Saturday, February 23, 2008
Capitalists For Universal Health Care
Ask not what capitalism can do for health care, but what a universal health care system can do for capitalism. Capitalists should not be thinking about the market forces within the health care system itself. We should be thinking about how our health care system restricts our nation’s climate for healthy capitalism across all industries.
Instead of running scared from the idea of socialized medicine, universal government run health care should be on the top of the priority list for every red blooded capitalist in America. Sound funny? It shouldn't. One of the biggest barriers for small businesses and even large corporations in America is the escalating cost of health care. According to David Cay Johnston in his new book "Free Lunch", Toyota recently turned down the state of Alabama's offer to have a 100% subsidized multi-million dollar auto plant built and paid for completely by the Alabama tax payers. Why would any company turn down so much money in subsidies? Are you kidding? A completely free auto plant! Toyota executives decided that it made more sense to locate the new plant in Canada and pay all the costs themselves. American "for-profit" health care was the culprit. If you think that sounds strange then just ask General Motors how much it costs to keep American workers in health plans. The current system is bad for business. I know because I run a small business and our insurance costs are through the roof. When important employers leave our nation because our health care system stifles business, then we have a big problem. How does that Canadian health care system look now?
Another big issue is that our current health care system ties insurance to employment. These conditions keep many workers from changing jobs and expanding their career. Millions more workers squander their innovation and entrepreneurial skills because they simply can’t get health care if they decide to start their own business. Shouldn’t we as a nation be interested in building a system that facilitates innovation and our entrepreneurial spirit? Shouldn't our health care system attract business and invite capitalism? Why does the insurance industry win out over all the rest of us when they already get billions in handouts from the government?
This is a general election pitch that would appeal across party lines. I hope Barack Obama picks up on this message soon. Maybe we should turn the tables on the health industry and outsource them to china!
14 comments:
Another big issue is that our current health care system ties insurance to employment.
This is why I don't see it changing anytime soon. Here in Canada I can quit my job at any time for a new one and the only thing I have to worry about are dental, eye care and prescription drug costs. I don't think American big business wants its wage slaves having such freedom.
Very interesting. I've been wanting to read Free Lunch. Good post and good blog.
Cheers.
Universal Health Care sounds great in theory, and it sounds like it has worked in some countries. But the huge profits of the drug industries, hospital corporations, even physician salaries make it cost-prohibitive in the US.
I like what PJ O'Rourke says - "You think health care is expensive now? Just wait until it's free!"
Pretty brilliant argument. But you gotta ask, "why are costs going up?"
Until that's answered, trying to fix it will likely result in what government efforts always result in:
Making the problem worse.
It is simple. Costs go up because you have an industry trying to run with capitalism BUT without competition and choice. America is the ONLY industrialized nation without socialized health care. It is the most expensive system. The problem is obvious!
Government must step in and run the industry. This is the perfect industry to socialize. Anytime you have a product that people don't choose to buy but are forced to use, then you will have great fraud as capitalism does what it does best. It exploits those that have little choice. When is the last time a dying person decided IF they would call an ambulance or shopped for price? It doesn't work. If you have health care workers running a "for-profit" practice then they are going to exploit sick people.
I like many things PJ O'Rourke says, but he is dead wrong here. For the same reason we should not privitize police or fire protection we should not have private health care. The nation once tried to privitize fire protection, but it failed miserably. People would watch houses burn because it was on the wrong side of the street and across the juristiction of a particular private supplier.
But why is there lack of choice and competition?
What causes that?
It is the nature of the product (health care).
You can't choose to use health care or not. It is simply not a product that allows for free choice. For the same reason a person being mugged cannot pause to shop for the best price for a police officer. Should we allow private contractors to police our streets? How about private for-profit judges?
Can you reasonably expect to have a dozen well fitted hospitals within reach of every american so that they can appropriately allow market forces to drive out the best prices? Even if those choices in service providers existed, would you really have a choice of using the service or passing? This is NOT like deciding to buy a new car or opting out and taking the bus. If you are having a heart attack, you have to call an ambulance.
Health care, like many other community services cannot be run by market economics. For example, look at what happened when we decided to oursource our military? Look at the higher cost of this recent war. It is so high exactly because 50% of the forces are private contractors. We pay $99 for every load of laundry that Haliburton processes for our soldiers in Iraq.
