The Health care Problem

Health care. Again.

I got slapped so hard by people who just love the idea of Single Payer Health care systems (and I don’t care what the Wiki article says on the subject. Tax funded health care is socialized medicine. Calling it anything else is attempting to sugarcoat the pill) when I sent out my Sicko comments the other day, I decided to do a little digging and see if I could find some hard evidence on the subject. Luckily I didn’t have to look too far.

CATO just happened to sponsor Health Care University 2007 about a month ago. If you listen to the podcasts, you might be shocked to learn a few things. Arnold Kling visits his article Government and Health Care: The Good, The Bad, and the Ugly and discusses what does and doesn’t work in currently instituted government programs.

Suppose that instead of looking at health care policy as a means to push an ideology or score political points, we examine it from a pragmatic American vantage point. What works? What does not work? What backfires? Those are the good, the bad, and the ugly, respectively. The table below summarizes our experience in terms of three goals of health care policy: improving access to care; improving the quality of care; and lowering the cost of our health care system.

Government and Health Care: The Good, The Bad, and the Ugly

A CATO scholar that thinks government can contribute positively to the health care problem? Shocking! But oddly, making very good arguments.

Michael D. Tanner
talks about what doesn’t work in the health care systems around the world. Things like innovation that isn’t available anywhere else but here. That there aren’t any single payer systems that work;

When you look at single payer systems, you can divide them into two categories, those that work, and those that are actually single payer systems.

In Canada, 800,000 people are on the waiting list for treatment. In the UK today, 40% of all cancer patients never get to see an oncologist (because they die before seeing them) (The UK NHS Wiki article shows the same heavy handed bias as the other article I linked to above. I’m thinking theres a gov’t employee who is paid specifically to insure that the wiki article on NHS stays pro-NHS. If everything is so good, why are there so many articles on NHS problems on the web?) in terms of survival rates, the US ranks number one in cancer survival, the UK ranks 16th.

The government health care systems that equate to the quality of the U.S. health care systems, like in France, feature co-payment plans with co-pays as high as 40%. This is not a single payer system. In fact, it’s not much different from the system we find ourselves in here in the U.S.

The problems with the U.S. system are problems that have been beaten to death already, as far as discussion goes. Mandates don’t work (Massachusetts is a stellar example of this) percentages of uninsured motorists exceed the percentages of those people who have no health insurance, in areas where automobile insurance is mandated.

Employer provided health insurance doesn’t work. It has given rise to the problems we currently have.

Just paying for the insurance has the same problems as employer provided insurance. Those who use the service do not have to pay the costs of the service. (and will be indistinguishable from any other gov’t welfare system; e.g. demand will far exceed supply, costs will spiral, and rationing will once again be necessary) This is also not a solution.

So, what is the solution? Well, Health Care University 2007 didn’t offer one (at least in the podcasts) but I would think that for the U.S., the solution is obvious. Get the government out of health care as much as possible. At least provide tax incentives for individuals to purchase their own health care, with plenty of choices; in other words, not just incentives for health insurance, but incentives for health savings accounts. (HSA’s are extremely unpopular with insurance companies, and insurance companies are active lobbyists. Consequently, you won’t hear about them during the evening news soundbites) Remove regulations that strangle the insurance industry. If you want more, visit CATO’s voluminous Research Areas on the subject.

As someone who pays for his (and most of his families) health care costs out of pocket, I have to say that it isn’t the day to day costs that are a problem; it isn’t even the “what if you child breaks a bone?” type accidents that are a problem.

No, the problem arises when you have a chronic ailment that requires costly procedures, and most of the time these types of ailments will get your insurance (under the current system) canceled. Of what use were those $300 a month family health care coverage payments worth then?

HSA, HSA, HSA. I don’t think I can repeat that enough. Let me save that money myself, and after a few years, I won’t even need insurance coverage other than catastrophic care (which I dare you to find these days. Seriously, have you seen one?) so why would I need government assistance at all?


2019. Health Savings Accounts were a chimera.

Critics contend that low-income people, who are more likely to be uninsured, do not earn enough to benefit from the tax breaks offered by health savings accounts. These tax breaks are too modest, when compared to the actual cost of insurance, to persuade significant numbers to buy this coverage.

Wikipedia

The writing on the wall is and will always be that the cost of healthcare is more than anyone not in the 1% can afford. That is, if you live long enough to get cancer or a chronic illness. Someone has to pay for the professionals to research and create cures for the health ills of every human being, and the healthy simply don’t care about the cost of maintaining their health until they become ill. Then they go bankrupt trying to repair something that would have been more cheaply fixed had they not ignorantly broken it.

…things like, sleeping only four hours a night because insomnia keeps you awake for most of the night anyway, so why bother going to bed unless you are so tired that you almost doze off while chewing your dinner? Had I thought to look into sleep deprivation or sleep problems sooner, I might have worked a lot later in life. Believing I didn’t need a doctor to tell me what my problems were was my fool for a patient moment without having to go through all those years of residency and schooling.

To use the phrase socialized medicine is to repeat oneself needlessly. All medicine contains costs borne by the public at large. All of it. It is a classic case of an economic externality, which is why businesses toss the cost of healthcare around like a hot potato. No one wants to foot the bill, therefore everyone must be forced to foot the bill. How that cost is paid equitably, while providing access to limited facilities equitably? That is the really hard and important question. One that I am finally fully cognizant of lacking the knowledge and expertise to solve. It’s about fucking time, if I do say so myself.

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