Sunday, November 22, 2015

Are General Propositions Worth A Damn?

I daresay that the chief aim of many is to frame general propositions but no general proposition is worth a damn.

Oliver Wendell Holmes (1841-1935)

Eliminating uninsured is a worthy general proposition, but price is often frightful for taxpayers, economic growth, middle class, and individual liberties.

Ending discrimination on basis of age, gender, and religion are fine general propositions, except for those who cherish keeping traditional values of their own kind.

Paying doctors for “value” rather than “volume” is rational general proposition, but it requires regulations based on impersonal big data rather than on personal wants.

Universally connecting individuals through the social media is powerful general proposition, except it may breed narcissism and ignorance of collective society.

Tolerance for other cultures is admirable general proposition, but other cultures may be intolerant of you and demand you to submit to their ideology or be extinguished.

Equal outcome for all is an idealistic general proposition, except that it ignores human ambitions, skills, and drive to rise above and improve the lot of the common herd.

The secular belief that anything goes is understandable and pleasurable general proposition, but it may produce addictions, degrade society, and create anarchy.

Going to war against ISIS is widespread reactive general proposition, but to kill or be killed has hazards such as what does it take to do the job and what do you do when you win.

Innovation and entrepreneurship are proven general propositions for creating prosperity, but progressive taxes and onerous government regulations retard their implementation.

The French call for Liberte!, Egalite !, and Fraternite! are desirable general propositions, but are not free and must be coupled with a commitment to Securite! whatever the price.

Ten Other General Propositions about Health Reform

One, the poor and uninsured will always be with us, no matter how noble your intent or intent your desire to alter the situation.

Two, to satisfy most of the people most of the time and to stay in office, you have to keep changing the rules to satisfy more of the people more of the time.

Three, to cover most of the people most of the time, you have to use Other People’s Money – the Have’s, the Young, and the Healthy – and most of this money comes from the Middle Class, not from the Rich.

Four, to cover most of the people most of the time requires a healthy growing economy: that economy may require progressives embracing an economic system they do not believe in.

Five, to make health care affordable and to protect patients against insurers’ abuse is not about covering routine care: it is about health insurance that protects patients with chronic high cost diseases against catastrophe.

Six, to afford people with equal opportunities are not the same as guaranteeing equal outcomes; to try to equalize the two is to try to reverse the laws of human nature.

Seven, to achieve successful reform you must grasp the reality that many people prefer personal one-on-one care from a physician to team-care from an institution or from government.

Eight, to judge the “quality” of medicine, or the satisfaction of care delivered, by data outcomes alone is a fool’s errand.

Nine, to think of the computer as the only effective tool for improving health care is foolish and simplistic; the computer is not effective for communicating many people, for many of the people you want to reach are not computer-savvy nor do they care to be.

Ten, to achieve effective reform, you must recognize that individualism and humanism are not always compatible with collectivism.

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