Should The U.S. Have Government Controlled Medical Care?

We're always being told that America should get with it. Let the government be in charge like in all the other advanced countries. But I don't know about that. First of all America isn't like other countries. It's a lot bigger, a lot more diversified and has a culture with a strong element of personal independence and skepticism about government functioning. Besides that, if you really look into it there is no such thing as generic "single payer". The systems in all these other countries differ greatly from one another and most have a considerable amount of private pay. The majority are having financial problems of their own and many are encouraging more private involvement to relieve the pressure.

Moreover, the fact is that the American health care system has a great deal of government involvement and control. Between Medicare, Medicaid and various other government run programs such as the VA, the military, and the whole host of State sponsored programs, and also funding of insurance for government employees, as well as the tax exclusions for employer insurance, somewhere in the range of 65% of our health care is government financed as compared to about 71% in Canada. http://tinyurl.com/y7cw3kxl

Some complain that the problem with the American system is it's fragmentation. I would say that that's a blessing in disguise. Our poster child single payer system, Medicare, must compete with our private insurance system in the benefits it offers so that Medicare finds it difficult to economize by rationing services to cut costs as is done in other countries and so it continues to rush headlong into bankruptcy. It's the same situation with Medicaid and the VA which both get poor grades when held up to comparison to the private system.

Not that the American system is so good; it isn't. Technologically speaking American medicine is the best in the world despite the idiotic ranking of the World Health Organization statistics that put us just below Costa Rica and just above Slovenia. But regarding economics and efficiency we're nowhere near where we should be. And I'm not just talking about Obamacare. I'll give the Democrats credit for good intentions but their attempt to fix a flawed system has made things worse. Somehow these bright people don't seem to understand basic economic principles, natural human behavior or the inner workings of medical interactions. The reason I think is that they're in love with central government control, and just like many lovers, are blind to their loved one's many flaws.

So what should a real American health care system look like. One that emphasizes personal choice and individualization. One that incentivizes efficiency and low cost and innovation of services. One that encourages involvement in one's own health behaviors. And, yes, one that is generous in helping those who have disabilities, or who suffer medical misfortune, or even those who bring their medical troubles on themselves. The basics of such a system are well understood by many of the thought leaders in medical economics. The politics of getting there are difficult considering that all of us have individually adjusted our lives and efforts to the present system so that any policy changes for the better will have to be gradual and carefully done. In the interests of time and space that discussion will be left to a companion post.