I think the argument goes this way. The Country can not afford the Obama health care plan and besides it is not the role of government to be in the health care business. Some are quick to add that they want the Government to keep its hands off Medicare. I wonder if these people (who make up a sizeable part of the voting population) have really thought this subject through?
For a moment let’s follow this logic. Let’s eliminate any government role in health care. That means that if your employer provides health care or supplements your expense, the employer must do it without any tax break. Instead his health care costs turn into wages or salary augmentation and become fully taxable to you. How many employers do you think would continue providing health care benefits?
Next, the average person would find that the full cost of buying medical care or buying insurance to provide health care coverage that he or she was paying over $ 500 per month for each person he or she were insuring (a family of four would spend $ 2000 per month). This average amount reflect currently the per capita cost for US health care and are 60-100% more than any other modern country in the world.
In a free market environment, each of us could shop around and buy insurance coverage that better fit our needs. One might buy insurance with co-pays or large deductibles. If one was young and healthy maybe one could find a policy that assumed you would be healthy and charged you less. But there is no free lunch and since nothing was being done to contain and preferrably lowering health care costs, someone else would be paying a lot more for their coverage than the average.
Common sense should bring you to the conclusion that no government involvement must result in a lot more uninsured. And since government was out of health care, the stampede of the uninsured to the ER would be met with barred and protected doors. No entrance signs would greet the unfortunate.
Socially our society would split into the haves and have nots (even more than today). With less money, the current medical delivery system would necessarily need to contract. Doctors would have to make less and hospitals would need to rationalize their services, like any other business. This is an ugly future if left to market forces.
My guess, however, that out of these ashes would rise a new and competitive system. There are enough doctors and hospitial administrators who believe their mission is to heal and protect their patients health. These renegades would form cooperative arrangements with rates that were far more affordable. They would teach and demand preventive health care and they would abandon “fee for service”. These coops would be scattered and it would be difficult for anyone to travel with assurance that medical care would be available in a location they were unfamiliar with. Oh, if there was only some national regulations.
For the rich, there is no issue and never will be. It is the middle class that has to wake up and think about health care. The current system offers no one incentives to drive costs down. Fee for service and relatively speaking cheap health care (though Medicaid or employer support) motivate doctors and hospitals to make as much money as they can, and citizens to avoid any meaningful involvement in their own health care.
So the question is should we go all the way, or is there another way to make sense of health care?