The health care circular firing squad

The debate over health care is fast reaching a fever pitch of sloganeering and circular arguments. A screaming collection of cowboys driving herds of mooing cattle over the landscape have come close to derailing any real action that seemed probable just a few months ago. On the right, a phalanx of insurance companies, big pharma, and the AMA; on the left, a scrum of typically weak Democratic senators. The rational middle is, at the moment, looking for cover in the crossfire. I think it is time to step into the body armor and state a few facts.

1. Health care costs for working families are climbing faster than real income annually...this is called a "deficit".
2. Health care costs for small businesses are climbing at the same rate. Most of the pizza parlours, convenience stores, ice cream shops, and even chain retailers are unable to provide coverage to the majority of their workers.
3. As a matter of record, federal management of health care, in the form of Medicare and Medicaid is frightening. They are slow to pay, pay less than market rates, and are restrictive to those that they cover.
4. Reverse the argument; if you outlaw insurance today, prices would fall tomorrow. The implication is that medical insurance DRIVES cost increases by allowing scale to pay for the increases. This does not bode well for nations with universal public health coverage. Indeed, European nations face problems with paying for their programs that grow with time.
5. The medical marketplace is broken. Supply and demand still apply, but the producer/consumer relationship is out of alignment. Simply put, we patients are not the consumers, the insurance companies are. They buy bundles of reasonably positive patient outcomes from medical providers at the point where supply meets demand. We patients (whether individual or commercial) are simply incremental to the equation. We are analogous to the small supplier who spends capital to scale up in response to a Wal-Mart contract. They must continually charge less and less to keep the contract, and are stuck because of the capital commitment. We are stuck because we must have health care, and we must continually pay more and more.

For those of you idealists who cling to the principles of freedom and choice, good for you. But don't believe the myth that you and your doctor have choices in the care of you or your family. Small pseudo-governments (insurance companies) in which we have no voice make the decisions on what care you and yours receive, and when.

Real reform means restructuring the marketplace so that the consumers are not insurance companies. The big insurers, big pharma, and medical facilities must be in a situation where they have to compete on price and quality with each other. For those of you capitalists out there, recognize that currently the insurance providers act as monopolists, and that is NOT free market economics.

Let's hear what you have to say on this...