As the attempt to reform our health-care system crescendos, it is difficult to pinpoint exactly where the debate lost its way. Perhaps it never truly began in the right direction.
Between the fear-mongering and the screaming, it seems some of the most pressing issues – medical inflation and warped incentives – have been sidelined. And why? Perhaps because they are more complex. These issues require quite a bit of explanation and historical context, which doesn’t always fly too well in a sound-bite culture.
One of the main problems regarding our health-care industry is its lack of any organization. There was no grand design in its creation; it is a Frankenstein monster, cobbled and patched carelessly together since its birth in the wage controls of the World War II era, with little regard for consequences.
Yet, any grand design is practically doomed from the beginning, as the only two viable options – a single-payer system or a complete overhaul of incentives and the creation of a truly free market – are both met with opposition. Consequently, we receive a bill that is the worst of both worlds.
True, the House bill does work at creating a marketplace in the health insurance exchanges (an important, but underplayed, provision), but it also includes a public option. Supposedly, the public option is meant to control prices by adding a more virtuous competition into the marketplace, but when you look at the details – its limited eligibility, and the fact that prices will be set by negotiations with health care providers – it doesn’t seem as if it will control prices at all. After all, medical inflation has not left Medicare and Medicaid, two government plans, unscathed.
So, who is to blame? The Democrats or the Republicans? Both. To their credit, the Democrats have actually gotten the ball rolling on health-care reform and have put forth a bill, though their proposal remains flawed.
The Republicans, on the other hand, are too busy trying to give President Barack Obama his “Waterloo” (this can be seen in the misnomer “Obamacare,” which would be more accurately titled “Congresscare”) and preaching about fictional provisions such as nonexistent “death panels” to actually provide legitimate criticism and a legitimate alternative.
Both accept money from the big health insurance and pharmaceutical giants and allow them to actively craft the bill as well.
We, the citizens, are also to blame. We are too easily led by the talking heads to one particular conclusion. A single-payer system is not the devil, and it does not ration care any more than our current system does. Any system we adopt will require a give-and-take.
A single-payer system will cover everyone, unburden businesses that pay for employees’ health care (and thus help small businesses). It will purge the system of waste, but everyone will be required to pay through taxes and waiting lines — secondary, optional care will be a bit longer (though primary care may very well be shorter, as it is in Britain).
Remember, the government is already inextricably involved in our health-care system. A complete rebuilding of the health-care free market, hand in hand with other reforms (like tort reform), can control prices through innovative market forces and reshaped incentives. Both plans are bold and both have their strong and weak points. What we can’t afford is another plan that simply slaps a Band Aid on the issue and kicks it along to the next generation.