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11.16.2004

Health Care Reform

I think most reasonable people would agree that the overall health care system is not perfect, there are many things that need to be addressed. However, the overall system does not need to overhauled to provide universal coverage as the Democrats suggest. Basic economics shows that free markets will allow prices to control the use of scarce resources, and, by-and-large, that is what most in the GOP want to see in all sectors of the economy. The basics of our current system provide the most good of the greatest number of citizens, I would argue that it succeeds. According to the Census Bureau (page 14), in 2003 84.4% of the population, 88.6% of children, were covered by private or government health insurance. While that number is lower than we would all like, those covered receive excellent and timely care.

As for those that say that doctors and other health professionals are just trying to make a much money as they can, well that's true, we do live in a capitalist society. After the industrial revolution most of us cannot go buy a piece of land, cultivate it, and live from the sweat of our brow -- even those that can need money to survive and pay for services. The reason capitalism works is that each individual has an incentive to put their talents and skills to use and earn the best living they can. If you were to ask doctors and others who work in the health care industry not to work for profit, and not to make the living their skills and talents deserve it would be immoral. Each person deserves to get what they can for their services, just as you and I try to get what as much as we can for ours. It's the basis of our economy, the most successful economy the world has ever seen.

I think that the current Administration has the right idea, our system is fundamentally sound, it just needs some tuning and increased emphasis on free market pricing. Here is (part of) the President's plan for health care:
  • Established new, tax-free Health Savings Accounts (HSA) which allow Americans to own and control their own health care.
  • Opened or expanded community and rural health centers with the goal of serving an additional 6.1 million people who live in underscored and rural areas.
  • Granted waivers and flexibility to states to extend eligibility under Medicaid and the State Children’s Health Insurance Program (SCHIP) to an estimated 2.6 million low-income Americans.
  • Implemented a new rule to lower drug costs for millions of Americans by strengthening competition between generic and brand-name drugs, saving American consumers more than $35 billion in drug costs over the next ten years.
  • Created a Medicare Prescription Drug Benefit to help seniors pay for their medicines.

Personally, flexible spending accounts have really helped me save money on health care costs, so I know that the HSA's that the Bush Administration has proposed are a great idea. Contrary to popular portrayal, Republicans are not cold-hearted, we just have a different view how to achieve the same goals. To that end I would like to see a program which could reduce the number of un-insured children in this country. Adults who can't afford health insurance have the ability to work for it or find employment which provides health benefits, but children should not be hurt by a parents irresponsibility (I am by no means suggesting that everyone who is uninsured is irresponsible, just those who have not made decisions and set priorities to allow them to provide for their families). I would like to see programs (state-level preferably) which allow un-insured parents purchase health insurance for their children at very low rates. The states could certainly use their buying power to negotiate reasonable prices for this. I would also like to see more free-market principles brought into the system, specifically insurance companies providing incentives to the consumer for smart shopping.

In the end, it comes down to two things for me,
  • Individuals need to take responsibility for their decisions and priorities. If they cannot (I mean really cannot due to mental or physical handicap, injury from armed service, or other actual inability) then society has an obligation to help, but you have to agree that not all of the uninsured 15.6% are unable to provide for themselves. If not, it is immoral to hold me accountable for someone else's failure to take care of themselves.
  • Look to private enterprise for the solutions to almost all issues in this area. Private interests invented cars, planes, vaccines, most medicines, computers, etc.; the government is not a producer, it is a consumer. If reform can be made, then there is an incentive for individuals to make it. Profits are not evil, they equal life, liberty, and personal security for individuals.
The reason Democrats always get ripped on health care is because almost all their plans have a goal of "universal" coverage, which does not sit well with most Americans. It's not that Americans don't want everyone to have health care, its the negatives of a universal system that turn us off. We can barely keep Social Security alive, and its not universal, how can we fund a universal system? Megan McArdle has a very thought provoking post on poverty and welfare reform, and it strikes me a very pertinent to this topic. She writes,
it's clear to me from the research I've done to write about poverty, and from reading books like DeParle's, that the poor suffer from three main problems: their own poor impulse control or decision making; a culture that encourages poor decision making; and limited means, which give them no buffer against the results of their poor decision making.
I completely agree with this. She goes on to discuss how government funded housing can contribute to the downward spiral of poverty. The fact is, in our country corporate health benefits are just another form of compensation for most, and if you aren't able to provide for yourself you won't be able to get health insurance either. In most cases lack of private health insurance is most likely attributed to the causes of poverty.

I don't know how many others out there feel the same way about this that I do, but I don't agree with Democrats penchant for wide-ranging social programs because I find them basically immoral. How dare they take the moral implications of individuals decision to provide for themselves or their families and place them on you and I? If someone cannot set their priorities and make proper decisions to take care of themselves or their family, why should the blood be on our hands? This is the basic fallacy of the Left when it comes to social programs, they believe that YOU are responsible for the decisions others make.

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