine, we should find ways to make the practice of front-line medicine more attractive.?
4. It also seems to me that the absence of health insurance is not the same as the absence of quality health care.  The new health care legislation seems to disagree with that premise.
5. It seems to me that we must challenge the growing perception that government has the obligation to take the risk out of life.  Government cannot do that!  This pervasive assumption is absolutely lethal to our Republic and creates financially unsustainable promises?witness Medicare, Medicaid and even Social Security.
6. It also seems to me that we must challenge the idea, now the vital center of the health care legislation passed last summer, that health care is a basic human right in America.  It is not and it cannot ever be viewed in that manner.  Even if this were a proper approach, what kind of health care are we talking about?  All health care?  Are we entitled to all available health care technology no matter what the cost?  Do we truly believe that, as a civilization, we regard health care on the same level as all First Amendment rights, for example?
7. Finally, I believe rather strongly that we must force American citizens to accept some of the consequences of their personal lifestyle decisions.  For example, is there a human right to health care if a person chooses to be obese?  Chooses to smoke cigarettes?  Chooses to consume alcohol at a dangerous rate?  It seems to me that we need to have some kind of discussion about personal responsibility and accountability when it comes to accepting the consequences of certain lifestyle choices, including consequences in terms of personal health.  Rarely is this kind of discussion ever a part of health care debates or proposals.

In short, I am profoundly concerned about the direction the US has taken with the health care legislation passed last summer.  It seems to me to be a recipe for national disaster and it defies some basic common sense perspectives.  It is not good public policy, nor does it address some of the basic issues dealing with health care in this nation.

See Olasky?s short piece in World (23 October 2010).