Health Care Doom on the Horizon

The relationship between Americans and their health care delivery is about to make a dramatic change for the worse.  Consumers of health care are poised to vote for a federally managed system.  Why would they go down this predictably awful rabbit hole?  They'll do it because they are overwhelmed and frightened in the current system.  They'll do it because this may be the only option that a typical voter understands.  They'll do it because our elected leaders do not have the courage to enact changes that could make things work and don't want to give up power.  And it will happen because the media will demonize and target anyone who isn't on the socialist bandwagon.

Currently, we have a situation in America where the insured among us are utilizing health care less than in the past.  This is because of the financial implications of high-deductible insurance policies, most people's only affordable option.  As a result, it is arguable that the very people who bear the financial burden for our medical care — namely, the minority among us who are insured Americans — are among those getting the worst care in our country.  It is well known that Americans often live on the edge of their finances.  So when it comes to budgeting for our deductible when health issues arise, we are frequently left with hard decisions.  This often results in the insured tolerating illness rather than seeking appropriate, expensive care.

The result of this development will most assuredly result in even conservative voters being swayed toward a federally managed health delivery system.  With the elderly freely using Medicare and Medicaid participants getting treatment with seemingly no debilitating financial consequences, it would be easy to desire something similar for the rest of us.  After all, what could be more messed up than the current system, where a simple visit to the emergency room can lead to bankruptcy?

The federal option for health care delivery will undoubtedly be wretched.  Ask any veteran or doctors who trained at those hospitals about their experience with the V.A., the best example of a federally run health delivery option.  You'll hear stories that will curl your toes.  It is not possible for government to provide quality care in a timely manner affordably, just as equality and liberty can't coexist without one sacrificing itself to the other.  Add on the layers of bureaucracy in a federally run hospital to the inefficiencies and redundancies they mandate, and the results are predictable.

Yet the people may opt for it anyway, because it is hard to imagine relying on the current system creating a more affordable market.  We are not using the economic tools that work to bring down costs.  There is no such thing as capitalism or a free market in health care delivery.  If a group of doctors think they can provide better care at cheaper prices than your community hospital, they cannot easily do so.  Government regulations would not grant them permission, because it is more "in the community's interest" to keep the inefficient and expensive existing hospital afloat than to allow the creative destruction that capitalism provides.  Ending local government's control over "certificate of need" would lower costs, but politics keeps these laws going.

Additionally, hospitals are allowed to charge much more for services than private practitioners of medicine and surgery.  This is because they have convinced local governments that this is justifiable because they have to take care of the indigent.  A lot of the recent dramatic rise in health care costs is a result of the incestuous relationship between hospital corporations and the government.  Doctors are getting absorbed into hospital employment with the lure that their pay will not go down as precipitously if they are paid the higher allowable fees that they can bill through the hospital.

You can add the insurance industry to the hospital corporations and the government as the three players that keep the system unaffordable and non-competitive.  Many competitive options for insurance coverage could decrease cost.  But these are opposed by the industry and are lobbied away.  The laws that could make these legal are unlikely to be enacted because power would shift from government and insurance companies to the individual.

One such idea is insurance pooling.  Suppose that someone who would normally be almost uninsurable, like a 33-year-old waitress with Crohn's disease, could join in with other waitresses and shop as a group for policies across state lines.  This would put market forces to work and necessarily drive down her costs.  This is because most waitresses are young and fairly healthy, and the actuaries in the insurance companies would jump to bid for this business.  For particularly difficult to insure populations, there could even be federally subsidized pools.  This could work for the uninsured and unemployed.

For this concept to work, there would have to be allowances for buying insurance across state lines.  Politicians have too many pet causes to allow this to happen.  Most insurance coverage in New York City mandates coverage for transgender operations.  Years ago in Connecticut, insurance had to cover hair plugs.  As you might suspect, insurance can run much higher in these environments when compared to similar coverage (not including these boondoggles) in the upper Midwest.  If a resident of New York or Connecticut could buy the Midwestern policy for similar coverage without the local mandates, costs would go down.

Another priority would be transferring ownership of insurance to individuals rather than through their employers.  But tax incentives encourage the opposite.  Policies that do not end when changing jobs or crossing into other states would be preferable, but business tax deductions change the game.  If individuals could deduct insurance cost, as businesses have traditionally done, it could work.

Tort reform would remove a lot of dysfunction and wasteful spending.  But most lawmakers are lawyers, so the possibility of goring this cash cow is remote.  (What will happen to this sector if the federal government runs medicine?)  Allowing information technology to evolve naturally rather than instituting top-down, central control to the medical records, billing, and other information systems would result in savings, too.  But I.T. is essential to maintaining power, which makes any change non-negotiable.

Americans may have had enough, egged on by progressive media.  Plots to make medical care more affordable by re-introducing the free market and capitalism through changes in the current laws seem to have died off.  The fawning hero-worship directed toward former president Obama by the media glorified the idea of health care as a human right, with support for this wrong-headed idea achieving his goal of "fundamentally changing America."  Medicare for all is depicted in the press as a desirable idea despite common sense suspecting the contrary.  When it is shown that the cost of administering health care through the existing system proves that insurance companies eat up around a third of the health care dollar, it does seem ridiculous to maintain the status quo.  After all, the cost of administration in the Veterans Administration is far less.  But we know intuitively that care will be worse.  And, as anyone who knows history can tell you, giving them power over our health care decision-making will be the final nail in the coffin of our freedom.

Yet, when the simple idea of a Health Savings Account, a necessary pillar of any health care reform, is above the heads of many voters, we have lost.  Because the media will shoot down any politician brave enough to try anything but a federal option (remember Tom Price, [R-GA]?), it is harder than ever to have any kind of inertia for reasonable change.  With the shortsightedness of insurance companies and hospital corporations essentially pricing themselves out of existence for access to more money today, it looks hopeless.  And when federal debt continues to be viewed as a "so what?" by politicians and citizens alike, we are done. 

https://www.americanthinker.com/articles/2019/10/health_care_doom_on_the_horizon.html