Watch closely around 0:45 — it’s a really good quote!

I keep reading about the ongoing debate, with each side issuing pointed jabs into the other. What makes this debate so salient? Why are people so polarized about health care?

From the Right

Anything associated with big government scares conservatives. This is a reasonable fear as organizations that grow too large become more and more inefficient. Considering an article in the Houston Chronicle I saw this morning (4 Years after Rita, thousands still await funds), I understand the fear of a government with a track record of failure assuming more responsibility.

The cost of government sponsored healthcare is also problematic. It may sound nice to tax the rich, but if you’re rich, why would you support this idea? Heck, do I want another 5% of my earnings to be involuntarily taken and applied to other people? No, not really. In a country already mired in a deep recession, the idea that more money will be taken out of the private sector and redistributed to pay for health care costs is disturbing. It seems the last thing we need is for consumer spending to decrease. Congress seems to be myopic, passing bills that have profound long-term effects. Social security is already slated to be insolvent in only 30-or-so years, so why would the government take on that additional responsibility. Last fall, companies that were “too big to fail” did fail. Governments can get too big and fail if their financial obligations become too severe. It’s possible that people will stop buying government bonds at some point. Will health care push us over the top?

The current health care system does not function as efficiently as it could. (Although this is not to say that it is broken.) In a supply and demand sense, the solution to expensive and inaccessible healthcare is to flood the system with new talent and technology to drive the price down. Universal health care, instead, floods the market with 50 million patients who need health services. If the market is already tight, then we should expect delays for even the most basic of services. A black market may very well appear for those with more money. Uuniversal health care only makes the system less efficient and more likely to fail.

From the Left

Universal health care is a right for all humanity and it seems unethical to exclude the poor and destitute from this privilege. The gross inequality between the wealthy and the poor is also unethical as rich folks pad their pockets while the poor suffer. This is a good argument. Why should people be complaining about whether to buy an $80k or $90k car when people are dying because they have no access to health insurance? The really potent argument is related to kids, who make no determination about where they live or who their parents are. Why should they suffer through illness without access to healthcare? This is a moral argument, not a practical one.

Although I’ve never heard the argument that the government is efficient, the government does have power to create change that regular organizations do not. Since the health care issue is a moral one, then the government should institute legislation that promotes this right and guarantees it as a universal privilege, much like education is a universal privilege among denizens of the United States. No one debates if access to education is a positive thing—most everyone knows that it is. So too with health care, but the entire public just does not realize that it is a right.

The cost may be prohibitive to funding a new universal health care system, but the need is there. They say the current system is broken, so the question then becomes why would we not do something? People don’t have access to health insurance. People are dying—this is serious. Let’s fix the system and give everyone access, regardless of the cost.

Some Middle Ground

I shudder at this moral issue being shoved down our throats. Is it a moral issue to spend trillions of dollars to insure people who willingly and repeatedly chose to abuse their bodies? (Think obesity, heart disease, smoking, etc.) We regularly remind people of the need to avoid these things, but people still engage in bad behavior. Should we create a system that overlooks this problem?

If the health care system is already overburdened, then how can we expect it to get better by expanding the pool by 20%? That just means access to health care will be universal, not better. I think politicians use terms that are not accurate. By “better” they mean universal, not “better health care.” Perhaps they mean both, but the facts do not agree. (I understand that if you gain health insurance, you’re more likely to say “I have better health care” but that’s another issue.)

True, insurance companies are not about providing good health care. As my buddy Micah says, “They collect premiums–that’s what they do.” We cannot expect another governmental agency will improve our health care system. It just adds another set of bureaucrats determining whether you really need a procedure. When I’m sick, I don’t want Joe Bureaucrat deciding I do not need a procedure that my doctor requested.

My Solution

Adding to the supply. Since the supply of doctors is low, I propose that we establish a gigantic scholarship fund ($50B +) that provides full scholarships to people who want to be nurses, PA’s and doctors. This fund will pay for students to become medical professionals without incurring huge amounts of debt. The caveat is that they will agree to work in low-income clinics for 5 years after they finish medical school. This will improve access to health-care for the poor.

Researching cures. I propose that another $50B be spent toward medical research. This money will be given in proportion to disease mortality rate. Say, for example, that cancer kills 60% of Americans. Then 60% of this fund will go to cancer research. Researching cures will improve the effectiveness of medical care and reduce the long term mortality rates. In the name of fairness, agencies who accept this money must agree to return 25% of the profits from drugs discovered with this money to a future research fund.

Discouraging bad behavior. Cigarettes are taxed highly because they are bad for you. Sodas, high-fat snacks, and unhealthy processed foods should likewise be taxed. People often cringe at this proposal, but legislators have the right to discourage people from doing bad. All laws follow this pattern—and it’s why we get tickets for driving too fast. The health of the nation is a national problem—we’re overly individualistic, and this would remind us that the success (or failure) of a nation affects everyone. All of the revenue generated from this tax would go to funding medical research and scholarships. If you do not want to pay the tax, do not buy so many sodas.

Encouraging good behavior. Preventative medicine should be stressed. Vaccinations are great and a huge part of the ongoing health of the nation. Additional research should be done to improve vaccines. Health club membership should be encouraged as should forms of exercise. Perhaps fitness club memberships could be made tax-deductible and biking lanes made more prevalent. Parks and walking tracks could be supported to provide people with places to get exercise.

Changing the terms. Universal health insurance is a terrible goal. Insurance is not the goal. Health is the goal. We want people to be healthy and make good choices. We do not want to provide insurance that reinforces an ability to live an unhealthy lifestyle. It makes no sense. The health insurance debate is like a debate as to whether to give a patient Advil or Aspirin for pain. The pain is still there! Insurance helps alleviate the pain but does not address the root issue that people live unhealthy lifestyles.

Insurance companies also negotiate a preferred rate. As a customer at a doctor’s office, you must pay the full rate, not the negotiated rate. I propose that doctors can choose to accept the negotiated rate from any customer, regardless of insurance coverage. If you don’t have insurance, then you can pay the reduced rate. For doctor’s offices that wait months for insurance payments, this could be a good option to collect fees more quickly. People without insurance would also benefit from lower payments.

In Closing

I am sure that there are other solutions, and that some of the ideas listed above have holes in them, but I think my ideas create a long term plan to deal with healthcare in America.

What do you think?

Kari surprised me this week and told me she wanted a blog. Of course, how could I say “no” to her using technology?

Check out Kari’s blog here: The Maddox’s.