Tuesday, January 26, 2010

Random Thoughts on Health Care

Having spent some time watching the circus called the health care reform debate, just a few random thoughts.

It seems to me that both parties have missed the point some when it comes to reforming our health care system.

First, the GOP and conservatives need to recognize that as a society Americans have decided that although health care may not be a right, we do not want people dying in the street because they could not get medical treatment. With that being the case, someone needs to coordinate how this happens, and relying strictly on charity has its limitations (Who to contact, what is paid for, who gets treated, etc. ). So far, I haven't seen a suggestion for anyone to coordinate care for the poor that would work better than government. I'm not saying it's impossible and I can't say that I like to idea of expanded government, but I'd sure like to see some specific ideas that would be better. Relying on emergency rooms to care for the indigent (which some conservatives point to in order to say that no one is denied care in the US) is expensive and inefficient.

I also question the idea that people overuse the health care system (also a common conservative meme). I don't know anyone who enjoys doctor, hospital, or emergency room visits. Generally, these are experiences people tend to avoid if they can. One doesn't go to the doctor because they're feeling great. Moreover, when a doctor suggests a test or a treatment, I'm unlikely to argue. Why? Because I don't have a medical degree or much experience in treating disease. What my insurance buys is the doctor's medical expertise. How do I know if the doc is right or wrong? Am I actually qualified to make those decisions?

What do people who have pre-existing, severe problems do? In our current private system, these people are uninsurable unless they are covered by an employer's insurance. If we move to a system that does not use employer-supplied health insurance, what do these people do?

One last thing, covering the uninsured is not going to be free. If additional taxation is not the answer, tell me how this is to be paid for. Assume there are not enough inefficiencies in the current system that the money could be found as savings due to higher efficiency. History hasn't demonstrated those theoretical savings can be found in reality, so assuming great savings from streamlining doesn't seem valid.

For the Dems, what in the bill you are trying to pass is going to make things more efficient? So far, it looks like an incoherent mess that isn't understood by anyone. It's a bill so bad that the leadership basically had to buy off senators who had problems with the bill. What's worse, it doesn't even solve the problem of the uninsured. So, what good is it?

Face facts, libs. You are not going to get single-payer health care. If somehow you did, the new system would face the same financial/demographic problems faced by similar systems in Europe.

So. Perhaps it's time to pay some attention to ideas from the other side of the aisle (yes, those despised Republicans). Why not start with tort reform? If docs are practicing defensive medicine just to cover themselves against lawsuits, isn't that inefficient and expensive? Wouldn't the wealth spent on this be better not spent, thus resulting in (hopefully) lower prices and thus, lower premiums?

In addition, why shouldn't it be possible to buy insurance from firms in other states? Wouldn't competition result in lower prices? Also, how about some recognition of the free ride that foreign governments get from drug research funded in the US via our higher drug prices. How would you solve that problem while keeping the level of innovation high?

Lastly, how do these problems get solved without taxing us to death? As a people, Americans are not exactly undertaxed. By the time I get done paying taxes to the Feds, the state, and my local goverments, close to 40% of my modest income goes to taxes. Do you really think people like me can afford massive tax increases?