The Medical Care Crisis

Yesterday marked the premiere of Michael Moore's new film "Sicko," which presented his look at the crisis in health care in America. I haven't seen the film, nor do I intend to, but I appreciate the continued attention it is bringing to one of the most important issues in America today.

Few would deny there's a terrible crisis in health care. As a society, we spend more on health care than almost any other country, but the level and quality of care we receive in exchange is uneven at best, and very poor at worst. From the politically conservative viewpoint, there's not necessarily anything wrong with this: the marketplace governs the cost of health care like it governs the cost of everything else, and the law of supply and demand dictates that better care will be available to those willing and able to pay more. Liberals, on the other hand, decry a system that reduces an individual's health to a question of dollars and cents, profit and loss.

Who's right?

I wrote about this issue last year, following a lengthy discussion with my sister-in-law Brenda, who is a Physician's Assistant and who offered the medical professional's side of the debate (which doesn't often come through in the overall noise level). It's time to revisit the health care issue...as with immigration reform, I have my own thoughts on what's right and wrong with health care.

The preamble to the United States Constitution (battered and ignored by the current administration though it is) states that the government is formed to "establish justice, ensure domestic tranquillity, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity." The word "welfare" has some unfortunate connotations, but it's important in the sense the founders used it: the government has a responsibility (and, indeed, an enlightened self-interest) to look out for the general welfare of its citizens. With that in mind, I offer a few initial thoughts on health care reform.

The cost of health care is out of sight. The reasons are many, but here are three thoughts on reducing them:

- Reduce the cost of a medical education. The average doctor graduates from medical school as much as a quarter of a million dollars in debt. He or she needs to repay all those loans, and so - quite naturally - passes the costs on to the patient. The cost of medical school for qualified students should be centrally funded by the government. Yes, you'll argue, someone still has to pay the cost of that education, but I maintain that the money is there and much of it can easily be made available by controlling useless and stupid pork-barrel projects.

- Get rid of insurance companies and their pass-through costs and profit orientation by centrally funding health care through a national tax. This would allow doctors to concentrate more on caring for patients and less on the burden of complying with the administrative requirements of many different insurance plans.

- If the previous suggestion is too much to take, make all medical expenses (for doctor's visits, hospital care, ambulance service, and prescription drugs) tax deductable. Yes, I know I've complained often in this blog about the bastardization of our tax system, but I think this is a legitimate move - after all, a sick or dead taxpayer doesn't pay much in taxes.

Okay, that's my initial foray into the debate. I think all these suggestions are workable and affordable, and are a perfectly legitimate role for the government to take on.

What do you think? If you've got a better plan, let's hear it.

Have a good day. Stay healthy. More thoughts tomorrow.

Bilbo