Healthcare for the Needy
Sarah Dine comments on Michael Moore’s movie in the Health Affairs blog and raises interesting points about our obligation to provide for “the needy ones ‘at clusters all about.” One problem with all such discussions is that they equate providing healthcare for the needy to buying health insurance for the uninsured. So what’s the problem?
First, not all the uninsured are needy. Estimates up to 30% just choose to self-insure. Some of us think that the system would be better if everyone did that, as long as they had some umbrella for disasters. That’s what I do with my car.
Another problem is that we’re already paying for healthcare for the uninsured in the form of excess payments in our health insurance. There is a kicker in every premium for that purpose. There are also funds in most jurisdictions to compensate hospitals for healthcare they provide the uninsured.
Throwing more money into the system (by purchasing more insurance policies) would enrich the insurance companies and providers at all levels but would do nothing to reform the healthcare system. In fact, it would probably get worse. If what you’re doing isn’t working, doing more of it won’t improve the situation.
Welfare programs like Medicaid and SCHIP overlap with each other and with private insurance, so it’s hard to evaluate changes in benefits. The challenge is to provide access to healthcare for everyone without increasing what we are paying today. The only way to do this is to make our present system more efficient. For that, we need motivation, a.k.a. competition.
There are intimations in Dine’s blog (and in MM’s movie) that “government” should “provide for our sick.” But the biggest problem with Medicare today is Congress. The Medicare payment scheme is perverted by special interests. There is a reason we have so few public hospitals today--the city fathers couldn’t keep their hands out of the till and off the tiller. Government is good at collecting taxes and raising armies. We should keep them out of healthcare decisions. (They don’t do well at fighting wars, but that’s another story.)
First, not all the uninsured are needy. Estimates up to 30% just choose to self-insure. Some of us think that the system would be better if everyone did that, as long as they had some umbrella for disasters. That’s what I do with my car.
Another problem is that we’re already paying for healthcare for the uninsured in the form of excess payments in our health insurance. There is a kicker in every premium for that purpose. There are also funds in most jurisdictions to compensate hospitals for healthcare they provide the uninsured.
Throwing more money into the system (by purchasing more insurance policies) would enrich the insurance companies and providers at all levels but would do nothing to reform the healthcare system. In fact, it would probably get worse. If what you’re doing isn’t working, doing more of it won’t improve the situation.
Welfare programs like Medicaid and SCHIP overlap with each other and with private insurance, so it’s hard to evaluate changes in benefits. The challenge is to provide access to healthcare for everyone without increasing what we are paying today. The only way to do this is to make our present system more efficient. For that, we need motivation, a.k.a. competition.
There are intimations in Dine’s blog (and in MM’s movie) that “government” should “provide for our sick.” But the biggest problem with Medicare today is Congress. The Medicare payment scheme is perverted by special interests. There is a reason we have so few public hospitals today--the city fathers couldn’t keep their hands out of the till and off the tiller. Government is good at collecting taxes and raising armies. We should keep them out of healthcare decisions. (They don’t do well at fighting wars, but that’s another story.)
Comments
Very well said, and I agree. I believe their needs to be reform but not necessarily in the way that Moore suggests. One aspect that does need attention is the governments relationship with big pharma. Our senior citizens are having to fill their prescriptions from foreign pharmacies to stay within their budget and escape the rediculously inflated prices here in the United States. Something needs to be done.
Posted by: Greg | August 16, 2007 03:32 PM