Health Care Choices...

Dr. Paul Hsieh, the wizard behind the curtains at GeekPress, has an excellent opinion piece in the Rocky Mountain News. In it, he takes a stand against Colorado's Amendment 56, a proposed law that Coloradans will vote on in November. This law would require all but the tiniest businesses to provide company-paid health insurance for all of their workers. An excerpt:

Two motivations behind this proposed law are (1) the mistaken notion that health care should be a guaranteed “right," and (2) the desire to force businesses (rather than government) to pay for this supposed obligation. But health care is a need, not a right. A right is a freedom of action in a social context, such as the freedom of speech.

It is not an automatic claim on a good or service that must be produced by someone else. There is no such thing as a “right” to a car or an appendectomy. Any attempt by the government to guarantee a false “right” to health care can only be done by violating the actual rights of someone — in this case, business owners.

Dr. Hsieh is not in the majority amongst doctors, if I believe what I read on the matter. Most doctors would like to see all patients have health insurance, and they really don't care very much how that's done – they'll support just about any proposal to provide universal health care insurance.

I'd like to see a few simple, basic reforms to our current health care system:

• The removal of the special tax status that health insurance expenses now have for businesses, coupled with making health insurance costs tax-deductible for individuals. This would remove the artificial incentive for employers to provide health insurance, which is the only reason that employers are expected to provide health insurance today. At the same time, it would create an incentive for individuals to purchase health insurance, in exactly the same way that the mortgage deduction provides an incentive for people to purchase a home.
  
  
• The removal of all the current regulatory barriers to providing and purchasing intrastate health insurance. These regulations today primarily benefit the insurance companies, by limiting the competitive environment to individual states, and discouraging low-cost nationwide entrants. Many people aren't even aware of these regulations, because it is primarily the employers who must deal with them. Today a resident of (say) New York is not allowed to purchase a less-expensive health insurance policy from a company in (say) South Dakota. There's no good reason for this from the consumer's perspective, though it's wonderful from the insurance company's perspective (and the state legislators who benefit from the insurance companies' largesse).

I believe that if just those reforms were enacted, our health care system would be transformed by the forces of competition in the marketplace. For example, consumers would suddenly become aware that if they were willing to cover the minor, routine health care costs themselves, they could purchase very low cost major medical insurance to cover the truly catastrophic illnesses or injuries. This is a choice most people simply don't have today – but I'd be willing to bet you many people would make that choice if they could. Similarly, doctors and hospitals would suddenly have an incentive to provide high quality health care at a lower cost. The incentives today that encourage doctors to order extra (but unnecessary) tests would be flipped upside down – suddenly those extra tests will make them less competitive. These are the exact same market forces that give us the modern miracles of production, like personal computers and the fantastically high quality automobiles we drive today...

I know I'm dreaming, but...I'm allowed to dream, aren't I?