I have a lot of friends and acquaintances in the state of Washington, and I have had cause to ponder their state in particular given a job assignment I have had for the last couple of days in working with requests for information about Washington’s health care exchange. The failure of both the federal exchanges and the state exchanges in terms of educating their citizens on reasonable expectations for cost and coverage, as well as to provide timely access and information about health plans and what is covered and how much it is going to cost us, is shocking (if not exactly surprising) and well-documented. It is rather touching, in a sad and melancholy way, the sort of blind faith that people have in governments that have done nothing to show themselves worthy of such trust.

Quite a few people seem rather fortunate to receive any kind of help and assistance in working with the complexities of health care. This is a noble and honorable way to behave; it’s not the fault of the people that our health care industry is so complicated, even if people have often failed to take responsibility for living the right way (and most of us who are relatively health are so because of luck or divine providence and not often due to any particular skill on our part). Some people, on the other hand, seem genuinely upset that their questions are being answered by someone in the private sector as opposed to someone working in the public sector. Given the massive government incompetence this whole roll-out of health care reform has provided us, this bias against private sector businesses is both unwarranted and unwise. If there is to be any salvaging of conditions, it is going to be because of people outside of the government sector, as public efforts have done little good so far.

There are a lot of sad stories that I have to read in the comments that people leave. One reads of parents who need health insurance to get the tests for drug and alcohol to get their children back from Child Protective Services. One reads of pregnant women looking for insurance for their little ones. One reads of people on disability whose medications cost more than their monthly SSI check. One reads of volunteers in Asia looking for temporary insurance, or unemployed Ph.D’s or people whose work health insurance costs about a quarter of their part-time income. One reads of technical glitches, of phone calls to the government that are not answered or returned, of people who cannot login to a website that was supposed to be up and running a month ago. One reads of people who cannot afford to get sick while they try to hold on until the near year. And so on and so on.

It is hard not to feel a great deal of compassion for these people, despite the fact that they appear not to be very wise. Clearly, many of these people have made serious mistakes, and many of them are living lives that they are probably greatly disappointed with. To be sure, life has not gone as they have wished or planned, and health care plays a large role in that unhappiness, as a result of their choices and experiences as well as a cause of much stress and frustration and anxious concern. In such a situation, I feel for these people like Jesus Christ felt about the commonfolk of his time in Matthew 9:36: “When he saw the crowds he had compassion on them, because they were harassed and helpless, like sheep without a shepherd.” So it is in our time as well.

If any sort of perfection or even wisdom in how we live our lives was required for us to feel compassion for others, then none of us (and certainly not I) would ever deserve compassion for the difficulties we find ourselves in. To be sure, our people are not without blame for the state that we are in, both in our lifestyle and behavior as well as our expectations of medical care, particularly with regards to drugs and surgeries. There are larger systemic problems in the design of our health care system. Unfortunately, vested political and economic interests, as well as a refusal for people to countenance large-scale behavioral problems or a change in their overall moral worldview to live in a godly way [1], have made any kind of amelioration in our conditions a very difficult and unpleasant matter. Far from simply reducing costs, living a better life is the aim that we ought to have, a life that is lived well without looking down on others, but rather setting a positive example. Quite frankly, most people do not have any idea how to live.

Despite these follies and failures, I still have compassion on my people. Having been without health insurance for about four years, and looking at the unfortunate combination of an individual mandate for health care and a fairly high expense for that health care, even given my youth and relative health, I cannot say I find the current situation to be all that pleasant. Perhaps my biggest personal complaint, aside from the fact that none of the various state and federal exchanges are actually functioning properly, is in part of the systemic design failures of forcing an individual mandate in which people look for health care as individuals, without any kind of benefits from the law of large numbers [2], which makes for a lot of new customers for health insurance plans (that aren’t very good) without those people getting any benefit from being forced to shop for overpriced and underperforming health care plans. And don’t even get me started on the injustice and imbalance of what benefits are required to whom and why young people are expected to subsidize the elderly, single people required to subsidize families, and men to subsidize women, all of which are rather personally offensive to me. I still have compassion on my fellow people and the difficulties we are in, and hopefully we can all act in such a way as to help people deal with the mess of our current system and the mess of the present reforms. At least I do my best to do so on a day to day basis. Our first interest is to help others live a better life, and then to help ourselves while doing so.

[1] https://edgeinducedcohesion.wordpress.com/2013/10/28/achieving-health-care-for-all/

[2] https://edgeinducedcohesion.wordpress.com/2012/11/13/making-the-law-of-large-numbers-work-for-you/