For the past few months, I have kept silent on the topic of health care reform and the presidents proposals. I have felt his policies, while well intentioned, have been misguided and naive. Today he was in Minneapolis making his pitch for health care reform. Since he is coming to my town to state his views, I have decided to break my silence and share my views.
First off, I applaud Obama for addressing this very serious issue. Medical bills are the number one cause of personal bankruptcy in this country. Too many folks are loosing their health insurance because they are being laid off, and there is a good chance they may not get them from their new employer. It is a serious issue which needs to be addressed.
What I disagree with is the way the new policies are being structured; specifically, there are three major flaws I see, which make his policies unacceptable. For those of you who doubt my any of my statements, I have included my sources for your reference:
1. Lack of tort reform for medical malpractice:
One reason health care costs are so high is that doctors often prescribe tests that are not necessary. This is done for two reasons. First, doctors are paid by the number of tests they perform, not the number of patience they see, and second, liability concerns. This results in unnecessary costs being added to the system. This is a cause of high health care, which is not be addressed in Obama's cure. The current proposed "cure" is to provide health care to everyone in its current, inefficient, expensive form. It is addressing a symptom, not the cause, of high health care costs. ("Life is Expensive", The Economist, May 28, 2009; "Heading for the Emergency Room", The Economist, June 25th, 2009)
2. No incentive to get healthy:
The best case scenarios for health care reform put the price at over $1 trillion. History suggests the true figure will be 5-10 times higher. By the best case estimates of $1 trillion, this will amount to a budget deficit of 5.5% of GDP in 2019, assuming the economy recovers next year. Yet for all this money, there appears to be no programs or funding designed to reward for healthy lifestyles, or programs to improve the public health. If health care becomes a "right" of all Americas, it is unlikely that folks will take better care of their health. Likely, it would get worse, knowing there is a safety net to protect and take care of them. Again, like the idea of tort reform, the proposed policy does not address the cause - Americans by and large lead unhealthy lifestyles; the proposed policy only attempts to provide an inefficient and expensive "cure". ("Will the Blue Dogs Bolt?", The Economist, June 18, 2009; "Falls the Shadow", The Economist, July 23, 2009)
3. The United States Postal Service vs. FedEx
Obama's policy provide for a government sponsored health insurance option. Nothing should strike fear into the hearts of Americans more. Our government has proved time and time again that it can not adequately deliver services that address the public's need. Anyone who doubts this need only look at one organization: The US Postal Service. If the USPS addressed the needs of the public, FedEx would not exist today. The USPS had the infrastructure, the people and the resources to establish an overnight delivery service, but they didn't. Private enterprise did. It identified a need and delivered a service which started with a concept in 1973 to a company that generates $35 billion in revenue today. All of this could have been the USPS's, but it is not. Public services do not face the pressure of market forces to adapt, evolve and change. Defenders of the USPS claim it was never intended to be an overnight delivery service; if that was really true, they would not be offering that service today (36 years too late).
The government needs to stick to its charter: establish the laws of the land. If the requirement is that all Americans need to carry some form of health insurance, pass the law which mandates this requirement; let private enterprise deliver the service. As with Auto Insurance, Progressive and Geiko have been able to deliver services, profitably, to those considered insurable. This is what the private sector does best; it is not what the US government has ever been able to do.