By Carl S. Milsted, Jr.
Many liberals are up in arms these days over the USA PATRIOT Act and other recent assaults on our civil liberties. Hurray! Alas, many of these same liberals are chomping at the bit to implement even more intrusions upon our privacy. They want the government to know about your every throat swab, hemorrhoid exam, and AIDS test. That is, they are calling for some form of socialized medicine.
Message to liberals: please reconsider!
Seriously, do you really want people like Dick Cheney to have access to your medical records? With any form of single-payer healthcare they will.
You are probably envisioning single-payer healthcare as part of an overall victory by your party, and it would be – temporarily. But even if the Republicans get a drubbing this fall, at some time they will be back in power, and then they will have access to records of every psychiatric exam, birth control prescription and abortion. Is that what you want?
Worth the risk, you say? Better to lose some privacy than to continue our current heartless and inefficient healthcare system? You might be right if those were our only two choices. They aren’t.
Alternatives exist. If we so desire, we could have a healthier nation, with affordable, patient-driven healthcare. But it does require opening our minds to many different ideas. The solutions to our dilemma consist of many tweaks to the existing system.
U.S. healthcare is bad for many reasons: drugs and doctors are expensive, insurance and managed care are fraught with moral hazards, poor people fail to get cheap early care and then clog the emergency rooms, and Americans in general are unhealthy.
That’s right; our healthcare system is bad in part because we are unhealthy – not the other way around. Better diet and exercise would do much to reduce the incidence of heart disease, depression, diabetes and other expensive to treat maladies. Reduce the incidence of expensive diseases, and the cost of insurance goes down. Cut he cost of insurance and more poor people could afford insurance, which would unclog the emergency rooms.
(Read my column from last month for ideas on how to improve America’s diet.)
But even if insurance costs go down by a factor of two, health insurance would still be expensive for many. One solution would be a tax credit for getting health insurance. Unlike a tax deduction, a tax credit would be valuable to the poor, the very people most need health insurance.
Such a tax credit could go to the individual instead of the employer, putting an end to corporate wage serfdom. The tax credit should be a fixed amount. If you can find adequate coverage that costs less than the credit, you get to pocket the difference. This gives consumers and incentive to shop, which is very important to reducing moral hazards.
But we wouldn’t be thinking so much in terms of insurance if doctors and drugs were cheaper.
Doctors are so expensive because we have a cartel in place; doctors are required for many tasks that could be done by health practitioners with lesser degrees. Imagine if it required a Ph.D. in computer science to put up a web page.
Drugs are so expensive in the U.S. because our FDA is far more cautious than equivalent agencies in other First World countries. We could cut drug prices by simply approving drugs that have been approved in other First World countries. If we wish to be cautious, we could require that such other country approvals be in place for several years to take advantage of their post-market monitoring.
Healthcare in the United States can be fixed without resort to a single-payer plan. But healthcare advocates have to want it. Otherwise, we are stuck with the choice between big corporations and Homeland Security having access to our medical records.
Let me end by conceding one advantage to single-payer healthcare: Roe v. Wade becomes moot. If the federal government has a record of every healthcare transaction, no one can argue with a straight face that medical decisions are a matter of personal privacy. Whether abortion is a legitimate medical procedure becomes a matter for legislatures to decide.
What? You don’t like this feature of single-payer healthcare? Too bad. The Religious Right will be aware of the line of reasoning above the moment single-payer gets implemented. I will make sure of it.
Carl Milsted is a senior editor for The Free Liberal.