Health Care Apples And Oranges
I’ve stolen the above title from tgirsch over at Lean Left. That and the statement that both Canada-style and USA-style health care has serious flaws are the only bits worth repeating. I was hoping that he’d also make one of his typical smarmy statements about the “free market”, but alas that was not the case. Truth is that both systems need a IV transfusion of a little free market to break out if their anemic slog.
tgirsch rightly spanks this WSJ article though. Although the author David Gratzer does come out strongly for the USA system, he does fail to note any shortcomings, and he drops the ball when it’s his turn to propose some solutions. Hmmm, maybe if you buy his book you’ll get those answers. (Yup, he’s writing in the WSJ to plug his new book) Hopefully, I’ll be picking up that ball and running with it.
I’m planning on a few posts over the next few days. I’ve had them kicking around in my head for a while, I suppose this quote it what spurred me to get started on them:
tgirsch Says:
[For the record, I don’t support adopting a strictly Canadian-style health care system. Instead, we should survey the top health care systems in the world and selectively pick the best aspects of them to build a world-class health care system for everyone, not just the well-to-do...
Sounds pretty good offhand, however he goes on:
Now despite the fact that he’s willing to travel the world to sample the very best ideas in health care, in the very next sentence he’s already got what he thinks is the perfect solution, one which would undoubtedly be the rose-colored glasses he’d view every other solution through. What bothers me most, however, is the knee-jerk assumption that more government regulation and control are what’s needed, not less.
Now I’m not going to claim that our national public school system is utterly broken, because it isn’t [1], but the reason why is because there really isn’t a national public school system. Oh sure there’s the federal boondoggle that is the school lunch program and the No Child Left Behind crap, but by and large the public schools are controlled locally, and funded with largely local funds to boot. This one fact that there’s a lot of control locally Is what I believe prevents public education to be the typical federal bloat-aucracy that I would expect it to be. His analogy breaks down here because I’m assuming his idea is that if you resided in Maryland and were vacationing in Tennessee and for some reason needed emergency care, his idea would be that the local health care system would not turn you away, or charge you cash prices because you were not funding the local emergency care network with your property taxes. That kinda thing does happen every day with our public school system. Every once in a while they catch a congress-critter trying to enroll his/her offspring in Montgomery County Maryland schools, instead of the District of Columbia’s public school system, even though the representative in question resides in the District (that’s because DC’s schools are horribly broken, compared to some of the local suburbs).
A better analogy might be our public retirement system, also called Social Security. Here, everyone pays in to the system according to their income, (except for a certain white religious minority), and everyone dips into the same retirement pool when they are eligible to receive payments. Except that if your income is still too high, you get taxed on those benefits at a higher rate. Except that we’ve let our congress-critters (Republicans and Democrats alike) steal the Social Security trust fund, transferring it by decree into the general fund, and leaving the Social Security Administration with a pocket full of IOUs not worth the paper that they are printed on. Except we’ve allowed ourselves to be saddled with a de facto citizens ID card, originally not intended for identification purposes at all, yet now has transformed itself into an essential ID number, without which one can not function today in society. Except that very same ID number has been used and abused as a way to violate the privacy of citizens by public and private parties for decades.
So now that I’ve trashed tgirsch’s proposed system (and by extension, Canadian style health care, HillaryCare, single-payer health care, socialized medicine, universal health care, and any other related name from the euphemism treadmill for the same socialist crap), where are my solutions? Well for that, you’ll have to wait until my next few blog posts. To preview, the problem with US style health care is that there’s little incentive to control costs. More on this later.
[1] I will interject here that I’m a strong advocate of vouchers, and abolishing public schools altogether, letting the private schools compete with each other and cater to the educational wishes of their customers.
tgirsch Says :
You may have read that I think this would be a “perfect solution,” but I sure as hell didn’t write it. I do think, however, that there does have to be some level of government involvement/funding, or it can’t work. Health care is inherently expensive and is needed by everyone. I just don’t see any purely free market system that could provide adequate health care to, say, a single mom making $20k per year.
That’s not to say that more government control / regulation is necessarily what’s needed. Just that more intelligent government involvement is needed. Here’s a hint: If you’re going to have the government provide prescription medication, don’t include industry protections that prevent that same government (and, by extension, the taxpayers) from negotiating for lower prices.
I wouldn’t tell that to the Bonds market, if I were you…
I wouldn’t say that you’ve trashed anything, because I didn’t even really propose a system. You focused in on one narrow suggestion and assumed that I intended this to be a comprehensive plan. I think it’s pretty clear that I didn’t. I’m totally open to suggestions, actually; I just want those suggestions to actually allow for universal health care (whether privately-funded, publicly-funded, or some combination thereof).
You realize that this is a uniquely un-democratic proposition, right? While on the surface it seems you’re doing the opposite, you’d actually be denying the taxpayers their right to have a say in how their tax dollars are spent. (In the vast majority of cases, the parents of a public school student pay only a very small fraction of the actual cost of their child’s education. The property tax payers in their district — all of them — pay the bulk of it.)
2007-07-30 12:24 PermalinkStandard Mischief Says :
It’s all part of an Evil Plotâ„¢ to get you breeders to pay for your own damn kid’s education, and not shift a major portion of that debt onto the childless among us.
What we’ll do is use the automatic improvements that are a direct result of the free market to privatize the school system, totally eliminating public schools altogether.
Once that is destroyed, we’ll peg the yearly voucher payments to a cost of living adjustment (COLA). Because the government “cooks the books” on the official rate of inflation, the real buying power will slowly erode over the decades. Gradually, parents will come to understand that we no longer live in a subsistence farming economy and they need to make wise reproductive decisions.
Shhh, please don’t spill the beans.
2007-08-03 12:16 Permalink