Doctor filling out medical records for a patient and fellow staff. [Shutterstock – Irenaphoto]
Though it is altogether forgotten these days, the health insurance concept was originally intended to help working people (by which I mean all those who depend on income derived from their own personal labor, rather than their wealth, however invested) aggregate resources, so that, by spreading the cost of occasional health emergencies over a large enough pool of relatively small contributions, it would be more than adequate to help individuals cope with health crises without having to disgorge all their savings and/or destroy their livelihood. This is an assurance the wealthy can enjoy as a matter of course, provided they do not spend their substance on carnal dissipation, fruitless or physically injurious luxuries, or inordinate ambitious undertakings.
Thus, even for the wealthy, their self-insurance requires self-discipline. But this is even more obviously the case for working people, for whom bodily health is their fundamental asset, the substance of their substance, so to speak. Actuarial tables, health examinations, risk assessments and all the other features we associate with the health insurance business reflect this fundamental fact. This fact actually points to the real purpose that ought to drive the health insurance business, which is to insure health. It ought to focus primary attention on healthy habits of mind and body—nutrition, sleep and exercise—including the mental and spiritual exercises (prayer, sports, mentally engaging diversions) that help to reduce emotional stresses that can wear down the body’s systems for maintaining and defending itself.
As I have pointed out before, this obvious meaning of health insurance was the defining purpose of health care; and the preoccupation of the medical profession, before modern times. The first care of doctors in ancient times was to advise people about the courses of action that would best maintain their health, which were sometimes also effective in restoring it. For example, they observed, and preserved in memory, which diets appeared, in effect, associated with families and communities known for good health and longevity. The results contributed to health regimes in the full sense of the term- encompassing the habits that seemed to preserve people from sickness, and the particular foods, herbs and spices that also helped them recover from it.
That process of learning from experience was, as it were, put on steroids by the methods of modern empirical science. In the course of the nineteenth and twentieth centuries, the treatment of disease benefitted enormously from scientific advances. Scrupulously hygienic practices, and the discovery of antibiotics, encouraged the development of safely invasive surgical techniques, eventually (now almost miraculously) enhanced by advances in electronics, data processing and computer science. First, Doctors could more directly observe what was going on inside the body. Now, they can actually reach in and act on what they see, using ever less invasive tools, made possible by new technology. Advances in the collection, storage and analysis of data mean their diagnoses and consequent actions benefit from astronomically expanding databases. They can be analyzed and results quickly communicated, to develop treatments that can then be demonstrated, and sometimes even directly performed, across great distances.
Tragically, these advances in empirical knowledge and practices fed the aspect of human nature that has, from the first, tempted people to believe that the fruits of human perception can expand our reach without limitation. The serpent still whispers “…and ye shall be as gods, knowing good and evil.” The “God Complex” has become a proverbial theme, even in our popular culture. But the fact that some humans are encouraged to mistake themselves for gods, means returning to the day, long prevalent in human societies everywhere, when others are invited, or else, compelled to think of themselves as less than human.
Pseudo-philosophers of empiricism have come up with moral and political theories that, by erasing the defining boundaries that distinguish humanity, confound people with beasts and even with spiritless objects that have no individual soul at all. This dispirits all the aspects of individuality that allow us to conceive of ourselves as responsible persons, and act accordingly. Except for those who have eaten of the fruit of the tree of knowledge, humanity is said to have no special claim to consideration. The ebbs and flows of our lives, however exalted in our fantasies of love and romance, are no more significant than the lava that spurts from an exploding volcano, or the visible streams of energetic matter arcing from the Sun’s surface.
Say if you like that we can still feel the difference. That feeling is literally immaterial—it makes no difference when people are led to believe that there is no power in feeling but the matter itself that flows, and the material effects it works in us and in the world. The being, unperceived except in thought, that corresponds to our sense of ourselves, can then be dismissed as a worthless illusion, except for those few who have systematically translated their conceptions into material power, with which to evince and enforce their will.
What has this to do with health insurance? In its original concept health insurance aimed to make sure that working people could deal with health emergencies without destroying the modicum of self-sufficiency accrued from their capacity to work. That modicum of self-sufficiency allows them to preserve a modicum of individual independence, because even in a health emergency they can maintain their individual bodies according to their own responsible choice, materially independent of the dictates of those with more accumulated power. Like an army’s lines of supply, this modicum of material independence is what allows the people, as a whole, to maintain their self-government. It keeps the vicissitudes of material crisis from transferring all their material substance into the hands of one or a few rulers, as the famine in Biblical Egypt forced its people to hand their property to Pharaoh, with the help of Joseph’s skillful plan.
Avoiding that material dependency helps people to preserve the wherewithal to act on the intuitive sense of individual self-worth they otherwise naturally feel. But the key to doing so is not just the pool of material resources that results from their aggregation. It is rather their faith in one another, faith engendered by the understanding that they share a common commitment to self-discipline, which is to say personal self-government, in respect of the determination to live within bounds conducive to their health. Health insurance is thus more likely to work, according to its original concept, when people share such a common bond of faith.
Is that why some such bond was so often the basis for the first successful health insurance schemes? What sense does it make, now, to assume that, in the absence of such a moral bond, any amount of political calculation will produce a government-dependent health care scheme not doomed to crumble under the financial consequences of individual dissipation? What sense does it make to assume that insuring health is even the aim, when elitist politicians are simultaneously insisting on a false understanding of “rights” that encourages all manner of risky and self-destructive sexual and other self-willed behavior. And on a national scale, no less. It makes no sense.
But it all falls into place if we assume that their aim is like Pharaoh’s, to reduce the American people to abject dependency. Once an elitist few stand, as it were, athwart the path to a man-made “tree of life”, will they not be as gods, in their own eyes, dispensing life and death to assure that none will have life who are disposed to oppose their will? They will not be dispensing health, but dispensing with the claim of liberty for all, excepting, of course, themselves and those they choose to benefit.