Health Savings Accounts?
If the biggest employers in the world can’t lower the costs of healthcare for their own employees, or offer it at all, then why would my ability as a lowly consumer be better at it than them? These companies are pioneers in developing strategies to lower costs to the consumer and even they can’t do it. When it comes to lowering health care costs for Americans, I’d want the biggest, baddest meanest of them all, the guys with the license to seek and destroy any healthcare warlords out there who run corrupt, inefficient regimes, who take their nation’s wealth in return for dysfunctional scraps of providers, procedures, and pills. I’d want the Marines of healthcare delivery and planning. Not the rent-a-cops.
Since we don’t have healthcare marines we turn to our employers, you know, the guys who keep us busy and give us money. They do what they can to get us health insurance, depending on how long we’ve been there, or how important we are to them. The whole point in insurance is to buy something that diffuses our risks among other people. The young subsidize the old, the healthy support the sick, and men pay for women. Face it, women’s reproductive systems just have more going on. And one way or another, the rich pay for the poor. We all have a threshold for being aware of the hardship of others. No one wants bodies in the streets, or images of kids covered in sores with flies buzzing around, like the commercials on TV. Not here. And no one, except for young, healthy males with a little cash could afford to fend for themselves when it comes to their health, and no group will be able to pull for lower costs, least of all old, sick poor moms. Only animals leave their parents to die when the old guy’s teeth fall out and he can no longer eat.
So we want someone with a lot of authority to negotiate on our behalf for more and better care for more people for less money. You’re waiting for the old progressive punchline of the government coming to save the day. Well, yes, but in a clever way that allows people to make money and compete while ensuring that everyone has what they need. Since it involves our mortality, we’d prefer to have the market playing Capture the Flag, and not Battle of Stalingrad. Most universal healthcare systems look this way—most are private, but made safe for the consumer by putting down fair rules like coordinating insurers with providers, occasionally negotiating rates for pills and procedures on behalf of companies, and setting premiums that send some money to people who need it more. They mandate that everybody be covered, they figure out how to do it, organize the key players and they make sure it keeps happening. This is a role for government. Big business has no stake in our equity, or lowering costs for consumers when it’s something we absolutely need to live. Something we need from cradle to grave.
Government has no business serving us beer and chips while we’re watching the Super Bowl. We don’t want it there, and we don’t want them around when we choose a doctor either. Understood. But, to borrow from Econ 101, the demand schedule for health and happiness is about as elastic as they come. We need someone to come along and make sure we have it. When it comes to it, we demand healthcare much more than beer and chips, and healthcare is much more expensive. This is the government coordinating a market that would otherwise have no long term scope. It would be fragmentary, dangerous, and taken advantage of only by young men in good health and some power. Would you give an old lady a machine gun and a can of tuna in Mogadishu and tell her “good luck”?
There is little ideology at stake here save indifference and contempt for people who are worse off.
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