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Would any of the bills working their way through Congress increase the choice of American consumers in terms of their health care? The answer is no! David Leonhardt of the New York Times writes: “That’s a reflection of the thorny politics of health care. On the one hand, big interest groups are lobbying hard to keep some form of the status quo. Insurers don’t want people to have more choice. Neither do employers nor labor unions, which now control huge piles of money spent on health care. Nor do hospitals and drug makers, which benefit from all the waste now in the system. On the other hand, the people who stand to benefit most from having more choice—all of us—are not agitating for change, because the costs of the system are hidden from us. A typical household spends $15,000 each year on health care. But most of it comes in the form of taxes or employer deductions from paychecks, which means insurance can seem practically free.”
The point is that no proposal currently under consideration would truly reform health care in America. No proposal currently being considered in Congress would give US citizens more control over their health care. No proposal would allow health insurance to be fully under the brutal and wonderful forces of the market. No proposal would empower consumers to treat their health care choices the way they treat everything else they consume. For example, most people consider price, quality and customer service when they make decisions to purchase things. Most people purchase a car or a home based on competitive price and the quality of the item. Most people scrutinize and weigh many factors when they make a decision to buy an item. The only exception is health care choices. There is little competition when it comes to health care. The typical consumer of health care must accept what their health insurance company or the HR department at their place of employment tells them to accept. Further, customer service plays no role in the decision-making of health care consumers. You must accept what is offered no matter how bad the service. Consumers are restricted to the plans their employer or the government mandates. Insurers are therefore spared the rigors of true competition, so consumers must accept what is offered. The end result is high costs and spotty, usually unsatisfactory service. When intellectually honest people look at this system, few could defend it. Unlike so many other aspects of our economy, the health care industry has little competition, little exposure to true market forces and does not really need to be concerned about customer service. It is difficult to defend this!
President Bush, at the end of his first term, introduced the Health Savings Account (HSA) idea, which was an attempt to initiate some competition into the health care system and empower the typical American citizen to view their health care decisions in the same manner as everything else they consume. The labor unions and most health insurance companies hate this innovation, because it takes power and influence away from them. The HSA is not an end-all solution but it is a step away from the nearly monopolistic system we currently have and which would be maintained under all major proposals currently before the Congress. If our President and our Congress truly want to reform the health care system in the US, give Americans real choice; let the market forces truly work; and empower US citizens to be true consumers, weighing costs, quality and customer service when they make their choices. All current proposals would simply maintain the status quo, which means no real choice for the consumer. You take what is offered—by your employer or by the government. It will perpetuate the semi-monopoly we currently have in the health care system of the US. In my judgment that is not reform. That is paternalistic government gone wild.
See David Leonhardt’s essay in the New York Times (26 August 2009). |
