Skip to comments.Healthcare: arguing about the price.
Posted on 06/30/2012 11:02:26 AM PDT by Sherman Logan
Healthcare: arguing about the price.
Just a word on healthcare in general.
My overall feeling is that I don't have a dog in the healthcare fight. We all know that joke whose punchline is: "We've already established what kind of girl you are. Now we're just arguing about the price."
A lot of the healthcare debate is like that, it seems to me. My conservative friends like to rail against "socialized medicine." Look: If hospitals can't turn away the indigent sick, you already have socialized healthcare. Who's going to pay the costs of that patient who can't pay for himself? You are; I am; she is; the insured person is, by government fiat on the insurance company; the taxpayer is. The costs have been socialized. Now we're just arguing about how, precisely, the money will flow.
If poor people and old people get their healthcare paid for out of current public funds, you have socialized healthcare. Medicaid and Medicare are socialized healthcare. What else are they? The bigger part of our healthcare system is socialized. We're just arguing about the price.
By failing to face up to this, public discussion of the healthcare issue is conducted in a fog of unreality.
Mitt Romney, for example, in his response to the Supreme Court decision, emitted a lot of hot air about, quote, "Consumers making their choices about what kind of healthcare they want," and how, quote, "Obamacare puts the federal government between you and your doctor," and how, quote, "We've gotta make sure that those people who have pre-existing conditions know that they will be able to be insured," and that, quote, "Obamacare is a job-killer."
With a healthcare system that is already three-quarters socialized, the federal government is already sitting there in the consulting room with you and your doctor. Consumers are already restricted in their healthcare choices by, in the cases of Medicare and Medicaid, government rules, or by insurance company rules otherwise, rules mostly dictated by legislators and judges. If "people who have pre-existing conditions know that they will be able to be insured," in what sense is that insurance? If I can go and buy an auto insurance policy right after I've had an accident, how is that insurance? Maybe it's right and moral that I should be able to do so, but it's not insurance. It's something else.
As for Obamacare being a job-killer: Well, any system of healthcare that enlists employers as part of the structure is killing jobs to some degree by imposing cost and administrative burdens on employers. It's a mere historical accident that American employers are yoked in to their employees' healthcare. There is no logical or moral requirement for them to be.
If a firm hires me to turn its lathes, sell its products, program its computers, or keep its books, what business is it of theirs whether, or how, I make provision for my own and my family's healthcare? It ought to be no business of theirs at all. To the degree that government forces it to be their business, government healthcare policy is killing jobs to some degree. Again, we're just arguing about the price.
Will a President Romney take a radical approach to any of this? Will he leave health insurance companies alone to do what they know how to do: offer people insurance based on rational calculations of risk? No: he just told us he will make the insurance companies continue to be what they have become conduits for government money and political patronage.
Will he unhook American employers from all concerns about their employees' healthcare? No: he'll keep them in the loop, imposing costs and administrative burdens on private companies that properly belong elsewhere.
Citizens of modern states will accept no other kind of health care but the socialized or mostly-socialized kind. This being the case, however regrettably, the most efficient option is to make the socialization as rational as possible. The problem with U.S. healthcare provision isn't that it's part-socialized: the problem is that the socialization is a disorganized, unholy mess.
Get insurance companies and employers out of the business, except when they voluntarily, without any political boondoggles, choose to be in it. Cover the population with a single-payer basic healthcare scheme funded from general revenues. If any citizen wants more, let them contract for it privately with insurers. If any private company wants to incentivize employees by offering them more, let them likewise do so as an entirely private arrangement with insurers.
There would be less socialism, and more private choice, in a system like that, than in what we now have, let alone what we are likely to have in any conceivable Obamacare or Romneycare future.
And that is in fact how things work over most of the advanced world. Yay for American exceptionalism: but this is one sphere in which American exceptionalism has gotten us into a bureaucratic mess, is encouraging ever-expanding government power, is pushing private choice and private enterprise out to the periphery when not actually killing them off, and is heading us into a world of public costs we can no way afford.
Sorry, conservative fans, friends, and colleagues. We're already socialized; and until the U.S. electorate is willing to let the indigent sick die for want of care which is to say, until the Earth crashes into the Sun we shall remain so. We're just arguing about the price the price in public money, in efficiency, and in liberty.
Let's corral the beast as best we can, and leave as much space for private choice as we can outside the corral.
I thought this part was especially good. With all the uproar over health care following the Supreme's decision this week, the facts of the situtation have been obscured.
The fact is we already had socialized medicine, and have for decades. What Obamacare does is shift around the control and add more inefficiencies to the process.
What we really ought to do is have a discussion over how to best handle health care in this country. What is not helpful is arguing whether we should or should not have a socialized system. That boat sailed decades ago, and it isn't coming back.
“What Obamacare does is shift around the control and add more inefficiencies to the process”
Bingo! It exempts undocumented workers, muslims, poor people and a host of others. I guess they plan on using the tax, er, penaly, er tax, is to pay the scores of obamaworkers to “administer” this plan into financial ruin.—Except that it already IS a Financial Ruin.
The beast will kill me, or I will kill the beast.
Federal govenment is a time-expired experiment.
It grows out of control and over-rides the needs of the people.
It has to go.
People will always be taken care of, however now with government forced healthcare, there will be no financial repercussions for those who truly can't afford it.
Life isn't fair and never will be, the only difference is when government gets involved, THEY decide who wins and who loses.
“Look: If hospitals can’t turn away the indigent sick, you already have socialized healthcare. Who’s going to pay the costs of that patient who can’t pay for himself? You are; “
I have always thought that was the basic problem with U.S. health care. That, and the need for tort reform.
A person should NOT be let of scot free if he gets emergency treatment. I can still see costs of his care being covered by you and me through our taxes if he dies with no estate. Also, the cost of a plain burial. That is the cost of living in a humane society.
Other than that, his estate and assets should be utilized to pay his legitimate bills. Maybe he’ll be in debt for a long time. Perhaps family or friends will help, he’ll inherit something and use that, a charity may help out, whatever, I don’t care. But it should be HIS debt until it is paid.
Who will collect from the 20 million illegals using hospital emergency rooms across the US for primary and emergency care? Under Obamacare, who will make them pay the tax for not buying health insurance?
What ObamaCare does is shift it from "can't turn away critical cases" to will degrade the care for those who have been paying their own way to give the same extent of "care" to everyone. The distinction is large in scale and cannot help but punish those who pay even more severely.
“Who will collect from the 20 million illegals using hospital emergency rooms across the US for primary and emergency care? Under Obamacare, who will make them pay the tax for not buying health insurance?”
My ideal scenario includes border enforcement.