Since we had a pretty good response to the environmental discussion last weekend I thought I would start a new topic for this pre-Inaugural weekend. Wanting to shy away from the more controversial subjects I thought I’d go with a tame one like….. Health Care Reform.

I presume it goes without saying that we all agree that there is a problem, that our current health care system is incredibly messed up and that unless we make some major reforms in the coming years we will experience a major meltdown.

Speaking for myself I am open to any solution from pure free market to single payer nationalized, the key issue is that the proposed system will actually work rather than simply create new problems or just make us feel better for a while.

On first glance I am not hopeful that a pure free market setup will work. While we don’t really have such a system now we did in the past and things didn’t work very well in terms of providing full coverage. For profit systems do have their advantages in terms of pushing innovations and also in enabling hospitals to obtain the newest equipment.

But they have the flaw of being for profit and thus being unable to provide services to everyone. If you are trying to make a profit then you can’t really care for those who need tons of free services.

On the opposite end of the scale I am also doubtful about a full blown nationalized single payer solution to the problem. Like the free market idea the single payer program has both good and bad points. On the good side it provides coverage to everyone, so people do not fall through the cracks.

But on the bad side because they are basically in the business of rationing health care the coverage provided to everyone is not always the best. We’ve all seen stories about long waiting lists in places like Canada and Europe where people with non life threatening conditions have to wait months on end to have pretty important procedures.

Because both extremes provide both good and bad soliutions, my guess is that the ultimate solution to the problem will probably be some mix of both free market and government and that the real question will be what kind of mix.

PATRICK EDABURN, Assistant Editor
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Copyright 2009 The Moderate Voice
  • adelinesdad

    I agree with you that the solution is likely something in the middle between free market and government run healthcare. An argument for the free market solution is that it encourages people to stay healthy, just as free market car insurance encourages people to drive safely. The difference, of course, is that we are not 100% in control of whether or not we stay healthy. I could get cancer tomorrow, even if I’m trying to stay healthy. It is simply not fair to make people who are unlucky enough to fall sick pay more than those who are lucky to be healthy.

    Then again, there are those who don’t take care of their health and are more likely to get sick, so why should I subsidize their care?

    My solution? Well I don’t have a specific one, but I like the idea of regulating insurance companies to require them to evaluate people based on the choices they make, not the health condition they are in. For example, you can charge a smoker more because they have a higher potential to get sick, but you’re not allowed to know if a patient already has cancer or not (thus the insurance company has to assess the chance that the person already has or will get cancer based on their lifestyle choices). This is difficult to implement though, but I think would be close to the ideal solution.

    I’ve written more here:

  • casualobserver

    Lifestyle choice risk HAS been used on individually underwritten coverage since the late 70’s. However, you will quickly bankrupt the small pool of self-admitted smokers, heavy drinkers and drug users without making a dent in paying for national health care costs.

    The issue with spiraling health care cost has never been one of severity, but rather frequency.

    Until you can throw political correctness to the wind and put the higher premiums where it ultimately originates…..on the overweight, the sedentary and those getting older, true risk-based pricing won’t exist.

  • mikkel

    Personally I’d like to see some major non-profit insurance and medical device players. If they were designed efficiently and had enough people to be able to influence prices, then it could do a lot for expanding coverage and keeping costs down. They’d need several hundred million if not a few billion in donations to get started but then could be self supportive…and that is a tiny price to pay to try.