Solving the healthcare problem won’t be easy, for a couple of reasons.   First, we don’t have a model that allows us to properly contain costs while providing adequate care.  Secondly, and more importantly, there is shared responsibility between the spheres of government.

I believe that we need a tiered, shared model – that is, all spheres of government should be involved, but in a certain hierarchy of responsibility:

1. Self Government

The primary responsibility for a person’s health falls upon the person themselves.  If they disregard common responsibility for their own health, they can not expect everyone else to keep or make them healthy.  As Jim Carey said to one of his clients in the movie Liar, Liar, “Stop breaking the law, *sshole!”  It’s my responsibility to exercise, eat right, drive safely, not smoke, etc.

2. Family Government

The secondary line of defense against sickness is the family – we need to encourage families to care for one another, in sickness and in health.  This sounds unreasonable in our dysfunctional, individualistic families, but we need to expect people to depend on their families, especially their spouses, parents, and children.

3. Church Government

The third line of defense should be the church.  Now, it is easy to decry the lack of church service in this area, but I have news for you.

First, there are a ton of faith-based and community initiatives, so many that there’s an entire dept of the HHS devoted to them.  Second, the EO has an interesting article on the growing trend of faith-based alternatives to health insurance, based on a Washington Post article.

What’s really interesting is that these plans emphasize, even require personal responsibility as part of membership. Check this out.

Tobacco use, immoderate drinking, homosexuality and extramarital sex are strictly forbidden, and anyone caught violating these proscriptions can be expelled. The plans don’t pay for abortion, or treatment of sexually transmitted diseases or HIV that was not, as Samaritan puts it, “contracted innocently.” While each plan’s rules differ, most exclude coverage of preexisting conditions, as well as treatment related to cancer recurrence, serious heart disease, obesity, psychiatric disorders or vision problems.

4. Private Business

This fourth sphere of government should offer the general public plans that both cover risk and make money for the business.  Privatized health care offers competition to keep costs down, flexibility in that if I want more, I can pay more, and choice of services.  However, as we know, there are downsides to this model.  Which is why we must emphasize the previous areas of responsibility (self, family, church/civic organizations), and include the last, Civil Govt.

5. Civil Government

While I am no fan of socialized medicine alone, I think we need a hybrid that can help avoid the problems of a fully privatized system, while allowing the civil government to not be the primary health care provider.  Socialized medicine helps the poor or suddenly disadvantaged.  But centralized government programs can be wasteful and money sinks – this needs strict limits, and should be set up to encourage personal responsibility, and to not reward foolishness.

A hybrid model, based on this hierarchy of responsibility, should work.  Now, we need a practical model.