Health care independence on the Fourth of July
By Richard E. Ralston
Two hundred years ago Thomas Jefferson sent Lewis and Clark to explore the vast spaces of North America from St. Louis to the Pacific Ocean. Jefferson understood the enormous challenges for the growth of knowledge and liberty on a continental scale. These were the first steps in the most spectacular expansion of individual freedom and human achievement in history.
Today the challenges are not geographical. While it took centuries of progress and effort to achieve the freedoms we still experience, we can lose them all in a single day when Congress is in session.
"Eternal vigilance is the price of liberty," wrote Wendell Phillips in 1852. This maxim is especially relevant today. We have choices and challenges in every aspect of our lives, but most notably in medicine. We can either watch our freedoms continue to slip away, or act to protect them.
The best way to celebrate Independence Day is to understand what we all must do to fight the seductive idea of government dependence. While this is most acute as it applies to health care, it is increasingly evident in all aspects of our daily lives. There are those in politics, in academia, in the media, and in Hollywood who are made very uncomfortable by the prospect of independent, autonomous citizens taking responsibility for their own lives and the pursuit of their own happiness. They would prefer a country in which everyone was dependent on government for all of their health care, dependent on government for the education of their children, dependent on government for their jobs, their housing, their retirement-dependent on government for life itself.
Unfortunately many of us now take for granted that someone else-anyone else-is responsible for providing us with health care. The catch is that any government that pays for all of our health care will control the details of every available treatment, every procedure, and every medication with the same grace and wisdom with which it controls the Department of Motor Vehicles. Worse, any government that pays for all of our health care will inevitably come to think it owns our bodies.
The current health care environment requires us to explore our options as vigorously as Lewis and Clark explored the topography. One step in the right direction is high deductible, low-premium health insurance in conjunction with a Health Savings Account (HSA). This combination can give you the freedom to make health care decisions for you and your family in an affordable way. If Congress acts to exclude the cost of these premiums from income tax they will be even more affordable. If your employer provides for some or all of your health insurance, request that they offer a plan with an HSA element. You would then be able to use those funds for health care as you see fit-and take them with you if you change employment or retire.
There are other things we will need to monitor to keep our health care decisions free from government regulation. The Federal government says it now wants to do more to protect your privacy. How? By requiring your doctor to keep all of your records on computers and make them available to the Federal Government. Physicians also have to prove they are protecting your privacy by meeting exhausting reporting requirements on what they are protecting. (Of course, if the government ends up paying for all of your health care, do you really think they won't have all the information about everything your doctor is doing?)
On this Independence Day, and on all future Independence Days, we have a choice. We will either be able to note the actions we are taking to preserve our freedom-or we will just be taking a day off work in the name of an historical event that has become irrelevant. We will be enjoying a celebration of life and freedom-or a rapidly receding memory. You decide.
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