November 23, 2009
Thoughts on Healthcare
Despite only a minority of citizens wanting such legislation, we have an Administration and a Congress pulling out all of the stops, burning up all of their political capital to get something enacted into Law.
To what end?
It can't be to lower costs, because it is ridiculously expensive. It can't be to improve care, because we are already the envy of the world when it comes to advances and delivery of care.
In fact, I would argue that it is precisely the government's meddling with the system that we insane levels of cost and waste in our healthcare payment system.
Remove the government subsidized healthcare programs.
Remove the government regulations on insurance companies, which actually reduces competitive pressures to delivery a superior product (health insurance) at a cheaper cost.
Remove the tax incentives for businesses to provide healthcare to their employees, and I think we'll see a market solution emerge and faster than any government mandated solution will.
And when that happens it will occur without people loosing freedoms and liberties. It won't violate our US Constition. It won't cost the tax payer trillions of dollars.
When the government pays for something (e.g. Medicare) by definition they have to take the money from someone who doesn't need or eligible for the service through confiscatory taxation to pay for it. Basic economics tells us that this removes the idea of the consumer from making rational choices. Since in this case the consumer isn't paying for the service, someone else is.
To take this a step further, consumers have rationally chosen to go for the least expensive option available to them which is most of the time employer provided insurance. Sure they may pay some or all of the group premiums but it can typically be cheaper than buying the same product on your own. Not to mention, Group insurance carries special legal priviledges through HIPAA that Individual insurance does not enjoy.
Sure there is the idea of HSAs, however, how many people know about them? How many Group plans offer them as an option. Certainly more and more are offering them, but I still have no worked for an employer where that has been an option.
So now you have a person with healthcare insurance that pays a monthly premium either in full or with help from their employer. The consumption of healthcare related services bear little correlation with the cost of those services because it's really not healthcare insurance, but rather a healthcare payment plan. Therefore, once again, the rational choice of what to consume and how much isn't there because there is no direct payment for the service being rendered/consumed.
I feel like this problem of bloated healthcare is really not all that hard to fix:
- Remove tax incentives for employers to provide healthcare insurance. They would still be allowed to, but it would factor in more as a true part of compensation, rather than a benefit they were artificially being manipulated into providing.
- Remove the distinction between Group and Individual plans.
- Remove the regulations on transportability. Make plans borderless.
- Provide tax credits for use in funding HSA plans.
These are just off the top of my head. I am sure something needs to be done with Medicare, but am no expert on what all is currently covered by Medicare or how it is executed.
The point is, we need to be moving more in the direction of payment for services directly from a consumer to a physician. If that consumer wishes to work out some type of contract on their own with a provider like an insurance company, then that should be completely market driven and not influenced by the government.
So, to me this makes perfect and clear sense. I cannot understand why were are doing what we are doing the way were are doing it, unless it is for other motives.
Without being too conspiratorial, I think those motives fall along the same lines of every other progressive agenda for the past 100 years. The more people take from redistributive polcies of the government, the more people become dependant on the government to provide them things that they grow to not know how to live without. This creates a power push upward and centralized, versus downward and decentralized and ultimately in the hands of the people.
America, I think we are trading our freedoms, our liberties, our futures, and that of our children, for just the idea of a solved problem.
Disaster is ahead.