Posted by
Rioabq on Sunday, August 16, 2009 12:42:34 PM
It amazes me that in the national discussion of rising healthcare costs, there is no discussion of why costs are so high in the first place. Doesn't it also make sense that to bring healthcare costs down, we undo the mistakes made in the past instead of compounding the problem by increasing government control and increasing complexity.
Ever go back and find Doctors bills from the past. With the recent death of my Father, I retrieved his original birth certificate and found a Doctor bill for $6. Born in 1929 there was a direct link between doctor and patient. A doctor provided a service and he was paid by the patient. If the patient was poor, the doctor work out terms and maybe forms of barter would be used. Things began to change in World War 2 when wage and price controls were imposed and unions bargained for employers to provide their workers health insurance. Like a deal with the devil, this event planted the seed of our current crisis. It introduced a third party to the doctor patient relationship and it severed the financial relationship between doctor and patient. With employers now providing health insurance, medical care was now "free." As with anything free, demand increased dramatically. There has been a dramatic expansion in medicine and it has created the best healthcare system in the world, but it is very expensive because free market controls have been lacking.
The first way to lower healthcare costs is to bring back free market controls and reconnect the doctor patient financial relationship. The solution is to discourage employer provided insurance and encourage individuals to get their own healthcare insurance by eliminating the business tax break and giving it to individuals. Insurance companies would now have to compete for individuals. Businesses no longer saddled with providing insurance would raise their employees wages or expand their operations. Many individuals who previously wanted their employers to provide expensive insurance would now opt for high deductible low cost policies or Medical Savings accounts because its now in their financial interest to do so. Individuals would now shop for not the best medical care, but the best care at the lowest price. The parts of medical care bow exposed to free market forces lowers costs whether it be plastic surgery, botox, or vision corrective surgery.
The second way to lower healthcare costs is tort reform. As a physician, I know the fear of medical malpractice. In a system which does not limit awards for pain and suffering and does not have any downside for frivolous lawsuits such as loser pays, malpractice awards are astronomical. Physicians lives have been destroyed and malpractice attorneys have been made multimillionaires (like John Edwards.) In response to the fear of lawsuits, physicians will employ CYA behavior. They will order any and all tests to make sure they don't miss a diagnosis (aka defensive medicine). Malpractice insurance costs for physicians are very high. Neurosurgeons for example may pay over $200,000 for coverage. These costs add to the healthcare bill.
The third way to lower healthcare costs is rationing. This is what Obamacare is all about. The president will not say it. Democrats will not say it. The left wing media will not report it.
So why is there no discussion of free market controls or tort reform in the debate for healthcare reform? IMHO it would go against the wishes of the pillars of support for the Democratic party. Unions love their cadillac healthcare provided by their employers and will fight any attempts to change it (even though it weakens their employers ability to compete in the global marketplace and adds risk of bankruptcy (think GM or Chrysler)). Tort reform? Trial lawyers give millions to the democratic party, so this will never be mentioned.
I hope Republicans and blue dog democrats fight Obamacare tooth and nail. The only way Obamacare can lower costs is rationing.