I know this is an odd forum for this discussion, but when it comes to discussing the unmentionables of politics and religion, that ship has sailed. Besides, it’s my forum and I can say what I want so long as I don’t come off like a dangerous terrorist. Using that word should make me come up on some super secret government internet search, so I’d like to take this opportunity to welcome federal agents to my little blog about triathlon training and my toddler son. Enjoy.
The “health care debate” is getting a lot of press these days and for good reason. Our society has arrived at a decision point that will heavily influence how the system works for the next several decades or so. I’m not going to opine on the concept of health care– what it is, what it should be and all the implications on the obesity epidemic, preventive vs. disease-based care, and the large amount of influence the pharmaceutical industry appears to have on related public policy. Instead, my concern here is about health insurance cost and ethics.
Previously, I shared a link on Facebook to an article in The Atlantic titled How American Healthcare Killed My Father. It’s a long read but worthwhile if you’re the least bit interested in understanding why things are the way there are in our health insurance system. I won’t revisit that article here, but I would like to discuss some portions of a similarly minded article by Representative Paul Ryan titled Health Care in a Free Society. To simplify matters, I’ll reproduce some excerpts from the article (even though I don’t have express permission to do so but I have cited my source).
First, I’d like to confirm that I’ve heard the stupid spoutings of some Republicans that since 75% of those with health insurance are satisfied with their coverage so therefore nothing should be done. Those “satisfied” would for the most part be those covered under employer based plans without anyone in their family having a serious health problem. The current system is not a free market. For those with a high deductible plan and an HSA– the very tools intended to increase the consumer’s ability to make informed choices– how difficult have you found it to compare your pricing and service options? Can you believe that there are gag clauses in many contracts between insurance companies and providers that prevent the sharing of service levels and pricing with the “end consumer?” What about the folks who actually had insurance coverage and yet still go bankrupt when a serious health issue arises due to swiss cheese exceptions, caps and other weasel methods to prevent insurance from acting like insurance was originally designed to act?
I don’t know about you, but with the current system, I’m absolutely convinced that Humana (who just raised our rates by 19.8% this year) would do everything in their power to avoid covering my family in the event of a serious health event or condition. Things are not right with the system now. Change is needed, but what kind of change? Representative Ryan says it better than I could.
There are three basic models for health care delivery that are available to us: (1) today’s business-government partnership or “crony capitalism” model, in which bureaucratized insurance companies monopolize the field in most states; (2) the progressive model promoted by the Obama administration and congressional leaders, in which federal bureaucrats tell us which services they will allow; and (3) the model consistent with our Constitution, in which health care providers compete in a free and transparent market, and in which individual consumers are in control.
He later continues…
…health care reform to reduce costs should be guided by the principles of economic and political liberty, what would such reform look like?…
One, we should equalize the tax treatment of people paying for health care by ending the current discrimination against those who don’t get health insurance from their jobs…
Two, we need high-risk insurance pools in the states so that those with pre-existing conditions can obtain coverage that is not prohibitively expensive, and so that costs in non-high-risk pools are stabilized…
Three, we need to unlock existing health care monopolies by letting people purchase health insurance across state lines…
Four, we need to establish transparency in terms of costs and quality of health care.
To me, the first and the fourth item are most salient. The third item seems to clearly increase customer choice, assuming that one and four also occur. The second item, I don’t know enough about to intelligently comment.
So why can’t we agree on them? The answer is that the current health care debate is not really about how we can most effectively bring down costs. It is a debate less about policy than about ideology.
Here’s my concern when it comes to choosing an ideology– which approach will help our country thrive in an increasingly global, competitive marketplace by encouraging innovation and entrepreneurship?
Here’s a few hints. Penalizing the self employed by sticking with an employer-based system doesn’t encourage innovation and entrepreneurship. Increasing the percentage of productive income commandeered by the government doesn’t encourage innovation and entrepreneurship. Choosing an ideology that is the very antithesis of individual liberty and free markets doesn’t encourage innovation and entrepreneurship.
For those that support a widely applied public health insurance option, think past your immediate desires and consider the future of our nation. What will it take for our country to continue its position as a land of opportunity and innovation? What policies support that outcome?