© 2007 by Michael Swickard, Ph.D.
I was talking with my dermatologist about all the new procedures and treatments that make our lives better. Many were not available even 10 years ago. Still, skin health always starts with wearing a hat. In the Southwest that advice is centuries old.
The government may one day force us to wear hats. It would not surprise me. We have less and less control of our lives, even in medicine. We are made to do much we do not like and there is inefficiency. Could our health care system be worse? Unfortunately, the answer is yes.
At an education conference last week some Canadian attendees talked with me at lunch about their health care system. They like the government single-payer approach but said it is threatened by a political move to allow people to pay to move to the front of the line. Also, some Canadians are instead going to the
Some
Other New Mexicans are horrified. They ask two questions: First, who will decide if I truly need what I want in medical care? Second, this is the same government that runs the New Mexico Motor Vehicle Division. Do you want your health care to run like the MVD?
The core of the proponents’ argument is the notion that governments are best suited to take care of people because they operate more fairly. Our government is tasked with making sure we all get equal treatment. But what if you want more or different treatments? Socialism does not work because humans have different aspirations.
Some people work two jobs because they want more. Others are less driven. Some people think that everyone should be paid exactly the same wage. I do not. And some people think that if I have cancer and Bill Gates has cancer, we should get the same treatment. I expect that Bill Gates, with his massive wealth, would have more options than me. And that is OK.
Health savings accounts are one solution
When talking about medical care or grocery stores, we need to look at voluntary exchange theory. We want to have a positive sum gain from each transaction. When we voluntarily trade with someone, we want both the seller and the buyer to walk away feeling good. It should not be a gain for one person and a loss for the other.
In the private sector, if I do not like the way I am treated, I do not go back and that store may not survive. When governments run the MVD, all customers comply whether they like it or not. Successful capitalistic alternatives like MVD Express have sprung up. Would that be allowed in medicine? Probably not.
Today’s insurance companies ration health care almost like governments. However, they cannot force us to buy their insurance, so they remain somewhat customer sensitive.
When governments manage health care, there is no voluntary exchange. The government decides who gets what and when they get it. They decide for the patient and the doctor. Neither may be happy. Eventually, future doctors may not go to medical school. Or, maybe the very best future doctors decide not to go. We all lose if great doctors do something else.
The first principle of insurance is that you only insure that which you cannot stand to lose. You insure your house and car because their loss is catastrophic. But cutting the doctor’s visit price down to $25 increases the total cost of health care and unnecessarily complicates it.
The point is that medical insurance is portrayed as something for nothing. Everyone thinks they will get more than they pay. Ultimately, everyone gets less because the insurance dollars pay for the medical use and the expense of rationing.
One solution is health savings accounts that allow you to keep what you do not use. Some people might use every cent while others would select only what they really need. It works in grocery stores. Imagine if the government only gave you what food it thought you needed. Or, instead, that you could decide what food you want. Which is better?
Anyone with a sick child knows that access, not price, is the primary consideration. A friend’s son broke his head open. The EMTs were at her house quickly. They went rapidly by ambulance to the hospital where they waited six hours to see a doctor. What would she pay to move up the line? Will government control increase access or decrease it?
Two pieces of advice: First, wear a hat in the sun. Second, when thinking about changing our health care system, be careful to not make it even worse.
Swickard is a weekly columnist for this site. You can reach him at michael@swickard.com.