Posted by
Philip Mella on Monday, November 26, 2007 4:20:01 PM
It's now clear that a debate over health care will be
prominently featured in the 2008 election, and, as is the case with all
policy issues, he who frames in the most cogent cultural terms has the
inside track. Since it faithfully tracks the media's left-leaning
bent, yesterday's lengthy lead editorial in the New York Times is the perfect segue plot the debate's likely political trajectory.
As you work your way through it, you'll be struck by
its assertions concerning the underlying causes of our supposed crisis,
because they inadvertently illustrate some of the most compelling
reasons to permit the market place to finish what it began some dozen
years ago: To wit, a pandemic softening of demand while allowing the
system to create a multiplicity of hybrid health plans to suit
individual needs.
To begin with, you may be surprised by the Times'
conclusion that the "main driver of high medical spending here is our
wealth," not the fact that we have the most advanced medical technology
on earth, not to mention a pharmaceutical pipeline that continues to
produce miracle medicines that maintain optimal health in ways that
were fantasy just a decade ago.
But leave it to the Times to make the case
that having the world's superlative system is somehow a deficit, which
is what they do by arguing that we simply can't 'afford' it.
Curiously, after framing the issue with its uniquely biased parlance,
they ask a thoughtfully selective question that effectively defines the
contours of their solution:
What can be done to lower both the high level of health care spending and its high rate of increase from year to year?
Note
the absence of timely access and quality of care in that question. By
focusing exclusively on cost they are front-loading the debate, which
presumes that 'universality' trumps access and quality. That might
well be the case in nations where the government controls everything
from garbage collection to our choices in health care and where over
half of income disappears into the black hole of government spending,
but Americans correctly view an expanded government footprint with a
mix of skepticism and concern for quality.
They've heard the anecdotal stories from Canada and
Europe where routine referrals to specialists can take up to 18 weeks
and elective hip surgery the better part of a year. And, of course,
there is a reason pharmaceuticals are less expensive in those
countries--the government controls the price which means they
effectively control the amount of new medicines that are brought to
market. At a cost of upwards of $1 billion per drug, it's no wonder
the United States is the unqualified leader in producing the most
efficacious medicines in the world.
The Times also seems surprised that we pay our
physicians and hospitals more than other countries, and so they
blithely recommend that we "tap into the vast flow of money sluicing
through hospitals, nursing homes, and other health care facilities."
Without a scintilla of evidence the liberal sensibility sniffs out
alleged greed and waste and gathers the usual suspects for a
shakedown.
In a momentary flash of insight, the editors stumble
onto a market-based solution, which is consumer-driven plans, and which
are already fundamentally realigning incentives and inhibiting
unnecessary care. However, they misguidedly conclude that since they
aren't feasible for the poor they have no utility whatsoever.
After that dangerous brush with common sense they
return to embrace liberalism's pipe dream: a single payer system.
Their infatuation with such a system is understandable because, as they
dream, it
...would let the government offset the price-setting strength of the medical and
pharmaceutical industries, eliminate much of the waste due to a
multiplicity of private insurance plans, and greatly cut administrative
costs.
There
is predictable, if naive allure in adopting such a system because it
has such a sweeping appeal and is comforting, at least at the
conceptual level, because of its unalloyed altruism. But anyone who
has studied economics knows that price controls are never a long-term
solution because they skew incentives and create a wholly false
impression of systemic fiscal viability.
Since we know that the Times and its brethren
on the left have crafted a preordained conclusion, their arguments for
some form of universal coverage are couched in a polemic of health care
as a right, which conveniently recasts it as the legitimate charge of
government to control.
In truth, the solution to our 'crisis' is simple:
Dramatically reduce demand by continuing the practice of gradually
migrating the real costs to consumers through plans that allow
individuals to define their unique menu of services and associated
pricing; and, use the same market-based template for those unable to
afford care themselves--that is, they must pay at a level that inhibits
a profligate use of limited resources while encouraging healthful
lifestyle choices.
We don't have car insurance for oil changes, tune-ups
and tires, only for catastrophic losses--the same should apply in
health care. The market place is already making corrections, now is
not the time to usher in a government Trojan horse which will reduce
choice and compromise quality.