Health Care - First Do No Harm

The first question is do we in fact need to do anything? Over 17% of the US economy is devoted to health care. This is indeed a high percentage, and worse it is increasing. This is in direct contrast to other basic needs, such as food, for which the share of the economy has decreased over time.

Here is an article by Milton Friedman hits the nail on the head. The problem isn't that health care is insufficiently nationalized. Rather the opposite. About 50% of US health care costs are nationalized, either through tax benefits for employer provided health insurance or direct Medicare/Medicaid subsidies.

It is a fact that people spend their own money more wisely than other peoples' money. This is why free markets and private enterprise are more efficient that government redistribution of taxed income and assets. Why should health care be any different?

Once difference is that certain therapies are indeed very expensive (major surgery). But that doesn't mean everything should be paid by someone else.

Here's a simple analogy using auto insurance. First, everyone who drives in the US is required to have auto insurance. But this doesn't mean that the insurance also covers routing maintenance. It certainly doesn't cover the cost of gas or the car itself. It covers the consequences of accidents, which should be fairly rare. Could health insurance be treated similarly? In other words, you take care of yourself, through healthy lifestyle, regular check-ups, and the like that you pay for our of your own pocket. Insurance is limited to catastrophic events. For the elderly, perhaps more can be covered by insurance (certainly more would be needed) as a form of pension or social security.

But the bottom line, we all should take more responsibility for paying our own individual basic health care costs, just like we cover food, shelter, and clothing ourselves.

In my own experience, where I have attempted to pay for routine care myself when visiting the US, I am continually amazed at how difficult it is to pay cash. Unlike just about any other situation where payment is made for services, I often cannot pay on the spot. The last time I experienced something like that was in 1984, while shopping as a tourist in the Soviet Union (!)

If we can get the government out of health care, then the free market can drive efficiency and technological advancement that will reduce the cost of health care as a portion of the total economy.

This will make health care more widely available, even to the poorest in society. And it will do so permanently.

Nationalization of health insurance and health care, as proposed by Clinton, Obama, Edwards, et al, is exactly backwards.