GlobalShift

Our Current Health Care Mess – And How Did We Get There?

November 7, 2009, the United States House of Representatives passed a health care reform bill on a vote of 220-215.  The bill currently contains a “public option” which would allow individuals and companies to enroll in a government provided health coverage plan.  I’m careful, here, not to simply label the public option as “government run health care”.  No doubt our health care is broken, but is the government’s public option really the best way to serve the citizens (and even immigrants)?  Does universal coverage necessitate a government option?   I suggest that it doesn’t.

Let me say up front, I support the notion of universal coverage. From my current knowledge, I consider the morality of access to health care to be of higher consideration than the economics of it. I do not think that economics governs moral decisions but I also don’t think enlightened morality has to be in conflict with market economics. Is there a, more-or-less, free market solution to provide everyone with health coverage? It would have to drive down costs, improve overall efficiency and effectiveness, and stimulate healthier individual lives as well. Before outlining an alternative that could accomplish all of these goals, we must take a brief tour of how we got into this mess in the first place so we don’t make the same mistakes.We must first acknowledge that health insurance companies (HIC) are the villains in this scheme. I’m sympathetic to the business sector, but HIC can no longer be viewed as insurance providers. They are merely bureaucrats who decide when, what kind, and how you can receive medical treatment. This is why the republican cries of “we don’t want to put a bureaucrat between you and your doctor” should simply be ignored. We already have that. Insurance should be a fund available in the event of unforeseen problems occurring. It’s making an allowance for the unexpected. They shouldn’t make medical decisions nor decide how much is paid for medical treatment, you should.

How did HIC take over?… They had some help from Washington D.C. In 1942, employee health premiums became tax deductible to employers, not to individuals. Since health insurance was now coming from employers, what happens when you retire? Enter Medicare. Medicare effectively drove medical costs up, making it even more difficult for individuals to find their own health coverage. 1973’s Health Maintenance Organization (HMO) Act was a law aimed at providing cheaper health coverage by offering huge subsidies to HMOs, who, then, occupied only small portions of the market. Kaiser Permanente was the only major HMO and most of its members were compelled to join through unions. An oval office conversation has since come out, showing that D.C. insiders knew ahead of time that people would wind up paying more but getting less coverage.

Since that 1973 bill, federal subsidies for HMO’s have ballooned and a tax code meant to provide incentives for employer-based insurance has gotten more twisted. Regulations have arisen making it difficult for small-business owners and people that are self-employed to obtain health coverage. Should we assume that this government, our government, could competently provide health coverage to best meet the needs of its citizens?  I don’t have too much confidence.

Well, now that we’ve looked at how we got to our present day debacle, we can begin to see how we got into this mess. We begin to see why the United States spends a higher percentage of its gross domestic product and more per person on health care than the other industrialized nations. But this just the BEGINNING of the problem. A lot of complexities spiral out from here. So what can be done about it?  For a simple way to solve most of our health care woes Click Here.