Monday, November 4, 2013

Obamacare and Star Trek

I am in the midst of a conversation with someone over my last posting.  The issue involves the tradeoffs in Obamacare.  A program such as Obamacare will involve a number of tradeoffs within society.  Some of us will pay more for our health services to enable others who do not have such services to finally access them.  Most of us would go further by supporting some types of tradeoffs in general to achieve the purposes of Obamacare.  Whether we accept the specific tradeoffs in the new law is another question and it is the subject of our current national debate.

Well, I don’t want to go into Obamacare as a whole.   Though I have my own opinions about the program, my concern was for one particular tradeoff that to me was unfair.  To support my side of the argument I call upon the wisdom of Star Trek.

In my last blog I noted the situation where an individual with cancer was loosing her insurance and there was no affordable replacement in the exchange.  Was this a fair tradeoff considering how Obamacare was now providing health insurance for other Americans who could not afford it in the past?   My position is no, but more on this at the end of this post.

Jeremy Bentham was a philosopher and social reformer who lived in England from 1748 to 1832.  He is credited as being the first to articulate the philosophy of utilitarianism.   We know this philosophy because most of us have watched Star Trek.  In the movie “Star Trek II: The Wrath of Kahn” Spock justifies his death to Kirk by saying that the needs of the many outweigh the needs of the one.  The plot continued into “Star Trek III: In Search of Spock” when Kirk found Spock’s body for the purpose of restoring to it Spock’s mind and soul.   Spock’s father pointed out to Kirk at the end of movie that the effort to save Spock cost Kirk his ship and his crew.  To this question Kirk responded that the needs of the one outweighed the needs of the many.  This was a true Jeremy Bentham debate.  (For more contemporary Star Trek fans, the debate is included with some interesting character twists in the most recent Star Trek movie “Star Trek Into Darkness.”)

And so we have the same debate here.  When does the need of the one outweigh the needs of the many?    I would say that no one who has a life threatening disease or condition should be put in a position of risk simply because this nation is changing its health care system.    I don’t think any American would want this. 

My previous post was about how the politics of the last two months are playing out.  It was not on the costs and benefits of Obamacare, or how such tradeoffs can be improved.  But if that is the subject, whatever modifications we make to the system should include carve outs for people who are now caught in terrifying circumstances such as the cancer survivor from my previous post.  Within the overall global tradeoffs of Obamacare there can and should be exceptions for cases like hers.   There should also be set asides and ombudsmen to help people in these situations.   Since the media has not mentioned such mechanisms, I can only conclude that someone forgot to put such protections into the law.   If they are not in the law, at a minimum, they should be in the law.

What I am trying to point out in these two posts on Obamacare is that our political debate both for and against the new law is not consistent with our national character.  Both actions of shutting down the Government, which was discussed in the previous post, and constructing a program that threatens the lives of even a few people run against some of the most fundamental principles of fairness that we were taught as children.

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