When reading a
NYT article on Dr. Ben Carson, I was struck by the conservative tone to the article. Ben Carson is clearly a hero to many, including me, for coming from an impoverished background to become one of the most distinguished neurosurgeons in the nation. Since the article referenced the stimulus for the column, viz., The White House Prayer Breakfast, I watched the
speech on YouTube, and was amazed that someone with his background was so convinced of the need to inculcate the spirit of individual achievement to address virtually all of our problems. In short, as his extraordinarily poor childhood circumstances were overcome by his mother's insistence that reading and education was the key to success, at the expense of virtually no television, he is convinced that this is essentially the way to go for the nation.
Before proceeding, he announced that he is retiring from his successful career since neurosurgery does take so much out of one's being that he did not want to advance his career beyond a reasonable age. He is now considering options, including politics, and it appears that the Republican Party is beginning to salivate with the notion that he could become the first non-politician to become president.
As I read the article and listened to his speech, I admittedly was taken by his very palatable approach to an audience. He shared stories, often personal, to make his points and he was successful. His speech focused on education which he fosters with the Carson Foundation that recognizes high school scholars in all 50 states. Consistent with his history, the foundation spreads money to increase the availability of reading to students.
He focused on the nature of the PC environment whereby discussions are short circuited because the speaker is stating a position that is unacceptable to prior convictions, e.g., there was no way that I could be convinced that going into Iraq was justified. He stressed the need to focus on solutions from whatever source.
And then, he touched in a rather significant issue, health care. Given his occupational history, it was striking that he essentially rejected ACA in favor of personal health accounts and catastrophic health insurance. For those below a certain income level, their accounts would be subsidized by the government. He was consistent with his point that each person is called to be responsible for their lives.
The general approach is rational. I first read a very thoughtful
article in the Atlantic Monthly in 2009 (Wow! I can still remember, forcing Alzheimer's into the future) dealing with the cost of health care. The business executive, David Goldhill, examined the issue when reviewing his father's hospitalization with a series of untoward issues, requiring the use of ICU, and ultimately ending in death. From his business perspective, he noticed all sorts of anomalies. For instance, in contrast to business where the cost of new technology decreases over time, e.g., the price of a HD TV set is far less costly since it was first introduced, the cost of medical technology only increases. Granted the technology gets tweaked over time, driven by the benefits to the manufacturers and medical staffing, it was unclear that the end users were ultimately benefited significantly, measured by outcomes. i.e., our nation measures poorly when compared to other nations in measures of health. He felt that if the auto insurance model was applied to health care, the costs would decrease. In short, he envisioned a system comparable to Ben Carson's, whereby people insured themselves for significant problems, e.g., cancer, and the ordinary medical care would be addressed as people do with other problems in life (with the understanding that those below a certain income level would be addressed separately). He envisioned that if people had to pay for their own care, all sorts of costs would be reduced. For instance, the consumer would check on the costs of a clinic visit or a CT scan by various providers to see what was less costly. He also thought that the costs of products, e.g., scans, would decrease to address market issues, i.e., there would be less of a market for certain types of equipment because people would not pay for it.
And for review of what I would want, I would envision an extension of Medicare to all, paid by taxes, with prices for products determined by commissions based on geography and demographics that would establish on an annual basis the cost for each health care item (visit, procedure, etc.) on a cost plus reasonable profit. As in the present time, people could supplement the national plan with private insurance.
What I envision as desirable is contrary to Ben Carson's plan. Theoretically, I think that both could work well. The issue for me is practicality, leaving aside the big elephant in the room, i.e., national politics.
For Ben Carson's plan to work, we would have to consider whether promoting an ethic of self-direction and motivation to achieve, independent of socio-economic circumstances, is a reasonable and practical scenario. While I can envision that his approach would stimulate many to a more rigorous approach towards independence, I am concerned about those who fall by the wayside, unable to march to the beat of the drummer. While there may be far more people who identify with Ben Carson, I want to learn more about what he would do to address those left in the lurch.
The problem with my plan, as "great" as I think it is, is that it is politically unfeasible.
I admit that Obama's plan was a congressional mishmash, resulting in a highly
complex system that has yet to be tested. My plan offers simplicity and ease in implementation. It would control costs, not as efficiently as Ben Carson's plan, but effectively. My plan would be more stable, whereas a plan driven by capitalistic principles would ebb and flow based on efforts to achieve a higher market share.
In the end, if Ben Carson became President of the United States, and he was able to achieve success in implementing his health care plan, I would become an active spectator watching to see how it would unfold. It would be most interesting and give me something more to read.
,