The Real Stakes in the Health Care Debate

07/27/2009 12:01 am EST

Focus: MARKETS

Terry Savage

Author, The Savage Truth on Money

It comes down to this: Do you believe the government can do anything better than private, free-market, competitive enterprises?

Do you believe the government can educate our children better than competitive schools? Do you believe the government can make cars (General Motors will let us find out) better than a private company, competing against other private companies?

And, most of all these days, do you want to bet your life that the government can not only provide, but decide on the best course of health care for you when you feel that lump or start to ache?

In the end, it all comes down to whether Americans are willing to turn over one-sixth of the economy—and one of their most personal freedoms—to a government committee. Ultimately that’s the choice. Do you really believe America will get better health care—that you will get better health care—if a government committee is the “decider?”

Because that’s what you’ll be getting, with some of the plans now being discussed in Congress. Oh, sure, they announce that a government plan will exist “side by side” with private health care.  But then they’ll mandate lower prices for government-run programs, so you’ll sign up.

That will quickly drive everyone into the government-run system under the guise of “lower costs.” Once they get critical mass, they’ll be able to set the prices and reimbursement rates to make health care “more affordable.

But with the government dictating prices, what incentive will there be for the development of new medical technology or treatments?  Where will the incentive be—OK, let’s call it by its real name, the profit motive—for private companies to develop the cure for cancer?

If we had this system 35 years ago, we might never have had Lipitor, Zocor, or—heaven forbid—Viagra! (What, you think they sold Viagra just to make men happy?)

Without incentives, the system will break down. Ask any Canadian: They know not to go to the hospital emergency room on the weekend. The doctors are all at the golf course—they don’t have an incentive to work weekends. You get what you pay for, including the people, the technology, and the drugs. And you wait in line. Until recently, even if you had the money, it was illegal to seek better, private health care in Canada. Canadians abound at US facilities just across the border.

Already we have American physicians who refuse to take on any more Medicare patients because the reimbursement rates from the government are too low. The best doctors now have started charging “concierge fees”—to assure your right to access to first class care.

Concierge care is just a medical version of private schools, which exist as an alternative to your public school, run by the government. You want a better education for your kid—so you pay for private school. But remember, even if your kid goes to private school, you’re still paying taxes for the public school in your neighborhood. 

Now you see the future of government-run health care. Down the road, if you want a doctor who doesn’t take Medicare patients because of low reimbursement rates, maybe he or she will let you pay privately—or maybe not.

Oh, well, those who can still afford first-class care (after being taxed to pay for US health care) can go to China for hip replacements or cancer surgery if the wait is too long in America. Or you can wait in line—and wait on the government’s decision as to whether you will even qualify for that surgery at your age.

There must be a better alternative than either the current system that costs so much more than other countries’ and leaves millions of people without health care insurance or the other extreme of a government-run system. What say you? Please post a comment and join the conversation.

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