Real Thought

Much has been made this election cycle about some form of universal health care for United States citizens. I am staunchly against any form of universal health care. Why? There are several reasons beginning with the simple fact that the creation of a universal health care system in the United States is unconstitutional. The Constitution clearly enumerates the powers of Congress in Article I, section 8. Nowhere in that section is Congress given the power to provide health care for all Americans. Furthermore, the 10th Amendment clearly states that any powers not granted to Congress are retained by the states or the people. Therefore without a constitutional amendment, any discussion of a Federal universal health care plan should be considered moot.

For the sake of argument, let’s say that I agree that the Federal government has the power to create a universal health care system. I would still be opposed to such a system. Why? Because such a system would be antithetical to freedom. Any time that an individual or group of individuals cedes part of their freedom of choice to the government, that freedom is lost forever. If we allow the government to take control of the health care system in America, we lose the ability to make decisions about our personal health care. The decisions will be made by the entity which pays for the service rendered and, in the case of Federal universal health care, that entity will be the Federal government. Instead of the individual having the ultimate power when it comes to health care decisions, that authority would be transferred to government bureaucrats who would have the power to decide what health care services you deserve. Personally, I do not want the employees of a government bureaucracy to make those decisions for me. Can you imagine the level of health care if the people who work at your local DMV office had to approve your medical treatment? If many Americans are already dissatisfied with HMO’s imagine the poor service if we were all forced into a single, national, government run HMO.

Next, the call for universal health care is simply a method for the thoughtful and fit to subsidize the health care of the careless and unfit. Some 89% of Americans already have access to affordable, high quality health care. Any universal plan would cause those of us who remain healthy and fit and have the forethought to plan for medical care to pay for those who have neither the forethought nor the sense to avoid excessive medical costs. Now, I know that there are those who, by accident or through no fault of their own, end up needing much higher than average medical treatment. Those people should be helped, but I believe that in this day and age, that number is very small, no more than a handful a year at best. Surely some form of catastrophic health care insurance would be a better alternative for those unfortunates than a universal system?

I am also concerned about the costs of a universal system. As we have seen recently with Medicare prescription drug coverage, what was supposed to be a program which would be modest in cost rapidly became a large drain on government resources. Has there been any government program in the last sixty years which has actually lowered costs for the services provided? I cannot think of a single one. Only when an industry or service is privatized and market forces are allowed to act upon said industry or service do real costs decline. Competition is the driving force behind cost containment. Any monopoly will be, by definition, less efficient and more costly than an industry which is open to market forces and competition. Look at the computer industry, the automobile industry or the telecommunications industry. In each of those industries increased competition and government deregulation have succeeded in driving down costs and lowering real prices of the products or services which east of those industries provides as well as expanding consumer choice. Why should the health care industry be any different?

Finally, I have been a longtime consumer of “managed health care”. First as a military dependent and then as a public employee. Have I been happy with the quality of health care which I have received? For the most part, yes. But I have not had any really serious health concern. I have been blessed with reasonably good health and I have not had any serious injuries nor chronic diseases. The clinic model has worked for me so far. But the anonymous “doctor on call” model may not work for everyone and I have real concerns that in any “universal” system many needed, but expensive, services will be rationed or denied to those who may most need them in order to contain costs. I would hate to have universal heath care that denies heart surgery to a patient because it may not be “cost effective” or disallows a CAT scan to a patient with a head injury because the necessary scanner is unavailable because it was “too expensive” to purchase one. This seems inhuman and cruel to me and yet that is what is happening in Great Britain and Canada. For these reasons I remain steadfastly opposed to any universal health care plan. In a future post I will outline a plan to bring low cost health care within reach of all Americans without creating a “universal” plan or creating a new and expensive bureaucracy.