Writing in Capitalism Magazine, Richard E. Ralston asks the question . . . "Who broke health care?"
Health care was much more affordable in the 1960s. The government paid for less than 10 percent of all health care. Then the federal government created Medicare and Medicaid and wrote 130,000 pages of Medicare regulations. Now the government pays for 50 percent of all health care.
Has that fixed health care, or broken it?
In the same period, state regulation of medical insurance rapidly expanded, adding many coverage mandates that each policy must comply with. In some states you have to buy coverage for electric shock therapy, or in vitro fertilization, or acupuncture, or chiropractic, or hairpieces, or a social worker, or a marriage counselor, or a long list of other things, whether you want such coverage or not. And new mandates are added all the time, driving up insurance costs every year. Moreover, you are not allowed to buy better priced insurance from a competing provider in another state. Has that fixed health care, or broken it?
The government could easily make reforms that would reduce the cost of insurance without any additional spending: Basic policies without mandates. Tax deductible premiums. Competition between insurance companies across state lines.
Why is it, then, that the more government controls health care in order to fix it, the more expensive health care invariably becomes?
Politicians who broke health care and now complain that it is broken do not want people to be able to afford reasonable insurance. They see that as an obstacle in their path to eliminate all private insurance. They are not in favor of fixing anything, but of making us all dependent on the favor of politicians for our health and well being.
IBD tells how we can fix the broken health care system:
We keep hearing how health care is too expensive and that too many of us lack insurance. But in markets where providers actually compete, costs go down and access goes up. The solution to the health care problems in this country is not more of what caused the problem — a growing third-party-payer system — but competition. In markets where the procedures aren't typically covered by insurance or some other third party, and patients are responsible for paying their own bills, the providers, according to Devon M. Herrick of the National Center for Policy Analysis, "almost always compete on the basis of price and quality."
"And because they are not trapped in a system that pays for predetermined tasks at predetermined rates," Herrick writes in an NCPA report, "providers are free to repackage and reprice their services — just like vendors in other markets.
"It is primarily in these direct-pay markets that entrepreneurs are creating many innovative services to solve the very problems about which critics of the health care system complain."
Herrick looked at the markets in cosmetic surgery, laser eye surgery, laboratory and diagnostic testing, prescription drugs, walk-in clinics, telephone consultations and concierge medical services. He found that entrepreneurs competing for patients' business offer "greater convenience, lower prices and innovative services unavailable in traditional clinical settings."
Herrick also observed that access to health care is increased where there is competition. Advocates for the uninsured won't be persuaded because their goal is not increasing competition but forcing the public into a government-run health care system. But their biases do not diminish Herrick's findings.
Of course, the public knows little about these markets. Mainstream media, in partnership with the politicians and special interests, are obsessed with the government health care systems in Britain and Canada. In those countries, the third-party-payer arrangements have run up costs, caused artificial shortages, led to rationing of care and cut into quality — deep-seated problems that only competition can root out.
It should be obvious that when prices are set and services determined by a third-party bureaucracy, as in most of our medical care markets, the system is headed for trouble. The gross failures of the British and Canadian models are evidence that such a system cannot be sustained.
Rather than promote policies that give us more of what has corrupted most of the medical care markets in the U.S., as well as ruined treatment in Britain and Canada, lawmakers need to encourage competition. Health care is not a right but a service, and like all services, it is best allocated when government intervention is low.
Moving away from taxpayer-funded programs and toward self-sufficiency is not a popular idea. But it's a good one nonetheless. Should policymakers continue as expected on a path toward universal government care, health care in America, now the best in the world, will get worse, not better.