You are correct that you can't really choose to use healthcare or not. But you can't really choose to eat or not either.
The solution seems to be in providing options for choosing your food or healthcare. Different grocery stores, or different healthcare providers.
You point out that hospitals are't typically be multiplied without end. But I thought the issue was insurance? Why can't we have lots of options for that?
It does seem to be true that the number of hospitals in any given area is low. But why is this?
I would imagine it has something to do with the AMA.
Private contractor security has done a lot more for me than the police ever have. And I have been accosted, had my car stolen, etc.
Micah,
You can choose what to eat, where to eat, and even how much to eat. Can you really choose how many medical procedures to have? When you need a heart by-pass can you opt for a cheaper root canal instead? I a big advocate for capitalism, but the point is that all the important factors needed to create a healthy (pardon the pun) market economy do not exist in the health care industy.
You make a good point by mistakingly assuming the solution is insurance. Insurance is actually the problem. We need to cut insurance companies out of the loop. They have been on the gravy train too long. One of the bad assumptions of all the political candidates in the race right now is that they simply want to buy (or mandate the purchase of) insurance. That does us little good. It will get more people covered, but it simply makes the insurance companies rich the same way the defense industry is getting rich off the war. The real solution is pure socialized medicine. The last thing we should do is rely on corporations whose main determination of profitability is its ability to deny claims.
The reason we have fire service is because the danger of fire spreading, not for any other reason. Getting fires put out is a public good. There is no comparable problem for any medical problem other than infectious disease. But with infectious disease, the unfortunate problem is that medical care quite often is responsible for its spread.
As for choosing medical procedures, unless the case is emergent, one always has the option to shop around for where an operation is performed. And that applies to both heart bypasses and root canals.
Anyway how do you feel about the fact that socialized health care systems not providing access to the latest medications or withholding procedures for budget reasons? How do you feel about the a large percentage of British NHS doctors advocating for reducing expenditures on elderly? Do you think smokers should be refused a heart bypass?
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=510764&in_page_id=1774
Americans aren't lemmings and aren't going to allow the government to gain savings through such limitations of service. And Americans aren't going to look fondly on the situation if its best and brightest cease going into medicine because of caps on compensation.
If you are concerned about the competitive benefits that socialized health systems are giving countries by creating an underfunded healthcare monopoly and monopsony, you should perhaps advocate for improved service levels in those countries to raise their costs. Why should we bring our service levels down to theirs?
Anonymous,
Those nations with socialized medicine rank higher than the US. We currently rank 37th (below Cuba).
you said "Americans aren't lemmings and aren't going to allow the government to gain savings through such limitations of service. And Americans aren't going to look fondly on the situation if its best and brightest cease going into medicine because of caps on compensation."
What do you think insurance companies are doing now? Americans DO act like lemmings as they allow insurance companies to deny service and bankrupt our nation. The whole time those companies are increasing insurance costs and medical costs. The first motto of insurance companies is deny deny deny.
The reality is that health care is something that we already ration. The question for us all is to decide how we will ration it. Should we ration it based on the types of problems and the costs associated with the care OR should it be purely on allocation of wealth.
Even in socialized health care nations, people are free to purchase supplemental care/insurance to cover them if they want to have treatment above and beyond the norm. Bill Gates can stay on life support for 50 years if he wants to.
As for a shortage of doctors. I would advocate free government funded medical school for anyone that can get in. In exchange they would work for us at a reasonable salary when they get out. There are plenty of people willing to do that and we would likely get better quality doctors that care more about serving others rather than making a fortune. We could flood the market with high quality doctors and drive costs down and increase quality through competition (you know, market driven economics!). It would be a good investment.
Anonymous,
Also, healthcare is a public good. By providing health care we can substantially reduce the need for other government services caused by poor health. Illiminating poverty is not only a "nice thing to do". It is a smart economic move. Poverty is a drain on society and health care costs are a big reason for poverty.
The reason there is a shortage of doctors is because the American Medical Association specifies that there must be. The AMA is a union that works to keep supply of doctors down, and cost of doctors up.
Micah,
You've brought up some good points about the AMA. They really get little attention in this whole national debate.
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