The most disappointing thing about debating new or expanding government programs is that the question of how well similar programs have worked in the past is rarely discussed or understood. We can go around and around about the healthcare debate and talk systems, policies, prices, etc. At the end of the day, the idea of a single-payer/government provided health care system is so that people down on their luck are not condemned to death because they don't have enough money to pay for a given service. One could argue that there will always be disparity between the rich and poor and the level of healthcare offered to each group. One would be absolutely right assuming that the more money you have, the better care to which you will have access. This is a truism. It is true because it is true. The same could be said for people in power, particularly our legislative representatives. The sad irony is that the leaders in Washington, DC are not debating healthcare of the nation as a whole, as they are exempt from all of the rules being discussed. They are debating what your system will look like, not theirs.
The crux of this whole debate goes missing, though. I have yet to hear people explain the reason why we are in the situation we have today. That situation is constantly rising healthcare costs and a system whose transparency is that of a wet bedsheet. No one knows what is going on. The patient doesn't know what type of costs he will incur when visiting the doctor. The doctor doesn't know what a procedure will charge when he orders it done. The administration of the health care organization only worries about how and whether they will be paid. In the mean-time, no one gets the entire story - least of whom, the patient.
Let's talk for a short moment about health insurance. Why is it so expensive? Why can't we start to deal with those costs? Yes... why?
"American health insurance is more expensive because private insurers compete within state markets, not regional or national markets. The easiest way to encourage competition [and immediately lower costs] is to let the general public choose from competing private plans in a national market, just as federal employees do. To make this so-called national "Health Insurance Exchange" work, Congress is exploring new rules to increase the reliability and transparency of private insurance plans.
However, many of these new rules are likely to make health inflation worse, not better. Health-policy analysts call these regulations mandates. Mandates are the earmarks of the health-policy world. In the past, state lawmakers added insurance mandates to various laws, forcing plans to cover specific services and providers.
Thanks to mandates, insurers in one state (New Mexico) must cover oriental medicine in every insurance policy. Two states (Washington and Minnesota) require coverage for "port wine stain elimination." Three states have mandates for athletic trainers. Twelve states force insurers to cover acupuncture. Fifteen states force insurers to cover in vitro fertilization. In these and hundreds of similar cases, insurance mandates distort prices upward to reward different political agendas - and consumers pay.
Consider Wisconsin and New York. New Yorkers pay $12,000 for a basic insurance plan that would cost $3,000 in Wisconsin. The difference? Wisconsin has 34 mandates. New York has 51. By one estimate, mandates and other health regulations drive up the cost of premiums by 20 to 50 percent." (emphasis mine, p. 16 "Why Obama's Government Takeover of Health Care Will Be a Disaster" by David Gratzer)
As I write this, Wisconsin is considering (or may have already voted on) another mandate: coverage of mental health care. So, if I don't care about the cost of mental health care and want a plan that doesn't offer it (so I can save money)? Too bad. I have no choice. I am forced to pay a premium that I don't value and am not interested in using. Thank you Wisconsin legislators.
The frustrating element of these debates is a lack of introspection. There is a perverse lack of understanding as to why costs are what they are. Instead, we are focused on outcome. Changing the outcome of a misunderstood problem is like taking a bat to the golf course. Sure, you'll be able to hit the ball. I doubt, however, you will do so effectively.