Some might take issue with this article’s title. Applying ‘”caveat emptor” (“buyer beware”) to healthcare reform presupposes that healthcare is a commodity to be bought and sold. Like other services, healthcare IS a commodity that (to an extent) NEEDS to be bought and sold.
I admittedly do not know the details of the President’s health care proposal (I can not find any), but I know what I do not want to happen. I do not want the system to lose performance (including efficiency) incentives for doctors, patients, insurers, pharmaceutical companies, and device manufacturers. While some people are altruistic, the vast majority of people (and companies) are not.
Communism failed because there was no incentive for anyone to do anything.
The same principles apply to healthcare. If all doctors are paid the same, doctors will have no incentive to be better doctors. Even further, if the exceptional doctors are not rewarded, then exceptional people will not become doctors.
People like to rail against “the obscene profits of the drug companies.” Those obscene profits are the reason that drug companies bother to invent new drugs. It is not a coincidence that most pharmaceutical research is based in the United States. Our policies reward innovation and investment. Price controls on drugs would have many undesirable “side effects.”
If health care is "free," people are more likely to run to the doctor for trivial health complaints, further clogging a system that is guaranteed to become backlogged.
Getting any non-emergency procedure would likely require getting on a long waiting list, as they have to do for non-emergency procedures in Canada and Britain. There is a reason many Canadians come to the US for non-emergency procedures, and whatever the reason (waiting list or available quality of care), it is undeniable evidence that their system is not superior to ours.
One reason our health care system is comparatively expensive is the higher availability quality of care. Competition between hospitals and health care companies spurs them to have the latest technology to diagnose and treat patients. On the other hand, if people are forced to go to your hospital, you can do without that new MRI machine. You have no incentive to retain the best doctors, who WANT to have the latest technology to treat their patients. If it is a government monopoly, where else are the patients going to go? Where else are the doctors going to go? Perhaps, they will both go to another country.
While demonized (admittedly, some criticism is valid), health insurance companies do create pressure for efficiency. Without such scrutiny, inefficiencies would never be addressed. Money and resources that could have been used to actually treat people would be wasted.
Besides, I am not sure that private health insurance is currently as cost prohibitive as many people contend. On my own, I purchased health insurance from a major insurer that is almost as good as the programs I had through employers, and it is only $114 per month, including prescription benefits and the ability to choose my own doctor. Granted, I am a single man, but I am over 40 years of age. People use Cobra all the time as an example of out of control health premiums, but Cobra is a rip-off. After leaving my last two radio companies, I had Cobra offers of $500 and $600 per month. No thanks.
As the administration embarks on their effort to sell health care reform, people need to pay attention to the details. Scanning the administration’s health care reform website (http://www.healthreform.gov/), I found it contained a lot of platitudes and nebulous goals, but concrete recommendations were conspicuously absent.
If one pays attention to the details of the administration's sell job, it gets harder to buy into the feel good hype and harder to be frightened by the scare tactics. For instance, the number of Americans who have been bankrupted by medical expenses is grossly exaggerated by the administration. (http://blogs.abcnews.com/politicalpunch/2009/03/false-talking-1.html). While a comparatively smaller number of medical bankruptcies STILL is something that needs addressing, a comparatively smaller number of bankruptcies makes the changes needed to address them much less drastic.
Socialized medicine would not be free, as proponents think it would be. It would cost.
Boy, would it cost.
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4 comments:
This more of a rant, than reasoned argument -- where are the citations? Where is the "undeniable evidence" that Canada's system is not superior to ours? Or France? Or England? Focus on the moral question: What, if anything, do we owe to our countrymen in terms of basic health care? Nothing? Is it better to have 40 million uninsured? There is no question there would be a cost -- but what is the cost we have now? And we do have a form of 'socialized medicine' now, it's called Medicare and Medicaid; if you are going to call for the abolishment of those programs, well, then we get back to the basic moral question -- What, if anything, do we owe to our fellow citizens (or fellow humans, for that matter) in terms of basic health care?
