Saturday, August 8, 2009

Health care debate

Right now in this country we are trying to decide the future of health care. I believe that everyone agrees that the current escalation in costs can't continue and I would also like to believe that everyone agrees that everyone is entitled to adequate health care. Now, if some people want to continue to see costs escalate, or feel that some people should be denied health care, I don't understand why and would be interested to hear their reasons.

What I believe is under debate is the best way to achieve these outcomes. Clearly there is a fairly clear divide between the best way to control cost and the best way to provide health care to all. Some argue that a pure free market would accomplish this. Now, I don't think it would since in free markets there are always winners and losers. In health care, losers die or at least go broke. Currently, the system provides that if you get sick enough and don't have the right health care coverage, you will become poor and the taxpayers and health insurance companies will end up paying for what you couldn't manage to pay.

I don't find this result satisfactory. Now I should say, that I have what I consider quite wonderful health coverage. I don't have any reason to think the coverage will end so my position isn't dictated by the fact that I need coverage.

Going back to the pure free market approach, the main flaw in it is that knowledge is simply not equally shared. Those who have enough information and knowledge would do quite well while many others, possibly the majority, would be persuaded by questionable sales tactics and end up with inferior, overpriced products.

One way to address this, and this would be my preferred method, is simply to set up rules related to health insurance and also to make sure that any plan sold to the general public was held accountable for the claims it made, lets call it truth in advertising. Now some may feel that we don't need this since consumers and customers have some legal rights now, but arguing or suing a company following a serious illness is not a satisfactory solution if you were denied adequate care when you needed it.

While choosing health care can be complex and deciding whether you want an HMO or a PPO or are willing to pay more for even more choices should be made easier by knowing that the promises made by the plans were in fact legitimate. It would also seem important to me that any plan covered preventive medicine and catastrophic insurance.

Will this cost more? I think it should cost less, especially if the preventive medicine part is effective. Now when I say it should cost less, I am talking about the total amount spent on health care in this country, not the way that cost is proportioned. Currently we have a significant part of the population who utilize the most expensive type of health care imaginable, trips to hospital emergency rooms. Of course many of these trips are absorbed in the costs we already pay.

Now, it is possible, that costs could go up. The increased demand for health care may result in price increases. I think this won't happen, but the simple question remains, do Americans really think some people are not entitled to care?

Certainly there should be a debate about the amount of Government involvement and whether there should be a Government plan as part of the mix. However, I would like to think we could have that debate in a rational way. Currently, we are seeing activists trying to prevent debate by using tactics intended to disrupt meetings. This tactic is designed to get press coverage and influence the public. It may or may not work, but those who advocate it are clearly not proponents of honest debate and democracy.

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