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There, I got your attention, but I stand by the title of this post.
The conservatives are right when they point out that, what they bill as "RomneyCare" in Massachusetts, has become an utter failure, with wait times increasing to over a year in some cases for a primary care doctor. What they probably fail to consider is why this has happened. There are two components of the Massachusetts plan that are flatly anti-free market: 1. The mandate for people to have to buy health insurance and 2. the requirement that insurance companies be forced to insure those they already know will be a net loss. So what is the net result of this? Well, health insurance companies won't leave the health insurance market, but only because of this mandate that everyone (even the young and healthy) must buy health insurance at a price set by an oligopoly of health insurers. However, healthy people rarely need to see the doctor urgently. Sick people do, but sick people are a net loss to the health insurance company. So what should the health insurance company do? Pay the doctors squat. Now, the sick person will not be able to see the doctor (thus no outlay), and even if they do see the doctor, the insurance company is paying a discount. Healthy people are satisfied with their health insurer, or as satisfied as they can be, but sick people will now try to leave the insurer to find different options. Thus there are three positives for health insurance companies to lowball the doctors: 1. artifically created shortages leading to lower costs, 2. lower payments leading to lower costs, and 3. dissatification among sick customers leading to lower net losses due to them potentially leaving.
The conservatives are right. RomneyCare has messed up the health care market in Massachusetts and has increased waiting times. If enacted, it may even be worse than foreign systems of health care for reasons I will get into in a second. What many conservatives fail to realize, except for perhaps the true libertarians, is that this country has already meddled into the free market of health care. By mandating community ratings for group policies, it is mutually beneficial for only the largest of employers to purchase health insurance. This, of course, creates the problem of being a "health insurance slave" of a large company, especially for employees who are sick or have sick family members. These employees have little leverage now in demanding a higher salary. Furthermore, by restricting the supply of doctors via stringent medical school admissions, the cost of health care has gone up.
So what is the solution? The solution is simple, let's follow free market principles to fix our nation's health care problem. If I want something at Wal-Mart, I buy it. I don't intimidate someone else to make them buy it for me, because aside from this being immoral, I do not want to be punished for doing this. If I am at church and I want to give food to a needy man, I just do it. I don't try to force other congregants to give to the needy man, because this would take too much time. Thus, if the American people want to guarantee health care (not health insurance) for all her people, it must pay for it itself. It must singly pay for the health care it wishes to guarantee that may be uneconomical to provide.
The government already has single payer insurance in many different spaces (flood insurance, crop insurance, unemployment insurance, Medicare, federally guaranteed mortgages and student loans etc.). The government does this because there is a public policy interest to ensure subsidization of these products. Thus, if the government doubly subsidizes buying a beach house via a federally backed mortgage and government flood insurance, why cannot we subsidize health care for those who cannot afford it without acting feigning shock at the fact that business's goal has always been to make a profit even at the expense of public welfare.
The insurance companies are doing their jobs when they turn down those that are already deathly sick. The United States, if it claims to be pro life, has not done its job in picking up the tab to insure those who can't afford their bills. Thus, here is what I propose:
1. Abrogate all restrictions and mandates on health insurance companies and replace them with regulations that only ensure fair play on behalf of both parties (the insured and the insurer). What you say is what you mean.
2. Adopt a policy that the government will pay all medical costs that exceed 15% of a household's income or $2250 for able-bodied adults who have no disabling health conditions, whichever is greater. Outsource this process to the health insurance companies, who will act as processors.
3. Require no co-pays or outlays for medical costs of children under 18. The last thing we want is parents trying to save a buck at the expense of their child's health.
4. Allow doctors and health care professionals, but not ERs, to have a luxury queue, with time set aside for appointments for those who pay a higher cost to see the doctor more quickly. However, require that doctors both publish their rates online and publish their current wait times for both the basic queue and luxury queue online. Outsource this website to a reputable company that can do the job (i.e. Google). Do not subsidize any extra cost from luxury care.
5. Set a maximum co-pay at some percentage of the basic (not luxury) cost (say 30%) for adults under their limit. The government will pay this so Americans do not delay getting important health care.
6. Increase taxes by 5% across the board, but do not do this while we are still in a recession (simple Keynesian economics).
7. Create a Federal Reserve like agency that can adjust rates to insure wait times remain acceptable.
8. Increase medical school seats. There are too many smart people who may not have gotten a 3.8 or aced their MCATs who would do well as doctors.
9. Reimburse all United States medical school costs (at $50,000 a year - the difference should then be kept by the school) if the medical student passes his or her boards. Allow even those who have passed his or her boards to retake them at his or her own cost if he or she wishes to display a greater competence.
10. Now allow insurance companies to insure individuals or employees, but require consumer ratings for various insurance products. I understand this probably goes against free market principles, but it goes to the heart of our notions of fairness and this will now have only a minor impact on health care delivery.
11. Provide government tax credits for healthy behavior, including low weight and smoking abstinence.
12. Have the government include personal trainers in its insurance, but drug test these trainers regularly for doping and severely penalize criminally any trainer that facilitates doping for his or her clients.
13. Provide a tax credit and require no co-pay except for luxury costs for all Americans to see a primary care doctor or physicians assistant semiannually for a physical.
14. Have the government, just like with flood insurance, provide and also require basic, but high limit, malpractice insurance at a discounted rate. Increase or decrease these rates based upon the doctor's relevant prior record.
Let me know what you think about my proposed plan.
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