I don't see how the government wouldn't be able to regulate the costs of health care, even if it was the only buyer in a universal health care system.
Remember, that I'm addressing an argument that says "We're not implementing universal health care
, just a single payer system so that everyone has coverage". So the actual health care providers (hospitals, doctors, clinics, etc) remain exactly as they are (and many are for-profit), but now the government will step in and pay for anyone's health bill. This creates a system where the government is paying the bill, but a private provider is setting the price. Of course the price will go up.
As I said, the only way the government can prevent costs from going up dramatically is to take pretty direct control of the whole industry (ie: socialized medicine). But that's exactly the type of system which most people in the US do not want. So it's valid to point out that the only way for the direction the Dems are taking us with regard to health care to work is the very system people don't want and which the Dems (publicly at least) insist they aren't forcing on us.
If we implemented something like that, part of the law could be that health institutions are only allowed to charge x for y procedure, or something along those lines.
Which is socialized medicine. The seller of a good should be allowed to sell it for whatever the market will bear. Having the government step in and say "You can only charge X for that because our bureaucrats determined that was the fair price" is a gross violation of the basic principles of liberty we're supposed to enjoy. Of course, the problem is the slippery slope aspect to this. You start by the government mandating what care must be provided. This causes costs to rise, so the government steps in to "help out" by covering the costs. But this creates a "free money" condition in the free market parts of the system, causing prices to rise even more. The government then responds by putting price controls on the health care, which will effectively drive any remaining free market parts out of the system because the government can set the prices so low that only government run hospitals and clinics (funded with taxpayer dollars) can afford to run at a loss.
One step inevitably leads to the next. So it's very fair to point at the public dislike of socialized systems and ask if there's a better way. And that better way is *less* government regulation, not more.
There's a reason that every other industrialized nation in the world pays less per person for health care than we do. Part of that is because they all have universal healthcare of some sort. Hell, maybe that's even the only reason.
Cost comparisons to right now, which is not really a free market system. As I pointed out earlier, our current system is already being heavily regulated and mandated. Either direction will reduce costs, but one involves more direct government control, and the other less. I think that most people in the US would rather have less.
I do think your point makes sense in regards to the national mandate for having health insurance though. I really don't like the idea myself, but I do think it's better than having over 4% of the population uninsured.
I think that's a bit of monetary sleight of hand though. Think about it. Right now, if you are uninsured but need care, you can go to a hospital and get it. If you are unable to pay for the cost, the state will pick up the tab. So right now, we have a system where the taxpayer will pay for the care for those who can't pay for it themselves. That's the 4% number you talk about. But the mandate will now require that everyone have health insurance. But there's no magic that makes more people able to pay for it, right? So the same number of people will still be uninsured, we're just changing what we call it when the government pays for their care.
The biggest side effect of this though is that now the government picks up the tab for anyone who can't afford insurance, not just for those who can't afford the health care. There are many people who are today struggling to maintain their health insurance, but who will fall under the income level to qualify for the "free" insurance from the government. Those people will automatically stop paying for insurance and let the government do it. So while technically the number of insured hasn't changed, the number who are being paid for with tax dollars instead of their own income has increased. Additionally, the bill just sets a $1500/year fine for not buying health insurance. Well, that's less than the cost for most insurance right now, so most people will just drop their insurance and pay the fine instead.
The net effect is that people who would have had to pay for their own health care (either because they had insurance, or had sufficient money to pay out of pocket if/when they purchased care), will now be paid for by tax dollars. In fact, most people will. So if we change the question from "what percentage have their own health insurance" to "what percentage are having their health care paid for by the taxpayer", that number will increase dramatically.
The main problem with our health care system is how corrupt the health insurance companies are. They charge ridiculous rates, even for limited coverage, and then turn around and deny people the care they need, just to increase their profits. Sometimes people DIE because of this. Other times, they go bankrupt. It's incredibly messed up.
Do you think that this problem is made better or worse when the government mandates that everyone must purchase health insurance? Can't you see that the best solution to providers of a good or service doing a bad job is to maximize the ability of the consumers to choose someone else? Right now our regulations make switching insurance companies very difficult if not impossible. Consumers are "stuck" with what they have. And when that's the case, the seller can take advantage of it.
Make it a real free market and insurance companies will fall over themselves to provide what the consumers want. And those who fail to do so will go out of business. That's how the free market works. When was the last time you paid $1500 for a TV from a store and then had the store refuse to give you the TV you just paid for? Doesn't happen, does it? Want to know why? Because if they did, no one would buy anything from them. How long would Amazon last if they just shipped the covers of the books you purchased to you and not the full book you paid for? Not very long, right?
That's how the free market works. And it's incredibly good at ensuring that consumers get the best product possible for the lowest price. It's only when you are at the extreme ends that this fails. Either an unchecked monopoly or too much government involvement can cause those market forces to fail. What you're seeing in the health care system in the US is absolutely because of too much government. It's just that it's happened so slowly and over a period of time likely longer than your lifetime that you didn't really notice it. To you, that's just the way it's always been.
But it hasn't always been that way. We used to have a system where pretty much anyone could afford basic medical care, and insurance for more expensive care was far far more affordable. We should move back in that direction IMO.
The issue I have with your last paragraph is that we don't currently have a system that promotes low costs and high quality.
Correct. Which is why we need to move back to a system which has less government involvement so that those free market mechanisms will work as they should.
For example, I've been seeing a psychiatrist at the local health clinic off and on since the end of December for my ADHD. That was when he diagnosed me, and it took nearly two months for us to find a medication and dosage that worked for me. The health insurance my mom pays for (because I can't afford it myself and she doesn't want me without health insurance) does not cover mental health issues at all, and because that's what the appointments were coded as, I have to pay full price for every one of those visits. Right now I owe the clinic close to $1500 total for all the visits.
Yup. And that high price is driven by the fact that most people are going to be paying with their insurance. If everyone had to pay for that out of their pockets, do you think they'd charge $1500? It might be expensive, but not so amazingly so. This is a tricky case because it's on the edge of what might be covered via insurance anyway. There are a number of much more clear cut cases where direct care should be relatively inexpensive, but is very pricey. It should *never* cost $100 or more just for 10 minutes of a doctors time. Yet that's pretty much the going rate now.
Anyways, my point is that health care in this country is ridiculously overpriced. I think if we had a universal health care system, we would all be better off.
I disagree. I think that the direct costs would be less obvious so you'd think you're getting a better deal. Universal health care hides the cost from the consumer, and in my opinion that's never a good idea.
The government could regulate costs to keep them down, so overall it would cost less for everybody. I would be perfectly fine with doing something like what the UK does, and allow people to purchase their own private insurance or whatever, if that's what they wanted to do.
That's not really a free choice though. A free choice involves the buyer choosing where to spend his money. If the government takes the money from you (in the form of taxes, or fees, or mandates) to pay for item X, no amount of saying "you're free to buy item Y instead" actually makes that a real choice. Edited, Apr 3rd 2012 6:10pm by gbaji