Saturday, September 5, 2009

Best post I've read on health care today

Robert Lawson from Division of Labor wrote the following on how he would like health care reformed. I think that is worthy of our attention:

Of course I would love to see no government involvement in health care or insurance at all, but government completely dominates almost everything about health care (as in finance). The system we have is based on the rules and incentives created by government. I honestly don't know what health care would look like without the government being involved. And given this starting place, it is all but impossible to disentangle the government's tentacles from the system.

But as far as logical first steps for policy: (1) end the tax advantage for obtaining health insurance from your employer. We HAVE to decouple health insurance from employment. Either allow individuals to deduct health costs or end the employer tax deduction. (2) End insurance policy mandates (e.g., mental health parity and the like) so people can buy insurance plans to fit their needs (3) Dramatically loosen (I would eliminate) medical licensing rules so that nurses and other health care pros can compete with doctors. (4) Drop prescription requirements for all drugs so we can get drugs without doctor approval.

It would be vastly better to handle most health care expenses out of pocket like we do everything else in life with insurance only used for catastrophic events. Medical savings accounts would help here perhaps. Insurance markets work well for fire, life, serious car accidents, etc. and can work for health care too but we can't insure day to day costs (well we can, but it is dumb to do so).

Alas, I expect we will always have some uninsured and some who have trouble paying for health care no matter what we do. Some people will die and suffer for lack of care or money. I know this bothers you. I don't like this myself but I accept that we live in a world of scarcity and that we will not have everything in life we want no matter how rich "we" become. I see health care as no more of a "right" than I do food or anything else. We can socialize medicine as you wish, but it will not end hardship or injustice. At best, socialized medicine will shift the margins of suffering to other areas (such as reducing medical innovation and economic growth in general).

Also I expect health care will continue to be very very expensive no matter what. If we want to drop a lot of money on wasteful and ineffective end-of-life procedures, which is the big problem, and we're spending our own money, then that's what we're going to do.


Rebecca said...

Excellent article! I like the no-prescription medicines.. but I really doubt the FDA will give up its power. Wishful thinking!!

Rich Mitchell said...

Love the thoughts in this post, but I don't see the government pulling itself out of any facet of health care. I'm just concentrating on making sure they don't get into any more of it!

Rich Mitchell
The Plain, Hard Truth
An information engine for Conservatives

VH said...

Rebecca-I think you're spot on, the FDA and the politicians that pander to its power and influence won't give it up easily.

Rich- True, government isn't releasing its grip without a fight and any time soon.

Mark Van Schuyver said...

Excellent piece. Thanks for sharing it.

Mark Van Schuyver said...

Excellent piece. Thanks for sharing it.

Megaman The Madman said...

Fantastic..Your opinions mirror mine perfectly. Another benefit to this, it would force people to live healthier,to prevent expensive visits..with less unhealthy due to healthy living habits, competition for the sick would drive costs down...Ah the basics of competition. and free markets...

broker Lorne said...

A great article. But as the others, I honestly do not see government not wanting to interfere in this issue. And yeah, even though nowadays you can insure things like weather, wedding, etc. some people will stay without a basic health insurance. And that is a shame.