Sunday, July 12, 2009

Health Care Debate (continued)

My last post compared health care insurance to food insurance, the latter being a ridiculous proposition that bears too much resemblance to the current health care industry. Paul Krugman made exactly the same point when he asked in his recent column (New York Times, 6/22/09) "Isn't the purpose of health care reform to protect American citizens, not insurance companies?"

Krugman, unfortunately, is a singular voice in a sea of complaints that insurance companies won't be able to compete with a public endeavor. "Regardless of how it is initially structured, a government plan would use its built-in advantages to take over the health insurance market," whined Karen M. Ignagni, president of America's Health Insurance Plans, and Scott P. Serota, president of Blue Cross and Blue Shield Association, in a letter to the U.S. Senate (New York Times, 6/24/09).

To which I believe the proper answer is "who cares?" If government can do it better, then why not let it? If private sector corporations can provide greater efficiency, better customer service, and enhanced results (more actual health care!), then let them demonstrate their capacity to do so.

If the purpose of public policy is to protect shareholders and employees of private sector companies, then letting buggy whip manufacturers go out of business was a huge mistake. And what about the corporations that used to make those ubiquitous dials on telephones? Where are they now? (Could it be that the great American free enterprise system actually has the capacity to retrain employees to perform functions that are useful and valuable in today's -- not yesterday's -- economic climate?)

This entire debate exemplifies what I regard as a central dilemma in this country today: we have totally lost sight of our true values, objectives, and aspirations. The ends have been displaced by the means. The holy grails of conservatism are free enterprise in the private sector, limited government, and low taxes, regardless of whether they actually produce the kind of country most Americans want to have. Why? Because these are the principles that preserve a comfortable status quo for the upper- and upper-middle class societies. The evolutionary power of self-preservation is alive and well.

Bob Cable and Dana Cox, in a recent "Point of View" op-ed piece in the Inland Valley Daily Bulletin (6/24/09), suggest that "Now would be a good time to remember how and why this great nation was formed..." Unfortunately, they don't provide an explicit conclusion. I'll suggest the following (without any claim to originality): 1) "to [organize]...its powers in such form, as to...[the People] shall seem most likely to effect their Safety and Happiness"; and 2) "to establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity."

All right, which is more essential to the promotion of the "general Welfare": maintaining the profitability of private sector insurance companies, or providing health care to every American using whatever method achieves the desired result most effectively and efficiently?

It's a rhetorical question.

1 comment:

  1. Predicting healthcare spending needs is insanely more difficult than predicting food needs. I am 21, my major healthcare purchases are likely to take place between 30 and 60 years from now. I have no earthly idea what anything will cost in 30 or 60 years, nor what my income over the interceding years will be, nor any idea what diseases might be prevalent/cured/rising anew at that time.

    Private sector profits aren't a huge portion of healthcare spending. And medicare's "overhead" is low because of four main factors:
    Accounts payable is outsourced to the IRS
    They don't have to asses/reassess premiums based on profitability and risk, they just take a tax out.
    They don't have to market themselves, since they enroll everyone automatically. To compete, a govt program would have to market itself.
    Fraud detection is outsourced to the DOJ.

    The reason that a government program might be more "effective" is that it has the force of the state behind it, that is, it can make people do things against their will (well, or threaten them with jail).

    I guess let me pose the point this way: What exactly would make the government better as a competitor than a 501c3?