Check out this "argument":
Uninsured patients get sick faster and die younger. Two medical reports, summarized in today’s New York Times, provide comprehensive evidence that lack of health insurance is seriously harmful to a patient’s health. The reports, from Harvard Medical School and the American Cancer Society, found that uninsured people suffer significantly worse health outcomes particularly for heart disease, stroke, diabetes, and cancer. Unsurprisingly, the uninsured cancer patients had lower survival rates, especially for cancers where adequate screening tests are available, such as breast and colorectal cancers.
If ever there were a case for universal health care, this is it.
(Record scratch.) OK, ok. First of all, medical reports that show people without health insurance consume less healthcare is kind of a duh moment for the medical establishment and for our intrepid blogger. Despite the fact that poor, uneducated people tend to live less healthy lifestyles, it’s also the case that poor people go uninsured. And if you consume less healthcare, you’re less likely to be healthy. (Again, duh.) But the staggering conclusion to this for our "progressive" healthcare-grows-on-trees friends is "universal healthcare", which means either a) socialize medicine and create a single-payer system, or b) force people to get health insurance or threaten them with some penalty a la Clintoncare 2.0.
Of course, they never bother to ask the question: "why don’t people have greater access to healthcare?" which is similar to asking "why is healthcare so expensive?"
I happen to know that avowedly more caring, passionate, elitists don’t care about the means, they only care about the ends, while never stopping to consider the whys and wherefores of the distributive injustices that exist in the current system. They call this ‘pragmatism’ but it is actually rather unpragmatic to fail in asking about the pathologies of a healthcare system. (It would be rather like a doctor treating a condition without diagnosing it!) But I digress. Our healthcare system has serious problems. And the only way to cure them is to change the underlying pathology: lack of access and affordability, which arises from:
a) Too many onerous state mandates that drive up costs (coverage mandates and community rating).
b) Lack of a competitive interstate insurance environment, driving up costs.
c) Lack of a competitive intrastate insurance environment (due to regulations in a)), driving up costs.
d) The inability to pool risk effectively in the individual market, driving up costs.
e) Insurance policies that encourage overconsumption, driving up costs.
f) A tax code that priveleges employees of companies that can afford to offer insurance, but doesn’t help people buying insurance on the individual market.
g) Hospitals and doctors that benefit from a third party system that encourages not cost consciousness, but overconsumption, which drives up costs.
h) Failure of tort reform to cap damages against doctors and hospitals, driving up malpractice insurance claims and cost.
i) Creeping socialism via SCHIP expansion which removes children from the risk pool and drives up costs for those that remain, causing many to self-insure.
j) Terribly high costs for attempting to treat people at the end of life with heroic measures that invariably fail, but drive up costs anyway. (Or, similarly, keeping people in vegetative states for months and years praying for miracles that never come, while the insurance pool pays.)
k) Failing to charge people higher rates for unhealthy lifestyles to encourage healthier lifestyles.
l) Failure of information processing for patient records and other data that would help prevent cross-prescription or help doctors understand relevant patient history that would prevent complication.
m) I could go on, but…
These pathologies must be addressed, not ignored (or worse treated with the leaches and witchcraft of single payer). My top remedies?
1) Allow interstate purchase of insurance immediately.
2) Give tax credits to people to get health insurance if they’re on the individual market (level the tax code.)
3) Implement tort reform — especially caps on malpractice damages that made wealthy bloodsuckers like John Edwards rich.
4) Allow people to contract directly with physicians for pre-paid subscription maintenance care (not insurance).
5) Migrate more people onto HSAs and HDHPs so that they can save more money (tax protected) until old age, and have incentives to shop around and consume just what they need in healthcare, rather than go to the doctor for a cold or athlete’s foot.
6) Get people off of Medicaid and help them buy insurance on the market — to help stop the death spiral.
7) Deregulate insurance so that HMOs are not protected monopolies.