(Guest Post by Matthew Ladner)
JSM once noted that if government would simply require an education, that it might save itself the trouble of providing one. He could have added trying to provide one at enormous cost, but let’s not quibble over details.
This was the approach to the Romney reform in MA, but that reform ignores the fundamental problem with our system: third party payers create a powerful incentive to ignore costs. The Romney plan did not address this central problem.
If you don’t believe it, give me an unlimited line of credit with your money at a Vegas casino and watch me transform into a gambling fiend.
This would introduce supply and demand back into most of the health care market, which is precisely what is needed in order to curtail costs and thus prevent the continuing loss of coverage (which is a symptom, not the disease).
Government policy (both in the tax code and from Medicare and Medicaid) is directly responsible for the out of control costs we have experienced. Having quasi-socialized the health care system but without gaining monopoly power to dictate terms to health professionals, politicians have created a culture of “anything goes” in health care.
Paul Tsongas said it best “America is the only country that pretends that death is optional.”
The government, in essence, has created a health care culture which rejects the very essence of a government run plan, which is bureaucratically rationed care. Notice the scrambling to pretend that there are “no death panels” in the plan kicking around Congress. This is of course meaningless, as if there are no death panels there soon will be under a new name: Eurocare is all about having bureaucrats make cost/benefit decisions about health care. They withold treatment to 78 year old men with prostrate cancer so they can spend their limited resources on prenatal care.
Forget about arguing the ethics of Canadacare: after decades of anything goes Americans won’t go for it. If the Democrats pass it anyway, they are likely to rue the day. Put in death panels = driving off a cliff. Expanding coverage without rationing and death panels = faster fiscal suicide.
We’re caught in a trap…can’t walk out!
It seems to me then that some sort of catastrophic mandate/increased out of pocket expenses/health savings account approach outlined in the Times article far more profoundly sensible than the fiscal/political suicide pact currently under discussion.
Munchausen by proxy syndrome in health care might have been great fun for the politicians while it lasted, but with a $1.4 trillion dollar deficit this year, we can no longer afford it.