Before we talk about this health plan and that, we need to answer the first two questions.
- Is healthcare a right?
- If so, who pays?
By “right” we mean something that is owed to people, an entitlement that does not need to be earned in any way, and is in place regardless of effort. If we agree that healthcare is a right, then we must decide who pays for that right.
Desired results check (after all, results part of the address of the blog site). The goal should be to come up with a way to allow access to affordable, quality healthcare for those who desire it. The question should not be whether we should have single payer or pure free-market or somewhere in between. (Note the title question is not, “Should everyone have access to healthcare?” The answer to that question is a loud and hearty “Yes. Absolutely!”) To be clear, we are not talking about whether everyone deserves to have healthcare if they choose; we are asking if it is a right, or is it an earned benefit, subsidized when it cannot be earned.
OK, let’s tackle the first question. Is healthcare a right, or is it something that we earn, subsidizing those who can’t pay for it themselves?
I do not see healthcare as any more of a right than, say, adequate food or decent clothing and shelter. All of these should be earned, and subsidized when necessary. As with healthcare, access to these services and products is the key–not making them rights. For those who feel that healthcare is a right, remember that in most cases people can live longer without healthcare than without food. And lack of housing and clothing can easily lead to health problems, as well as a poor quality lifestyle and an unsuccessful life overall. The “healthcare is a right” argument can quickly lead to the conclusion that food, clothing and shelter are also rights.
The second question, regardless of the answer to the first, is who pays? The “who pays” part is bigger if we decide as a society that healthcare is a right rather than a benefit that needs to be earned, subsidized when the recipient cannot produce the necessary funds. That should be clear: Not only is no one paying personally or corporately, but if something is free, a lot more of it will be requested. And things would quickly go tilt if food, clothing, and shelter were added as rights.
Under the Affordable Care Act (ACA), “Obamacare,” the healthy who can afford to pay subsidize the less healthy who cannot afford to pay their insurance premiums. This observation explains why certain people love it and others hate it. If you were one of the 85% who were covered before the ACA and you do not qualify for a subsidy under the ACA, then your monthly premiums have been skyrocketing while your coverage has been plummeting, and you hate it. If you were part of the uncovered 15%, or were covered before and now qualify for a subsidy, you love it. In significant part, the ACA is an income transfer program, transferring money from the healthy who do not qualify for subsidies to the less healthy who do qualify. The taxpayers are required to kick in with dramatically expanded Medicaid.
If society’s conclusion is that healthcare is a right, then the taxpayers must pay for all of it. Not the government; government has no money unless it taxes people and businesses. Taxpayers must pay.
What’s the solution? Go back ten years or so to where we had 85% coverage with then comparatively reasonably-priced healthcare. Now, make that even better by reducing medical costs with tort reform (not having to pay for excessive settlements and attendant legal fees), and competition across state lines. Imagine, if you will, what would happen to prices at the pump if gas companies were not allowed to compete across state lines? Would anyone stand for that? And why did we with healthcare? The biggest reduction in cost should come from–wait for it–stimulating increases in the supply of medical facilities and providers. We all get it that increasing the supply of anything holds down costs. (Econ 101) Like with gas these days. Adjusted for inflation, the national average for gas was $2.30 a gallon in 1979. Still is. But medical costs during that same period have gone over the moon. Gas prices are low because the US has become more than energy independent (once little more than a dream); it is now the largest producer of gas and petroleum hydrocarbons in the world. We can apply the same principles to healthcare and achieve the same results. And no fracking. This solution will keep the price of medical services down for those who pay for themselves, and for the taxpayers who pay for those who need to be subsidized. And everyone who wishes will have affordable access to healthcare.
What are your thoughts? Comments, questions–emotional outbursts?
Will Luden, writing from my home office at 7,200’ in Colorado Springs.