I have noticed a pattern lately in the articles that I have been linking to (and displaying in my sidebar) – many of them (4 out of 10 currently) deal with the issue of health care. I would like to post on all four eventually but for now I would like to discuss my thoughts on some of the general principles that I am seeing in the health care discussion.
The idea of a single payer system spells economic disaster to me.
The idea of forcing everyone to purchase insurance seems fine on the surface with the typical caveats that we subsidize that cost for low income people. On the other hand, I think that people should be able to choose to not purchase insurance if they have enough personal wealth – with the understanding that they will be fully financially liable for any care they receive. This may sound backwards since the wealthy would be the most able to purchase insurance, but imagine that I am a very healthy millionaire (I am healthy, but I do not have even a fraction of a million dollars in net worth) – there is no reason to force me to purchase an insurance policy if I am willing and able to assume the costs of my health care. Perhaps I have to sign away any right to declare bankruptcy in the face of medical bills.
There are two major things that any attempt to fix our health care system must address if they are to have any hope of success.
The first is to make people sensitive to the costs of health care. Right now most of us are only sensitive to the costs of health insurance. Once we have insurance (whether our own, through an employer, or Medicaid/Medicare) we cease to be cost-conscious because most of the cost is already paid. (High deductible plans have the advantage of keeping the consumer cost conscious.)
The second crucial change that must be made is to find ways to encourage healthy lifestyles and preventive care.
If we address these two changes the entire problem would become more manageable because we would have better health and less being spent on elective procedures. We might even hope to have fewer lawsuits driving up the cost of health care as people become more involved in making their decisions of what procedures they undergo.
I’m currently reading a book by the Cato institute that calls it “health insulation coverage” instead of “health insurance coverage”. I agree with you that Single Payer would be a nightmare. It would be ironic that we would pass such countries as Britain and Canada on the path to Single Payer just as they’re beginning to realize that it was the wrong path.
P.S. It’s interesting that both sides see that there is a problem with health care costs, but neither side thinks the other sees a problem, because the problems we see are so diametrically opposed.
As with so many other issues, we need to come together with our political opponents and see their points of view, and then we’ll find a solution.
It is interesting that both sides see the same problem (the cost of health care) but view the cause so differently. One side says turn it over to the government because private industry is driving up costs through greed and inefficiency. The other side says return it to private industry because government is causing prices to rise through inefficiency.
Two things are clear – prices are higher than we want and inefficiency needs to be removed.
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