cartoon showing doctor with patient Who is responsible for my healthcare?
One of my earliest memories of healthcare occurred when I caused my brother to break his elbow. I was probably 12 or 13 and he was 7 or 8 years old when I pushed him out of a barn’s hayloft and he fell - breaking his elbow on impact with the ground.

My parents took my brother to a hospital in Memphis which specialized in bone fractures. Memphis is 125 miles away from Houston. The medical expenses, Dad’s time away from work, and the travel costs were a financial burden on my parents.

We didn’t have insurance and my folks had to pay the full cost. It took several years for them to recover financially. I still feel guilty for what I did to my brother; even though we were playing and it was an accident.

Millions of Americans grew up in this environment believing ‘the individual is responsible for paying for his or her healthcare.’

Increasingly, Americans are beginning to shift healthcare responsibility from the individual to the government. Millions of Americans believe that the federal and state governments are responsible for their healthcare costs. Liberal politicians have eagerly climbed aboard this issue because supporting free stuff means votes. The beauty of this philosophy is that the ‘free stuff’ is paid for by taxpayers; not the elected representatives!

Shifting responsibility for healthcare from the individual to the government has created a wide difference of opinion among Americans and has divided the country. One group says that individuals should be responsible for their personal health care. The other group believes that the federal and state governments should assume responsibility for an individual’s healthcare.

  1. What is the proper healthcare role of the government? Most Americans likely agree that a nationwide health crisis warrants government assistance.

    “A health crisis or public health crisis is a difficult situation or complex health system that affects humans in one or more geographic areas (mainly occurred in natural hazards), from a particular locality to encompass the entire planet. Health crises generally have significant impacts on community health, loss of life, and on the economy. They may result from disease, industrial processes or poor policy.” Source:

    Here are some examples:

    • 1858: Swill milk scandal
    • 1905: American meat scandal due to the publishing of Upton Sinclair's book "The Jungle".
    • 1918: Flu pandemic ‘Nationwide, October 1918 was the most deadly month, when 195,000 Americans died. The supply of health care workers, morticians, and gravediggers dwindled, and mass graves were often dug to bury the dead.’ Source:
    • 1963: Birth defects by thalidomide
    • 1981: Toxic oil syndrome or simply toxic syndrome
    • HIV/AIDS
    • 1996: Bovine spongiform encephalopathy (BSE), commonly known as mad-cow disease
    • 2001: Anthrax attacks in the United States, also known as Amerithrax
    • 2003: Severe acute respiratory syndrome (SARS)
    • 2004: Avian influenza (H5N1), sometimes avian flu, and commonly bird flu
    • 2007: Lead paint on toys from China

    Fortunately, we have government resources to combat a health crisis. Here is a list of agencies:

    1. Department of Health and Human Services which includes:
      • Centers for Disease Control and Prevention (CDC)
      • Centers for Medicare and Medicaid Services (CMS)
      • National Institutes of Health (NIH)
      • Food and Drug Administration (FDA)
      • Health Resources and Services Administration (HRSA)
      • Agency for Healthcare Research and Quality (AHRQ)
    2. Department of Labor (DOL) which includes the Occupational Safety and Health Administration (OSHA) III
    3. U.S. Environmental Protection Agency (EPA)


    4. The Veteran’s Administration which provides healthcare for our nation’s veterans.
    5. Additionally, each state has its own state health agency with individual health departments located throughout each state. Source:

    As you probably realize from this partial list, there are many federal and state health organizations being funded by our taxes.

  2. How many different organizations do we really need?

    I have over 40 years of government experience and have learned that nobody is more passionate about an organization than the administrators who survive and flourish within each organization. It’s their kingdom; their reason for existence (raison d'être). Administrators also look for growth opportunities. Transferring mission (or responsibilities) from your organization to another is frowned upon. As their organization grows, the administrators are promoted, given higher salaries, and gain more power. Administrators are a powerful force working to retain their organization and with sponsorship from elected representatives, the organization’s longevity is assured.

    The net effect of fighting to retain government organizations is to forego consolidations which could save overhead costs and provide more streamlined and efficient service.

  3. Why does everyone need health insurance?

    “The Patient Protection and Affordable Care Act - often shortened to the Affordable Care Act (ACA) and nicknamed Obamacare is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Under the act, hospitals and primary physicians needed to adopt their practices financially, technologically, and clinically to produce better health outcomes, lower costs, and improve their methods of distribution and accessibility.” Source:

    Prior to 2010, who provided healthcare to people without insurance? Medicare and Medicaid programs, state health departments, school nurses, pro bono contributions by doctors, charity hospitals, and many hospital emergency rooms nationwide provided healthcare to the poor.

    In spite of these resources, some people chose to forego medical care rather than accept charity. This situation was deemed intolerable by many liberals and after several attempts, they finally succeeded in establishing a massive federal healthcare insurance program partially funded by our taxes.

    This action has divided our nation philosophically. In 2017, conservative politicians are proclaiming that the Affordable Care Act is failing and its cost has escalated beyond our ability to pay. Supporters of the Affordable Care Act are not concerned about cost overruns because they refuse to assign cost to human health.

    I don’t know what the final outcome will be. As of July 2017, our elected politicians refuse to compromise with one another. Healthcare is the battlefield and politics is the weapon. In the meantime, our Nation is paying the price of this philosophical war.

  4. My solution to healthcare is one of compromise and common sense.

    • I believe owning a health insurance policy is a luxury and a person’s individual health is not guaranteed by the Constitution. As an analogy, not everyone can afford to own a car. If you can’t afford a car you use public transportation, you hitch rides with others, or walk. Why should the government give individuals a health insurance policy; especially when there are so many health service organizations offering ‘free’ or reduced cost benefits available for the indigent?
    • The role of state health departments should be expanded. They should operate on a 24/7 basis and should be located near hospital emergency rooms. Staffing should include a range of medical specialists.
    • Walk-in patients would be triaged by the health department.
    • Patients requiring emergency services would be treated by the hospital’s emergency room. Billing would be sent to the State Health Department.
    • All other illnesses would be treated by the health department staff.
    • Patients would be billed according to their ability to pay.
    • State health departments would receive funding from the federal and state governments.
    • Each state would determine the level of medical coverage for eligible patients. Their medical coverage would be paid for by individuals plus state and matching federal funds.
    • People undergoing medical training could be assigned to work (for a period of time) in health departments to gain practical experience.
    • Buying an insurance policy is the prerogative of people who can afford health insurance. These people should be able to select their doctors and choose medical procedures within the guidelines of their insurance policies.

    Is this a perfect solution? Maybe not, but this proposal:

    • Assigns each state with responsibility for determining what medical procedures the state is willing to provide its citizens.
    • Provides ideas on funding and how consolidating funding from several sources can save on medical costs.
    • Gets the federal government out of the health insurance business.
Joe R. East, Jr.

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Updated 07/15/2017
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