The argument from federalism: One of the
great benefits of federalism is that the states can act as the
laboratories of democracy. If a new public policy is tried
in the states and works (as happened with welfare reform in
Michigan and Wisconsin), then a similar program has a good chance
of succeeding at the national level. The welfare reform
went national and proved to be one of the most successful public
policy initiatives of the last half century. On the other
hand, major governmental healthcare initiatives have been tried
in Tennessee and Massachusetts. Neither of those have
panned out. That should be a cautionary sign to avoid
rushing ahead to just get a bill done!
The argument from misery: I cannot think
of any encounter with my government that I willingly seek out.
I hate going to the DMV. I hate going to the post
office. I hate getting my car inspected. I hate
getting a passport renewed. All of these things eat up
productive time in my day and are filled with useless,
inefficient waiting. This basic situation also applies to
people who rely on the government for their healthcare.
When my wife did indigent care in Houston, her clients did
not pay for her services. They paid with their time.
LOTS OF WAITING. I don’t need more waiting in my
life. And because government employees are typically
unionized, I don’t need to be at the mercy of a bunch of
unionized employees any more than I already am.
The argument from incentivization: If the
government provides the care too cheaply, then there will be a
glut of clients who overwhelm the system and create the nightmare
of waiting as the price to pay. If the government offers
the care too expensively, people will opt out which is exactly
what they wanted to avoid. If the government tries to
control utilization by deciding what services you can and can’t
have, then you are up against a far worse foe than the worst HMO
you ever faced. And the government will go where the
insurance companies fear to tread. They will decide who
should live or die.
The argument from missing the verdammten point:
It is exceedingly clear that a huge reason for the
skyrocketing costs of medicine is the problem of predatory
litigation driven by lawyers looking for 30-40% of a bloody
fortune from an industry thought to be able to afford it.
Between the cost of malpractice insurance, the payouts, and
the defensive medicine that must be practiced to ward off
lawsuits, it is easy to see why healthcare is outrageously
expensive. Yet, the president very clearly said he would
not seek to deal with that problem in the legislation.
WHAT? WHY? Because the trial lawyers are very
good political donors? Not a compelling reason for the
formation of a particular public policy.
The argument from economic theory: Look at two
sectors of the healthcare market that are typically paid out of
pocket without the influence of insurance providers or the
government. I am thinking of plastic surgery and lasik
procedures for improving eyesight. Both of those services
are becoming less expensive in real dollars rather than
skyrocketing out of control. This happens to be the portion
of the healthcare industry where actual market conditions apply.
Customers pay for and receive value at a price that is
becoming more reasonable all the time.
