Health Care Basics Must Be Recognized By GOP — With the Republican health care reform in a mess, we’d like to suggest getting back to the basics with regard to principles and purpose.
Health insurance is not health care. “Insurance” does not insure your health, something that should be blindingly obvious. What it does is to insure that the doctors and other medical professionals get paid.
The purpose of public health is to minimize the need for care yet provide it when needed for those who cannot pay what medical professionals ask as going rates.
Minimizing the need includes things like sanitary sewer systems, draining swamps and discouraging pointless risky behavior such as that which spreads HIV. One of the first steps in getting back to basics is to stop being afraid to point this out.
When care is needed, an insurance policy is not the only means to do so. Bill Gates and Warren Buffet would be silly to have an insurance policy. They can easily cover anything that might happen to them out of pocket.
For those who aren’t billionaires, places like Philadelphia General Hospital existed in the last century to provide free care to the desperate. Of course there was no incentive to maintain them and a huge incentive to use them as dumping grounds so their demise was practically ordained.
Free markets cannot be mocked.
Step two concerning back to the basics is to recognize that health care is provided by people not governments, corporations or bureaucracies. Maximizing health care means maximizing the number of competent people who can provide it and giving them an incentive to do so to all comers.
Money is obviously going to be a factor even for the most saintly, but except for the most vile — and they are rare — it is not going to be the only factor. Social rewards are almost as important. Most successful people will discount services to those who can’t afford what they normally charge. Most will even do charity work — unless, of course, regulation and time available prevent them. You doubt this happens ponder that retired doctors can’t work part-time without still carrying malpractice insurance.
An OB/GYN pays about $20,000 per year for it. Insurance companies will discount about 50 percent for part-timers. A $10,000 per year nut to cover would certainly put a damper on a doctor wanting to occasionally help out at a charity hospital for $50 per hour.
And no amount of money is going to keep someone from bailing out when the job stops being fun and they no longer need it. One of the biggest complaints doctors have is mandated paper work either by government or an insurance carrier.
And this gets us to insurance companies. An insurance company is a business that seeks to spread risk while making a profit. The top executives at these places easily surpass six figures. Do they earn it? Probably not but that’s not their fault. With government mandates for features not necessarily wanted by all customers (substance abuse counseling, birth control) and restrictions on competition, they can do a lot of coasting. Call it the joys of cronyism.
Insurance companies have a use and they are not inherently bad. The Trump plan to open competition across state lines is excellent. We don’t have an objection either to a mandate for individuals to carry it. Public health has a cost and its better for people to be allowed to choose their coverage rather than leave the decision to government agents who will inevitably pocket as much of it as they can if funded via a traditional tax.
Regardless, it must be remembered that it is people who provide health care and not bureaucracies. Forgetting this while ignoring that bureaucracies inevitably become corrupt are the biggest failings of doomed Obamacare.