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universal healthcare

Sunday,  02/10/08  08:14 PM

Here's a theory for you to disregard completely...  Universal healthcare is bad. 

I've felt this for some time, but re-thought about it recently upon reading Dave Winer's post about Debating healthcare in 2008.  Dave and I disagree about most things related to politics, and this is no exception.  {He simplifies things to Republicans = bad, Democrats = good, and stops there.}  Implicit in his thinking is that of course universal healthcare is something we all want, and that the debate is over how to get it.  A lot of people think that way, and all those people are wrong.

Universal health care is like universal anything, a leveler.  It is communism, pure and simple; the worst off get more, and the best off get less.  As one of the best off – and more to the point, as someone who has worked hard to be better off – I personally want the best I can get.  I am not sympathetic to those who can't afford the best health care, it is what it is.  I’m not ready to give everyone cars as nice as mine, either.

If you think this isn't true, consider that health care in the U.S. is the best in the world, for those who can afford it.  Better than the U.K., better than Canada, better than the Netherlands.  In those countries there is no private profit motive for healthcare providers which drives them to be best.  Good thing for them they have the U.S. market pushing technology of which they can then take advantage.

What is also true is that health care in the U.S. is not as good as other countries for those who can't afford it.  That's because good health care is too expensive.  So the question is, how to make it more affordable.  And the answer is, let the market figure it out.

The best thing we could do for health care is to get the government out of it.  Right now in the U.S. most pricing for most procedures is fixed by Medicare – the famous CPT codes.  Insurers are all driven by these.  The existence of these codes prevents the market from lowering prices through greater supply, and from raising supply through greater demand.  There is no monopoly; there are plenty of health care providers out there, and if freed from government intervention some would move to the high end, and others to the low end.  Pricing would match the market segments, and it would be easier for people at the low end to get health care.  You could have the government provide a basic level to everyone - economically - as a sort of welfare.  (Just like they subsidize education and phone access.)

Yes, I am advocating getting ride of Medicare.  Really.  The government should not be administering this ginormous retirement plan with health benefits for everyone.  It is massively inefficient and incredibly expensive.  Every single person who receives Medicare benefits could have saved that money themselves through a privately managed 401k-type plan, and would have incredibly more money for [private] medical insurance.  And those insurance policies would be a lot less expensive without the government's regulation.

Health care is just like anything else, the economics work just the same.  When you argue for universal health care, substitute something else to think about it clearly.  (Universal cars.  Universal food.  Universal housing.  Universal computers.)  In the best scenario the low end gets less, the high end gets more, but everybody gets something.  And that happens without any government intervention.

It's the American Way.