I do not consider this a rant. I do not see where anything I said was false. I would say my argument is reasoned.
If you want me to document that Canadians are coming to America to have procedures done because of waiting lists, I am sure I can provide that easily. I think people abandoning their system to use ours, while not proof that our system is superior to theirs, is definitely proof that their system is not superior to ours.
If you want me to document the problems of socialized medicine in other countries, including examples of the scenarios I predicted, I am sure I can provide examples of most of those as well.
The reality is that people in this country are not denied healthcare. It is against the law. If someone shows up at the emergency room, they must be treated. The insured pay for the uninsured. In addition, we have government programs for the most vulnerable. We have the Chip Program. We have Medicaid and Medicare (with fraud in the billions). We have health clinics. We have the Senior Prescription Drug Benefit. If all of these programs have not fixed health care in this country, what makes you think we need more? You are right, we do have socialized medicine in this country, and it has been a failure here as well. I have never called for the abolishment of these programs, but I do not think the reach of government needs to be expanded here. Chip and the Senior Drug Benefit are too new to fully judge, but the socialized medicine we do have, Medicare and Medicaid, are a mess. They are rife with fraud and need to be fixed, not expanded in their current form to cover everyone.
I agree that we have an obligation to help our fellow human beings. However, I think it is wrong to throw out our system in favor of another that is not demonstrably better.
I do not think that we need to throw the baby out with the bathwater here. Catastrophic care is the main problem for ALL stakeholders. An absurd percentage of health expenditures are made in the last few months of life, if you can call it life at that stage. Our problem is cultural (and legal), in that we feel the need to keep people alive until every last recourse in extending body function has been exhausted.
If we were honest about addressing the largest issue in our nation's healthcare system, we would examine end-of-life care. However, politicians can not spend money or give patronage in leading a moral change in the country.
Sorry -- what I should have said was: document, verify, be prepared to defend your position and question. And your response begins to do that -- and starts delving into the difficult issues, such as what does this mean in terms of end-of-life care? Does it mean rationing?
In general, (and this goes to all the bloggers, not just Bill) you want avoid generalized sweeping statements and have each statement stand on its own.
Although we mostly agree, Bill, unfortunately on some of your arguments I must disagree. You mentioned that you don't think "private health insurance is currently as cost prohibitive as many people contend." If that is the truth, then why are more people not insured. I have been researching and looking for private health care insurance that would not cost me an "arm and a leg," but I've had no luck. Unfortunately, a 33-year-old African-American woman with pre-existing health conditions and a long family history of serious health conditions living in an urban area is not given the same monthly quotes as a 40-year-old white man. Each insurance quote is based on the individual and the area in which they live. Yes, some insurance companies offer low monthly prices, however, the deductible is extremely high. Given that I have to visit the doctor probably more frequently than you, these deductible prices will affect me. Too, I have multiple prescriptions every month. In case you were not aware, with the deductible, before I begin to see the benefits of the insurance on copays for clinic visits and prescription costs, I have to pay the yearly deductible, which is $1,500 at the lowest.
Also, in my last blog, I was being facetious about needing surgery. No, I don't need surgery, but I'd like to know that I was receiving quality healthcare at any hospital if I was, and right now, public health care is not quality care. I know because every month, I have to visit the public health department for my follow-up visits, and if I didn't know the right questions to ask, I would not receive the quality care I deserve, like so many others.
I think it is about time that affordable, quality health care is offered to every one, and not just those who can afford it, or those on medicare/medicaid. Unfortunately, with medicare/medicaid, I would have to literally be a beggar on the street corner before qualifying for those programs. Because I make more than $5 a month, I have to pay for my healthcare and my prescriptions, which are not cheap.
No, I don't feel we should lose the incentives, because I wouldn't want to lose quality health care. But until we try a solution, even one as hyped-up as the one proposed by the President, we won't know what will or won't work. Like Linda says, don't we owe it to everyone to provide the same health care, regardless of their station in life?
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