The Gloves Come Off

First I want to start out by apologizing for the end of my last post. It went a little out of control with my rant which didn't add anything meaningful to my argument. I will strive to never let that happen again.

Let's have a discussion regarding life sustaining care for Medicare and Medicaid. Back in the sixties when these plans were created, they originated as universal government health care plans. There wasn't enough country-wide support for them in that form, so they evolved into plans primarily for the elderly (surprise - the elderly at the time didn't have to pay into the program with their tax money because they either already qualified for the program, or were not far from it... and the elderly make up the highest percentage of the voting public).

Since this is a very sensitive subject for a lot of people, I'll give you a little personal background to convince you that I am not totally disconnected from the real world. Firstly, no one is suggesting that the country should go cold turkey with these programs - this would cause irreparable harm to people that depend on the care these programs provide. Additionally that would represent a breach in trust between the government that has made a promise to people deeply invested in these programs (not that the government hasn't broken promises before - just that I'm not advocating breaking any more than they already have). My own grandmother depends on these programs ever since the day I took her to the hospital after a stroke. It is with this in mind that I would like to propose a road map to a better system for the entire country.

Did you know that there was a time when doctors advertised their prices? They even had sales in order to bring in new business. There was also a time when it was economical to fund research into new medical technologies in an effort to provide better services at a reduced cost. Doctors and Hospitals would compete for your business by striving to offer you the most advanced care in the nicest facilities with the most thoughtful staff. This was back in the time when the cost of health care meant something other than "its too high." Why don't you try this exercise: How much do you pay for your medical insurance? How much did that last prescription cost (not the co-pay - the actual per-pill cost)? How much does it cost for a physical at your doctor's office? What about a routine vaccination? Did you know the answer to any of these questions off the top of your head? If the answer is no, then you must either be super rich to the point that you don't have to worry about money or that you rely so much on someone else to watch over your medical care that the money doesn't matter. My guess is the latter over the former... but if that is the case, then why is the cost of health care so important to people now?

The simple solution to this problem is to put you back in the loop regarding the direct costs of your health care. If suddenly you had the choice to go to two identical doctor's offices where one charged you $35 for a check-up and the other charged you $50, then you could make a conscious choice as to which would be best for you. When the $50 guy sees his business drop, then he will find ways to get his costs down to compete with the $35 office. This model is called the Free Market. The problem with today's market is the government has come in and said that if you get Medicare, you won't have to see the cost to visit the doctor. So if you no longer care about cost (because the government is picking up the tab), why would the first office keep their prices at $35 when the guy down the road is doing the same thing and getting paid $50? And not only do the lower cost facilities get paid at the higher rate, the only thing they have to do in order to get your business is to be put on the "approved doctor" list. Anything else (like a comfortable waiting area, courteous staff, timely service, advances in efficiency) are unnecessary because the doctor's office no longer needs to compete for your service.

Now, to make this a good argument, I'll give you some an example. Back in 2004, Dr. Robert Barry was invited to testify in front of the Joint Economic Committee of Congress regarding a revolutionary type of clinic he had opened (here is his full testimony). In 2001 he left his practice as an ER doctor so that he could help the less fortunate in his community. His clinic began to attract people that were "political exiles within our healthcare system". I'll allow you to read the whole thing at your own pace, I just want to quote Dr. Barry's findings:

It seems that centralized bureaucracies simply cannot manage healthcare. Medical decisions are much too complex and personal to entrust to distant bureaucrats many of whom lack basic medical knowledge. The most efficient and humane solution is to allow ordinary Americans to manage their own care by giving them control over their healthcare dollars. It is, after all, their money and their health. They should control both.

The simple truth is this: there is no competition with the government. If the government gives a favorable deal to anything short of every health care provider, then those providers outside of the system suffer because people can't afford to pay the taxes required to sustain the government program AND to pay for the care they really want. Here is the road map:

1. End the tax benefit for employer health plans.
2. Begin to allow young people to opt-out of Medicare and Medicaid taxes (with the understanding that they will not be applicable for the programs in the future).
3. Begin a phase out government support for treatment of uninsured patient care.
4. Reimburse the people of the United States for the costs of these programs in the form of lower taxes.
5. Return freedom to the people.

Finally, just to hammer home the point that I am not crazy in my thinking that the government can't force people to be charitable, check out this article about the Christian duty to "actively seek the demise of all government welfare programs."