Fred LaSor: More thoughts on healthcare
April 8, 2017
For Nevada Appeal readers who missed the April 2 column in this paper about healthcare, it's one you should find and study carefully. Dr. Edward Gray has years of experience as a physician and surgeon, working in all kinds of healthcare situations, including the single-payer systems leading Democrats like Bernie Sanders, Elizabeth Warren, and Hillary Clinton support as the solution to the "shortage" of healthcare we face in America.
The single-payer systems Gray has worked in include the Veterans Administration, which has been pretty soundly criticized all around the USA, and the National Health Service in Great Britain. Both systems come under fire for inadequate care, long wait times, and poor service. My own observation when comparing single-payer with what we now have is if it were so good, lawmakers wouldn't exempt themselves from it.
This column will not repeat what the good doctor wrote last week. But I do want to highlight a few points that make a lot of sense to me.
First is Obamacare isn't working. Supporters claim millions of new people have insurance, but ignore the fact many new enrollees lost insurance they liked when Obamacare made it unavailable, and have subsequently been enrolled in Medicaid. Now we learn many clinics and physicians are opting out of Medicaid because the program has low repayment schedules that make it a net loss to accept those patients.
So you have new enrollees, but fewer providers every month who will accept their coverage. For statistical purposes, politicians say coverage has increased. People who like Obamacare point proudly to this as an improvement in healthcare. What is unsaid is those patients are finding it difficult to find a doctor or get an appointment, because doctors and clinics turn them away to avoid bankruptcy. On paper, things are better. In fact, they aren't. We should deal in facts.
Another point Gray makes is American ingenuity and enterprise would solve a lot of the problems with American healthcare if the government would get out of the way. This is a philosophy I have held for many years. Compare different industries to understand what we now have in medical care.
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In 1958, according to a recent Forbes article, a person would have worked 15 days to pay for their normal annual healthcare cost. In 2012, total healthcare costs for an American would have required 58 days' employment, a significant increase even accepting improved healthcare. The Forbes article continues: "In general, private markets tend to produce steadily lower prices in real terms and steadily rising quality," and concludes, "If we were willing to rely more on markets in medicine, we might be able to harness the superior ability of Americans to find good value for the money to produce results more similar to other goods."
The author of the Forbes study invites us to "do the following mental experiment: If I promised to pay 89 percent of the cost of your groceries, would what you buy be different?"
The Foundation for Economic Education pointed out recently from 1996 to 2016, the price of healthcare climbed 105 percent, while software is down 66 percent, and the cost of a large-screen TV is down 96 percent. That tells you the difference between a highly regulated industry (healthcare) and one that's not so regulated (electronics).
If we truly want affordable healthcare, we have to rely more on market mechanisms, as Gray writes, and less on lawmakers, who understand neither healthcare nor economics. Go read Gray's column.
Fred LaSor retired from the American Foreign Service in 1997 and lives in the Carson Valley.