October 18, 1999
Best medicine is liberty
Government "reform" means high costs, less service
Few people will argue there is nothing wrong with the status of health care in the United States. In fact, the sentiments against the status quo are almost unanimous: the system is broken.
Yet there are many whose ideas to fix the system will actually make the situation worse for everyone, and especially those who can least afford more costly social experiments. As a physician with more than 30 years of private practice, I have too often found that the very people most hurt by "reforms" in health care are the same ones politicians and pundits claimed they were going to help.
The current legislative drive regarding health care is no exception.
The more government has been involved, the greater the costs and distortions. Initially there was little resistance to the federal meddling, since payments were generous and services were rarely restricted. Doctors liked being paid adequately for services that in the past were done at discount or for free, while the patients saw they were getting great access without discernable costs. The nation's medical bill grew as the incentive for patients to economize eroded.
But while Americans may have deep pockets for the tax man to pull from and the bureaucrat to regulate, those pockets are neither bottomless nor overflowing. In recent years, the increasing tax-bite has become noticeable as the costs of the regulations have become more burdensome.
Yet rather than reverse the trend and liberate patients, physicians and the health care market, many in Congress would make the situation worse by adding new regulations and new fees, while eroding services and limiting choices.
Among the most egregious of these new regulations are "must provide" regulations on health insurance providers. These new regs translate into higher costs for the consumer as insurance companies become forced to provide coverage for services they have no desire to cover precisely because they are too costly. While the knee-jerk reaction might be to say, "That's great, they should pay for…" whatever. But such a reaction means limiting the choices of consumers, because insurance companies will either increase rates to cover the new costs, or deny coverage altogether.
A non-smoking, non-drinking single mother may not wish to pay premiums to cover the costs of an alcoholic man's addiction treatments, but new regulations could require just that. No longer will that single mom have the option to pay the lower insurance rates. Suddenly, she has no real choice; she must pay the higher rates or be without coverage.
Worse, yet, she may have no choice at all, as new regulations price her, or her insurer, out of the health insurance market with no alternative.
This is precisely what has happened over the last three decades. More and more people, from the lowest economic classes, have been methodically pushed from the system by the cost of greater regulation. The increased number of uninsured then becomes the rallying cry for more government action, which raises costs again…. A vicious cycle, benefiting no one.
The most important thing Congress can do is to stop practicing medicine and allow market forces to operate by allowing Medical Savings Accounts (MSAs) for everyone. Patient motivation to save and shop would be a major force in reducing cost, as physicians would once again negotiate fees with patients. MSAs would help satisfy the American's people's desire to control their own health care and provide incentives for consumers to take more responsibility for their care. MSAs will also allow those consumers to do business with insurance provider of their choice, who will cover the needs and procedures for which that family is willing and able to pay.
The American people deserve more than the status quo, and better than quasi-socialized medicine. The experience of the last thirty-plus years is clear: even in health care, liberty is the best medicine.