As noted previously, Tom Daschle spoke on the future of health care in the United States yesterday. While I am still waiting on a copy of his book, I find what he said to be unsurprising and largely in keeping with the thinking that “anything you can do, government can do better.” A few excerpts from his speech are as follows (read the whole thing if you have the time). I know I’m leaving many things out, but I want to comment on just a couple of his points:
But before we define the solution, I think it’s important that we define the problem. It’s important that we’re all on the same page, that we agree what the problem really is. Before we define the problem we have to destroy the myth. And the myth in our country has long been that we have the best healthcare system in the world. Why else would kings and leaders all around the world, people of prominence come to the United States?
Well to a certain extent that is true. But for every king who may come to the United States, there are thousands of people who leave the US to get medical care elsewhere. They call it now medical tourism. Thousands of people leave the United States because the quality and the cost is better in other countries. So how do we explain, well we explain by simply stating that we have islands of excellence in a sea of mediocrity.
God forbid a plane crash occurs in some airport involving a 747. What happens? Well in this country, the 747 crashes the national transportation safety board is on site within hours and within weeks or months we have a full report as to why it was that these 450 people on that plane were killed. We know because there was extraordinary record keeping. We know because there is extraordinary transparency. We know because there is a framework in place to examine these mistakes and fix them. A combination of the FAA and the NTSB and the transparency that comes with the laws involving aviation and we fix the problem. It’s why we have one of the safest aviation systems in the world.
First, in reference to medical tourism, let it be clear that Americans leave the United States to get medical treatment for a variety of reasons. Some of the most popular ones are as follows: drugs/treatment not approved in US by FDA , procedures are less expensive, procedures are against US laws on moral or ethical grounds (such as those which pertain to “reproductive health”). I do not have a problem with people going elsewhere to spend less (as I will do the same myself within the local context). If they are willing to accept the consequences (not necessarily good ones) of unapproved drugs or unethical procedures, so be it. I do not know if anyone has the numbers, but I would guess that when it comes to critical issues (life and death surgical procedures, for instance) that the United States receives a net inflow of “medical tourists” rather than the opposite. However, whether or not that is the case, this truth remains: there is no reason why we need more federal government intervention in health care to prevent people from going elsewhere for solutions.
Second, in reference to the fine job which the FAA an NTSB would do in the event of a crash I need to say two things: a) you have got to be kidding me if you are considering either of these organizations to be models of efficiency. It took the NTSB more than four years to figure out what might have happened to TWA flight 800. Back in 2001, Fortune had this to say about the FAA:
In 1982 the FAA embarked on a major modernization effort; after 12 years of delays and $1.5 billion in waste, the government declared it “out of control” and shut it down. (The FAA admits to inefficiency.) A semi-private business, the thinking goes, couldn’t afford to waste so much time and money. With less red tape, improvements could be implemented much more rapidly.
To my knowledge, several of the FAA issues which were addressed in that article still remain today. So, Mr. Daschle please do not use the hypothetical collaboration of the FAA and the NTSB as a means of proving how government agencies can efficiently address crises. Such an argument tends to fall off the rails without anyone helping it.
Government “help” in health care is becoming more and more like the medical care of 200 years ago, where the doctor would bleed the patient to make them better. An unknown writer at WizBang has several thoughts as to how we could actually help the health care system get better, instead of effectively killing it off:
- Get serious about Health Savings Accounts (HSAs). HSAs entice people into the health insurance market, moving away from expensive all-inclusive coverage and toward less expensive, catastrophic coverage. The tax-advantaged medical savings account is used for routine medical expenses. This contains costs by providing an incentive for judicious health care spending. People are in charge of their own money and keep the money they don’t spend.
- Make insurance portable. If the government is going to be in the business of subsidizing health care, tax credits should be directed to individuals and not to employers. This would allow people the opportunity to shop around, and would allow them to change jobs without worrying about health insurance coverage.
- Allow people to purchase insurance across state lines. With more options for consumers and more competition between insurance companies, prices would go down and services would improve.
- Get serious about tort reform: Patients should have access to legal remedies in cases of medical malpractice but the legal system needs to discourage endless, frivolous lawsuits.
- Don’t move toward socialist or government-run models of health care delivery. You say you think government-run health care is wrong. I agree. Government-run health care leads to lower quality, higher prices and shortages of health care services. For all practical purposes, Medicare and Medicaid amount to government-run health care, so don’t expand Medicare and Medicaid.
I’m liking these ideas–particularly the one regarding HSAs. If more people only knew what health care cost them, they would be more careful in lifestyle decisions and more appreciative of the care they get.
One more thing, and then I’ll let this simmer for a while: Mr. Daschle and Mr. Obama have at times both said that they do not want the government to take over health care entirely, they just want it (government) to use its power to alleviate the problems which currently exist. They speak of “oversight” and “accountability.” What they are conveniently leaving out is how simple it would then be for government to overlook the actual accounting for the increased cost. P.J. O’Rourke has succinctly said: “If you think health care is expensive now, wait until you see what it costs when it’s free.”