The Healthcare Debate

Here’s to Your Health
The View from the Middle

What if the government decided to make “free cars” to the list of unalienable rights listed in the Declaration of Independence? Of course, the government would have to become the sole provider of these cars and control production because they are so much smarter and more honest than we the citizens. The end result, in my opinion, is that everyone in the country would be driving a used Taurus, which our government would happily pay $100,000 for. Why, you ask, am I such a cynic?
The government loves the one thing that it is supposed to protect us from, and that is a monopoly. In a monopoly, there is no need for innovation. The shoppers have no choice. They have to come to the government for their free car. Why should the government offer choices? The cars are free! Take it or leave it. But why would they cost so much? A monopoly, which this would be, eliminates the incentive to be efficient, because there is no competition. Who needs to keep costs down? There’s only one choice, and we give the cars away for free (except for those pesky taxes they would have to take out of your paychecks every month).
And if you think a single payer health care system (which is what the Dems really want) would be any different, you are just kidding yourself. Costs would skyrocket. Patients wouldn’t care what tests are done. They wouldn’t care what those tests cost. After all, it’s free…isn’t it? And services would get worse. Doctors would be flooded with patient visits, because they’re free, right? Doctors would get paid less because they would have to accept whatever the government offers. This would cause these very smart people to choose other professions and eventually lead to a shortage of doctors.
I don’t know what is eventually going to be in the Republican healthcare bill, but I do have common sense and have talked to several doctors, so I have a strong opinion. First of all, it should allow people to choose what they are insured for or if they should even be insured at all. With Obamacare, for example, whether you are gay or 80 you must buy maternity care insurance. Really? Second, the government requires that you buy health insurance. Remember, in year one of Obamacare they made a big deal that the “fine/penalty/tax” for not buying was only $95 or 1% of your gross income, whichever was greater. Today, that fine can be as high as $5,000 for a person and $12,500 for a family. Who wants to bet that the “fine/penalty/tax” will eventually be higher than the insurance itself?
Next, we need to give our citizens the incentive to shop for services and doctors by giving them control of the money. Health Savings Accounts (HSA’s) are a great way to accomplish this. Medicaid and Medicare could put money into accounts for their participants that can be spent on health care or even other needs if they have a balance at the year’s end. This will cause people to think about how much a procedure costs or how much a doctor charges and to compare prices. This will drive competition up and prices down as consumers take ownership of their healthcare dollars. It would also stimulate the economy as left over dollars are spent in the open market.
Finally, we must provide coverage for what people want, and the reality is that some people only want catastrophic insurance. Let’s admit it that is what insurance is about anyway. People want to be protected from the impact of a cataclysmic disease or accident that could lead to financial ruin. However, we have perverted the concept of healthcare insurance into something that pays every penny of every procedure and every doctor’s visit. That kind of insurance conceives patients who don’t ask what treatments cost or if they are even necessary. It drives up costs, which someone will eventually have to pay for. Remember, there is no such thing as a free lunch and the government has NO money. The taxpayer eventually pays the piper.
When the details come out for this new bill, look for the presence of HSA’s and catastrophic coverage while eliminating the mandates. Tort reform may have to come later because of the limitations of reconciliation process, but ask any doctor about this aspect of health insurance and the tremendous impact it could have on costs. Doctors want to run tests that will actually help the patient, not just to protect themselves from litigation. In the end, common sense is the answer.