This week there were disclosures indicating that the federal government has done a lousy job of taking care of the medical and rehabilitation needs of our Veterans who have served in Iraq and Afghanistan. That’s an important and sad story, yet it is a subset of an even larger truth, that the Federal government of the United States doesn’t do anything very well or very efficiently.
Let’s look at several examples. How efficiently and effectively has the US Immigration and Naturalization Service processed the influx of immigrants into the United States? What has happened to airport traffic and passenger congestion over the past ten years under the Federal Aviation Administration? How effective was FEMA in handling the Katrina hurricane? How many thousands of people have died waiting for the US Food and Drug Administration to approve new drugs? How good is our boarder security? Do AMTRAK trains run on time? Have you tried to get a passport lately?
Given the fact that the Federal Government does such a miserable job of running everything they touch, how can anyone in this country possibly believe that we should have a single payer, nationalized health care system? Does anyone really want the Federal Government taking care of our health care needs? Can we be that stupid? According to many Democratic politicians, apparently we are.
There is no question that we have significant problems with our healthcare system in the United States. Critics argue that we spend more per capita on healthcare than any country on earth, yet many do not receive quality care. They’re right. We need more providers, less bureaucracy, lower costs, and more freedom of choice, yet more government will not achieve any of these results. Only by having less government and more competition in our healthcare system can we be successful in achieving a higher quality of healthcare for all Americans.
How do we introduce competition into our healthcare system? There are several ways. The excessive costs of our system can be blamed on the powerful insurance lobby, the monopoly power of the American Medical Association and high litigation costs. Instead of using insurance companies, consumers should pay for their medical costs directly. This will put downward pressure on costs, as consumers will be reluctant to overpay for medical services that are coming “out of pocket.” The poor would also pay out of pocket for their health care, with those who don’t have enough income being helped directly via taxpayer subsidies. Medical licensure laws should be liberalized, allowing for large numbers of less-skilled practitioners who handle minor problems like colds and influenza. For example, pharmacists could be given the authority to prescribe drugs when patients exhibit symptoms of common illnesses. The expansion of nurse practitioners and the proliferation of walk-in clinics are also a great step in the right direction.
Finally, if Congress really wants to do something positive about improving healthcare in the United States it should cap medical malpractice awards and make it very difficult to sue physicians. Under our current, litigious medical environment, physicians must order every test and often jump through expensive hoop after hoop to insure that they don’t get sued. This drives costs through the roof. Life is cruel sometimes. Babies are stillborn. Cancer spreads. Fat people become diabetic. This isn’t the fault of physicians. Litigation reform will be difficult, as many in Congress are lawyers. Nevertheless, it needs to be done.
One thing is certain. US healthcare is at a crossroads. With the almost certain election of more Democrats to the next Congress, Hillary and Bill will again push for nationalizing our health care system. There’s only one ironic “justice” about a nationalized healthcare system; it will decimate the influence of physicians, lawyers, and insurance companies. Once we’ve jumped off the national healthcare bridge, physicians will see their incomes drop and their autonomy squandered, as they become de-facto government employees. Lawyers and insurance companies will have far less influence dealing with the federal government than they have under the current system. At that point the AMA, the insurance companies and the lawyers will wish they had let go of some of their political power earlier, by making the system more competitive, but it will be too late. The final results, should we go to a nationalized system are certain; more government, lower quality, less accountability and higher cost.