Writing in Forbes Magazine this week, Shikha Dalmia tells of the American myth regarding health care:
Both ObamaCare’s supporters and opponents believe that –unlike Europe– America has something called a free market health care system. So long as this myth holds sway, it will be exceedingly difficult to prescribe free market fixes to America’s health care woes–or, conversely, end the lure of big government remedies.
The major difference between America and Europe of course is that America does not guarantee universal health insurance whereas Europe does. But this is not as big a deal as it might seem. Uncle Sam, along with state governments, still picks up nearly half of the country’s $2.5 trillion annual health care tab.
Ms Shickha goes on to explain that although U.S. health care costs are higher as a percent of GDP than those of Germany and France, it is because these EU countries ration health care by restricting access.
But the most potent form of rationing in France and Germany–and indeed much of Europe–is not overt, but covert: delayed access to cutting-edge drugs and therapies that become available to American patients years in advance.
The point is that there is no health care model, whether privately or publicly financed, that can offer unlimited access to medical services while containing costs. Ultimately, such a model arrives at a cross roads where it has to either limit access in an arbitrary way, or face uncontrolled cost increases. France and Germany, which are mostly publicly funded, are increasingly marching down the first road. America, which is half publicly and half privately funded, has so far taken the second path. Should America offer even more people such unlimited access through universal coverage, it too will end up rationing care or facing national bankruptcy.
The only sustainable system that avoids this Hobson’s choice is one that is based on a genuine free market in which there is some connection between what patients pay for coverage and the services they receive. That is emphatically not what America or any Western country has today. Looking to these countries for solutions as Obama and other advocates of universal health coverage are doing will lead to false diagnoses and false cures.
Don Watkins over at the Ayn Rand Center believes that it is time for a debate on the morality of universal health care:
Ezra Klein asks: What happened to the moral case for health care reform? Why is the Obama administration relying on the argument that its plan will save the government money rather than supposedly ethical notions such as “equal treatment for everybody”? According to Klein, those are the kinds of arguments that could sway the American public toward accepting socialized medi…, sorry, “national health care.”
Well, let me register my agreement with Ezra: it is time for a moral debate about health care.
* It’s time for a debate between those who demand “equal treatment for everybody” (except those who are to be unequally taxed to pay for it)–and those who demand equal freedom for Americans to purchase as much health care as they can afford.
* It’s time for a debate between those who believe it’s proper to force some people to pay for the health care needs of others–and those who believe that individuals should pay for their own health care or else appeal to private charity.
* It’s time for a debate between those who think doctors should be made into state employees, taking orders from bureaucrats who will decide which tests to perform and which treatments to offer–and those who believe that doctors have a right to offer their services to willing consumers on a free market.
* It’s time for a debate between those who think that the government should be able to dictate the private choices of individuals on the grounds that “society” is picking up the tab for their behavior–and those who think that each individual should be free to act on his own judgment, while taking responsibility for his own choices.
* It’s time for a debate between those who appeal to an entitlement mentality that demands the unearned–and those who believe in paying for what they get.
The health care debate is ultimately about morality. We face a choice between European-style health care based on European-style egalitarianism and envy–and American-style freedom in medicine based on American-style individualism. So, Ezra, which do you think is consistent with America’s founding principles?