Reply #95: government and rations [View All]

[question everything]

First, people don't want "government" to run their health care. They either believe that the private sector is more efficient or they just don't want a government body in their affairs. Both, of course, are illusions, but these are the claims.

Second, they believe that such a system would limit their freedom of choosing a provider and would limit the extend of expensive treatments. Again, both are illusions as many have seen with HMO and others.

Third, they listen to horror stories from Canada about people having to weight for months for elective surgery and for those who come to the U.S. for their treatments. I've heard that the systems used in France and Germany are better than the Canadian and the British - but no one is bothering to look there.

Last, and I think that there is a kernel of truth there: such a system will have to ration treatments. The state of the art treatments are expensive. And one reason they are - in my opinion - is that this is the only area in our lives that we do not act as educated consumers. We let our employers select our health insurance that selects our health care provider. We rarely study the invoices and have no way of questioning any billed item.

But in reality even our current systems ration treatments. It is just that in theory we can select another carrier that would not - and pay for it. Or our employer will. Having one universal system will have to ration treatments across the board - for the rich and the poor alike.

The answer, in my opinion, is not to force all to use the universal system. The real world is that there are wealthy individuals who want to and can buy more of resources than most of us do. And if they choose to opt out and to pay for their own - fine, let them. Similarly, if, at some point you want to go to an expert and pay for this from your own pocket - that's fine too.

But we need for employers to get out of the health care business, similar to the way are are out of the retirement business.

I've often compared health care to our education system. We pay taxes to support our public schools whether we use it or not. And those of us who want to pay from our pocket for private schools, can do so.

Same should be with universal health care. We support it with out taxes and expect it for everyone. But if some of us want to pay from our own pocket for a private insurance or a private hospital - we should be able to do this.