Health Care Reform

By Michael Haley

Today President Obama appointed Kathleen Sebelius to head up his Health and Human Services Department, a key position for his Presidency. It is a welcome effort because there is no doubt that we need serious reform, but like the efforts underway for alternative energy the costs for this program tend to be understated.

There is a vast body of literature and debate out there now, for a quick look at some of the key debating points here is a page at the New York Times that links to both Obama’s thinking and some of the arguments for and against various remedies.

My concern is that we are going to end up with a more expensive system that is worse than we have now if this is not done right. Obama is correct when he points out that health care costs have gone up four times faster than wages over the last eight years alone. It is indeed a crisis and something has to be done, as we all know.

One point made over and over by advocates for government paid insurance is that those without insurance go to emergency rooms which are more expensive. The thinking is that if they have insurance they will more often go to the doctor’s office, and they will get better care overall thus reducing the bigger expenses of letting their health go and contracting more serious and expensive problems.

I find that logic a bit specious for several reasons. For one thing, if the uninsured have insurance, they will go to the doctor a lot more often than they did before, offsetting the savings of not using the emergency room. If the emergency room is five times as expensive and they end up going five times as often, the cost ends up being the same.

I am also dubious of the claim that seeing the doctor more often will avoid major health complications. The vast majority of our medical care goes to people over fifty years old. If they get better health care they live longer, which is what is happening. Which costs more, frankly, as insensitive as that could sound. And the fact is that as one ages, you get health problems, the body wears down, even if you get good medical treatment.

The real problem with cost is that our health care system is over used. People go to the doctor too often, and many tests and treatments are done that are not necessary. Insuring everyone is going to send millions of people to doctor visits that are not going now, skyrocketing costs. This is exactly what has happened in Massachusetts, with their government paid insurance program.

All of the different plans to control costs come down to one of two ways. Either someone makes a rule that you can’t get treatment, or the price is high enough that people avoid "buying" it. The rule that you can’t get a particular treatment is made either by your insurance company or by the government.

That last paragraph explains the entire issue. The rest of the debate is centered around less significant issues, although I won’t deny there are some important ones.

No health care plan to reduce costs is going to work unless it reduces the amount of medical care being provided. Period. Look at alternative energy, one of the main areas of effort is to reduce the amount of energy that people use, to make it more efficient. The same thing has to be applied to health care.

Like energy, Americans are very wasteful when it comes to health care use. People like to go to the doctor, and when it is free, which is essentially the position that insurance puts you in, there is no restraint.

Recently I listened to a debate in the Irish Parliament led by the Health Minister, where MOP’s were objecting to her decision to not buy a new drug for the nationalized health service for a children’s disease. Her reason for not getting it was that it would cost $25 million and they just didn’t have the money. She won the debate and Irish children will not be able to get that drug. None of them.

That is the problem with nationalizing health care in any way, the government makes the decisions and one size fits all. That was the problem with HillaryCare.

The fact is that someone is going to have to decide who gets what care. The best and fairest way to do that is to charge the patients some amount of money so that they only get the treatments that they really need.

The idea that health care is a right and we should just pay to provide even the poorest and the most irresponsible a Mercedes level health care plan is not grounded in reality. It will never happen no matter how badly we may want it, because the money is just not there to do it and never will be. I hate to be such a Republican here, but some children will be left behind and there is nothing anyone can do about it.

Any health care plan that is going to work has got to involve patients paying something whenever they use the system. Otherwise it will be a government mandated dictatorship that will ultimately take away people’s dignity of being able to make their own free choices of what they want and how much work they are willing to do to get it.

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