In the spirit of ubiquitous presidential primary coverage, it is a great time to address the big domestic issue of the election: health care reform. I have managed to acquire some strong views on the direction that health care reform should go, which are informed by my more general socio-political-philosophical views. While I am certainly no expert, and know that no magic beans exist that can “fix” this convoluted system, I strongly believe the following:
- The federal government cannot efficiently or effectively manage the US health care system. This can be done thousands of times more cheaply, fairly, and efficiently by the private sector.
- Health insurance should not be an entitlement program. Only citizens who cannot afford coverage, as a result of being objectively considered impoverished, should have government-provided care.
- The major crisis facing the American health care system is not the growing population of uninsured, it is rising costs. Loss of affordable coverage is a symptom, not a malady, of the system. “Universal coverage” is a media buzzword which is irrelevant if rising costs are not halted.
- Many of the problems of the current system are due to government intervention in insurance and care, not inequalities in or failures of the market.
- Introducing competition and choice into health insurance and care will ultimately reduce costs and improve quality of care.
One of the big motivations for this site, even at the risk of turning into one of these goofballs (does it occur to anybody that to opine for hours per day, one should have at least a few years of real world experience at something other than blogging?), is the one-sidedness of the candidates positions on health care reform. Allegedly, John McCain and others advocate at least some form of free-market reforms, although you would never know this from listening to him speak. (Aside: presidential candidate who, far and away, best articulates a free-market health care reform? Rudy Giuliani. Tragic)
On the flip side, candidates Obama and Clinton have dominated the health care reform debate in terms of emphasis and media coverage. Both candidates have released detailed policy proposals for reform (which I must admit I have not yet read) promising to deliver “universal coverage” for all Americans. There are minor differences, but I think that both of these plans are disingenuous for two reasons: neither plan will be passed in its glorious entirety by Congress, nor would either plan actually cover every American. These are larger topics for the future.
The recent back-and-forth between the Obama and Clinton camps has been over whether mandates (a la Clinton), are required to cover everybody, or if simply subsidizing insurance will entice everybody to buy coverage (as Obama claims). This debate is ludicrous, and it falls far short of any actual debate about how best to reform health care. In essence, they are arguing over who can best force a federal entitlement on the American people. Who is best prepared to socialize American culture?
What both of these candidates are saying is that health insurance is too expensive, so instead of addressing the reasons for the rising costs, we are just going to change who pays for it. This makes people feel like their health care will be cheaper, the costs more manageable. But this is absolutely not true. Instead, two other things happen: the costs will be shifted to the government (paid for with taxes and fees), and the added layer of bureaucracy will increase the costs of coverage and the delivery of care.
Consider the status of our current health entitlement programs, Medicare and Medicaid. The New York Times recently described the funding problems facing these programs for the next few decades. The central problem here is that that the government is not an efficient provider of any service, let alone dynamic, technologically-advanced, and highly-personal field of medicine. Entitlements are expected to grow, whether they are for food, research, or health insurance.
Nonetheless, the Democrats are peddling their plans way more aggressively than the Republicans, which unfortunately means that they are controlling the debate about health care for most Americans. Rudy, can you give John a call?
Tags: Clinton, healthcare reform, Obama, Politics
