There's something about medicine and health care that have a way of stirring up emotions.  When I was growing up, my dad was the director of International Marketing for Upjohn Pharmaceuticals.  Our close family friend and next door neighbor was the president of one of the largest insurance companies.  My uncle and godfather was an eye surgeon and a hospital owner.   Fortunately, all three were great friends—and very diplomatic.  But the dinner conversations were—educational, to say the least.

In general, I've been pretty quiet about the current health care debate, with the exception of letting my various representatives know what I want them to do.  But today, my brother-in-law, Dennis McCarthy, who is one of the smartest guys I know, reminded me how even the experts can get confused.

Dennis posted a Facebook link to A second opinion on death totals for the uninsured that seems to suggest that whether or not one has health insurance makes no difference—that either way, one gets the care he or she needs.  The report looked at an earlier study that suggested as many as 22,000 people die annually in the U.S. for lack of health insurance.  But recently, Richard Kronick published a paper that challenged these findings.  The basis for the challenge

... is that Kronick adjusted [the data] for a number of demographic and health factors, such as status as a smoker and body mass index. When he did that, "the risk of subsequent mortality is no different for uninsured respondents than for those covered by employer-sponsored group insurance."

This brings to mind a wonderful quote by H. L. Mencken: "There is always an easy solution to every human problem — neat, plausible and wrong."

It is easy to argue almost any point you want to make if you use a simplistic model of reality.  The idea that there is an independent, Boolean variable—isInsured—at play here is just too simplistic.  Even Kronick himself quickly adds that his conclusions are "counterintuitive" and points out that "... the difficulties of inferring causality from observational analyses temper the strength of this conclusion."

For example, is insurance status really independent of smoker status and body mass index?  Might it be that regular preventative doctor visits (which uninsured generally do not experience) have some influence on smoker status and/or body mass index?

But, for me anyway, the issues run much deeper than whether or not mortality rates are independent of insurance status.  Even assuming that they are independent (which I doubt), quality of life is very much affected by the nature of health care one has available.

As a parent of three kids—one of whom is denied insurance based on a pre-existing condition (for which our nation's finest doctors at The University of Michigan Hospitals, The National Institutes for Health, and elsewhere can't even agree on the diagnosis, or even if there is definitively a long term problem)—I have given this matter a great deal of thought.   Fortunately, in our case, Carol and I are able to provide health care for ourselves and all of our kids, though at considerable expense.  But what about people that don't have the resources we have?  To bad, so sad?  Go to an emergency room whenever you have a problem?  (And forget about any preventative care?)

In my view, that is not moral.

In my view, quality health care, including preventative care, is a human right.  Just as is the right to not be a slave, to live in safety, etc.  I realize that some people may not agree with me on this, but nevertheless, I chose to believe it is—to define it as—a fundamental human right.

Still, I'm not a socialist.  Far from it.  I am an entrepreneur who has started a number of businesses and who as made a very good living.  I believe that health care workers—doctors, nurses, PAs, etc.—should make a very good living as they provide a very valuable service.  But, profiteering on a fundamental human right is wrong.  In addition, our current system is failing economically.  If you compare our per capita health care costs with any other industrial nation, we are way out of line—often more than double what the "socialists" experience and we are doing a terrible job of providing preventative care for many of our citizens.  We can do much better.

One of my friends has insurance; he is not one of the "40 million."  He'll be 51 in a few days and has yet to have a colonoscopy because his insurance won't cover it (in other words, has rationed his care).  And this despite the fact that his father died of colon cancer.  He is currently underemployed and cannot afford to pay for it himself, nor can he walk into an emergency room and get it.  But if he gets cancer, he will receive some emergency care.  This is not a good system.

This is a messy, complicated problem.  And it is made worse by the fact that enormous (and enormously powerful) institutions already exist that are precisely in the business of profiteering on health care.  But because it already exists, does not make it right.