November 29, 2004
The debate of government-provided health care raged throughout the campaign. Now, we don’t have to worry about Kerry being in office and pushing this on us, but judging from Bush’s history, I’m still a bit worried. Bush has not shown any real restraint in his spending during his first term, and his brand of “compassionate conservatism” seems to be a little too much Democrat-lite. I think he may take a few baby steps towards greater government control, so here’s why I think it’s a bad idea:
1) Health care is not a right
Rights are things that governments protect, not provide. People have only a right to freedom and to be left alone. The government involvement that best protects the rights of its citizens is to not get involved at all. When people make the argument that we have a fundamental “right” to health care, they forget about certain other people’s rights. Doctors, nurses, hospital administrators, and of course taxpayers. The reason that health care is not a right is that health care needs to be provided by someone. Whether that someone is a doctor, a spiritual healer, or the messiah, that someone cannot refuse to provide healthcare if it is a “right”. And once that doctor/etc is required to provide that care, he no longer has his rights protected. A system which arbitrarily subjugates one group’s rights (doctors who want to determine their own practice) to another (citizens who need health care) is inherently immoral. It doesn’t matter that the goal in mind, health care, is noble, if the method is immoral.
2) The government is not efficient
Do you want your doctor visits to most closely resemble the IRS, the DMV, or the post office? Our military, while the best in the world, isn’t exactly a shining model of efficiency. The rules behind something as simple as a tax code have been blasted beyond the point of comprehensibility. The IRS is supposed to offer competent tax advice, but they’re apparently wrong 50% of the time. The reason: there is no accountability. While private insurance is not incredibly efficient, it is driven by the need to adequately balance premiums and benefits. If they pay benefits too high without raising premiums, they go out of business. If they raise premiums without increasing service to create unreasonable profit, they lose business, and eventually will go out of business. There is a built-in corrective mechanism to ensure efficiency, which the government will never have as long as they are funded by taxes, which they can arbitrarily set or raise.
Likewise, if the government operates under the assumption that health care is a right, no burden should not be bared to cure or treat someone. I like to create a thought example. If, for example, I have a disease which will take a thousand dollars to cure, and I will die without a cure, should the government pay for it? Most people would say yes. After all, it is my right to be cured. Let’s say it is a hundred thousand dollars. Well, one can make the argument that spreading that over all the people in the US is not a major burden. How about a hundred million? Or a hundred billion? At some point, you reach a level where any reasonable person would admit that the burden on the rest of us is too high, and that I am not worth saving at that cost. In the market world, that limit is set by the market forces detailed above. Sometimes it’s not nice, but the system keeps working. In a government-run world, however, the government isn’t going to go bankrupt. The control on this sort of thing is absent.
3) Unpaid by the recipient is not “free”
I came across an article that I really liked. It compared health insurance to car insurance, and what would happen if car insurance covered things like oil changes and/or maintenance. Simply put, when something is provided to me at no cost, I am likely to use it as if it were free. Meaning that I am going to go to the doctor for something as simple as a cold, rather than waiting until it is serious. I am going to waste time and money on something that does not need attention, taking resources away from things that do. I will do this because I do not directly bear the “cost” of this attention. I personally believe that one of the factors leading to the increase in health care costs is the greater and greater role of insurance in the health care world. I am no longer required to make a choice between whether a service is needed, since I do not directly pay for it. As a result, I use unneeded services, making everyone else’s cost higher. That, spread over millions of people, raises the general cost of insurance drastically. If health insurance was more like car insurance, covering only the drastic and serious problems, we would all pay less. The more cost of health care that is felt directly by the consumer, the more market forces will self-improve the system and bring down overall costs.
4) There is no silver bullet
The number of drugs to treat problems is rising. The number of diseases that previously were deadly and are now treatable is growing. Life expectancy is increasing. Simply put, health care is becoming more expensive because it is continually getting better. And that is a good thing. Is there an easy answer to this question? Not at all. There are simple ways to improve or degrade the situation, but nothing is going to magically make health care cheap. I am currently sitting in Chicago for a major trade show about radiology. Companies are working their butts off to improve the ability to detect and treat diseases. The machines used are expensive and complex, and aren’t going to get cheaper. The only way to pay for this increased ability is by increasing cost, whether it be paid by consumers directly, insurance companies, or the government (of course, all three sources take their funds from individuals, in different ways). I would rather our health care can detect, treat, and cure more diseases, and if the cost of care rises to suit, so be it. It’s better than stagnation.
Over the course of the next few years, unfortunately I think greater government involvement is inevitable. I think that in the long term, it will lead to slower improvements in health care. Regardless of what system we use, the American people will perservere. But I believe that market-based health care will result in the strongest and fastest method for achieving improvements and better service. In the long term, if we can find cures (rather than treatments) for things like cancer, AIDS, diabetes, and a better understanding and treatment of the preconditions leading to heart disease, we will ultimately reduce the real cost of health care for most Americans. Preserving market-based health care will be the best way to see this day soon.
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