No one questions whether America is facing a health care crisis today. The question is what to do about it.

Every year, insurance premiums soar. As a result, fewer businesses are providing insurance to employees; or perhaps the employee needs to chip in, or the business pays partial coverage, etc. And in part, this is tied in with the fact of so much global competition -- we're competing against other countries who not only pay lower wages, but against those who provide fewer benefits and who don't deal with the same kind of legal crisis that puts so much emphasis on medical liability insurance. (This also means that doctors are freer to do what they really deem necessary to help people, without worrying that anything unconventional will land them in court.)

In the midst of this mess, we have a national mentality where we take little care about eating organic food and/or taking high-quality nutritional supplements (but we'll pay $15 for a synthetic multi-vitamin and think we're on a good track), getting enough sleep, doing things to reduce stress, and so on. We eat refined sugar and unhealthy fats galore, and then we're surprised when we end up getting sick and requiring expensive medical care.

What is the government's role in this health care crisis? What is the free market's role? I won't propose a definite answer, but will put some ideas together here and maybe ask a few questions.

The City Analogy

When you look at a city, that city is supposed to take care of its own basic needs. It needs to raise its own money to pay for infrastructure, which keeps it healthy enough to keep raising money to maintain that infrustructure and even to have extra funds for positive lifestyle investments, such as parks.

If the city decides not to spend any money on building or maintaining infrastructure, it shouldn't be surprised when it fails to thrive. And few would argue that it's the federal government's responsibility to go in and handle the infrastructure for the city. After all, how would that be fair to every other city in America? Unless of course you want to do the same for ALL cities. But then where is the money coming from? Farmers? If so, what about their subsidies.

In short, we have to remember that money for anything is either coming from someone else, or it's being printed, which devalues the dollar, which is detrimental to everyone (including those who are supposed to receive the benefit).

On the other hand, what if that city is socked with a hurricane or an earthquake? Most of us would agree that this is an instance when the federal government should step in and help financially -- in fact, individuals and other cities (having already contributed with their tax dollars through federal assistance) will often send more money to help the city recover. This is because we seem to understand two things: first, when one city is devastated like this, it affects us all; and second, that if the situation happened in our city, we would certainly want that kind of help.

So there is a difference here. In day-to-day matters, the city is expected to take care of itself; in extraordinary circumstances that couldn't be anticipated and are beyond reasonable preparation measures, the city can count on others to help.

The most important phrase here is "reasonable preparation measures." For instance, if a city ignored the warnings of most structural engineers and built its city offices atop a swamp, would it really be the responsibility of other cities to pay for their stupidity (through federal assistance) when the offices sank? If the city was using some new device that most experts agreed would cause an earthquake, and they ended up causing their own earthquake, should other cities pay to clean up the mess? After all, there is a limit to available money (unless we print more and devalue the dollar), and those dollars could go to those who had proven to be wise stewards of funding.

The Human Comparison

If we use this analogy to discuss today's health care crisis, then we'll note each person's responsibility to care for his health on a day-to-day basis. He needs to pay to keep things functioning well in his own body (infrastructure) so that he can thrive. This means paying for and taking preventive health measures as well as paying for any health care sought for typical / non-emergency health problems.

In this case, you could choose whatever preventive or corrective measures you wished to take, because you'd be paying for them out of pocket. And since insurance wasn't involved, there'd be no subsidizing of pharmaceuticals or other industries that "someone else" determines is legitimate (regardless of the science). The market, rather than special interests, decides what works. (And it's been shown many times that when people take adequate preventive measures, long-term costs can be greatly reduced because we're staying out of the hospital, which represents the bulk of our health care costs.)

In terms of prevention, some options can be expensive (such as organic foods and nutritional supplements), but getting exercise and good sleep and choosing fruits and veggies and lean meats (over fast food, for instance) is something anyone can afford. If someone doesn't care to make these healthy choices, then their lack of responsibility up front ends up landing them with responsibility when they get sick.

It terms of caring for those who can't afford corrective health measures, charities could spring up for those truly in need (and yes, some will argue that this should be the government's responsibility since they don't believe that people will take care of one another). In addition, more health care practitioners could work, as we do, on a sliding scale to help address different people's abilities to pay for services. A wise practitioner will be able to see who is abusing the system and refuse such people service while still providing this important option for those in honest need.

Where government could then kick in is in instances of medical emergencies -- expenses that someone cannot anticipate or be expected to have saved for. This is where society agrees that we ought to help because each of us would want to be helped in the same situation. This is the one area where you might argue for universal coverage, while day-to-day health issues were not under universal coverage.

This federal coverage would help accident victims as well as those whose health issues were not clearly due to their own lack of responsibility. For instance, if someone contracted lung cancer as the result of having an honest job in a dirty factory, this would be covered. (But should the government recover some of that cost from the business? Again, it's a matter of responsibility: did the factory know the danger?) But if someone contracted lung cancer after 20 years of smoking -- and the danger of smoking was known during that time -- should society really take on responsibility for the errors of that person's ways?

Responsibility and the Health Care Crisis

As you can see, I've used the word "responsibility" countless times through this article. Because that is what a nation of rights is supposed to be based on. As soon as we take responsiblity out of the equation, then we're not left with rights; we're left with privileges -- and these can be taken from us at any time. Rights cannot be (until we give them up by accepting privileges).

Responsibility should be at the heart of the health care debate, but as usual, when politicians get involved, it is thrown out the door and privilege is brought in place instead, because by wielding privileges, politicians can gain a great deal of power.

This general outline of responsibility taking part in solving our current health care crisis has some admitted challenges: who determines whether someone has taken adequate responsiblity for his health in order to earn the right of emergency coverage when cancer strikes? And when the government starts paying for universal emergency coverage, who determines the legitimate health care options for cancer? Right now, the legitimacy of health care options is extraordinarily political because there is so much money involved. So are you covered if you get cancer and agree to undergo chemotherapy, but not if you prefer to take a natural approach?

Part of this last question can be answered if we just get special interests out of our science. I'm ok, for instance, with alternative healing methods not being covered as long as scientists have not been able to show their efficacy. But the way the system works right now, we have major funding to promote conventional views that are highly destructive and only beneficial to a point; and this funding simultaneously quashes many of the alternative approaches that have shown on-going safety and efficacy. Until we eliminate this issue, then of course we'll continue with a health care crisis -- because we'll be pouring all of our money (private or public) into the coffers of huge companies that want our money, not our health.