Is A Comprehensive Universal U.S. Health Care System Possible?
Resolving the complexities of the American medical scene in one
comprehensive program has been an invitation to debacle for more than a
Editorial, “The Emerging Disaster of ObamaCare,” Washington Times, April 8, 2016
comprehensive, universal, government –run health system possible?
Is it possible for government alone to insure, record, oversee, standardize, dictate, and
pay for the care of 330 million Americans engaged in over 2 billion annual
health care engagements and transactions?
And, if the comprehensive strategy fails, is it possible for a centrally planned plan to be replaced by a comprehensive market-based
system relying on competition and free-choice?
Neither System Alone Is Possible
Neither system is possible. We need both. Even socialized countries are turning to markets
for relief from rationing and demands of
citizens for access to the latest in
life-saving technologies. And even the
most market based care must provide government
programs for the poor.
In the US, Medicare, Medicaid, ObamaCare, and the VA
cover 150 million, employers insure 160 million, and 20 million linger in the
Despite all the talk
income inequities, there are
never enough “rich” to cover everybody.
The possibility of a comprehensive system, either
exclusively government-driven or
privately-run is impossible. There are
simply too many complexities, variables and choices.
“In two words,” observed Samuel Goldswin of another venue, “ Im-
Yet the yearning for the impossible as articulated by
Senator Edward Kennedy at the 1980 Democratic
convention lives on, “The work goes on, the cause endures,
the hope still lives, and the dream lives on.” Senator Bernard Sanders has picked up the
progressive mantle by calling for Medicare-for-All at the cost of $15 trillion
over the next decade. Dreaming the
impossible dream to reach the unreachable star never dies.
government and the private-sector have their limitations when it comes to
providing comprehensive care –
government because it breeds an
incomprehensible bureaucracy that cannot deliver on its promises without
rationing, private markets because they
cannot provide unprofitable “free”
care, leaving sick patients out of luck
and out in the cold.
Here is Peter F.
Drucker (1909-2006), commenting on the role of government in his book The Age of Discontinuity,
“We no longer trust government to perform. We
have become a global shopping center and an information and knowledge economy
driven by the computer. Government is too big, cumbersome, and inefficient to
provide for or protect its citizens.”
“Once the ‘wicked private interests’ have been eliminated, the right course of
action will emerge, and decisions will be rational and automatic. Private
business and profits are bad – ergo, government ownership must be good.”
“The British in adopting
the ‘free health service’ believe that medical care would cost nothing. All the
health service is and can be is, of course, ‘prepaid’ health care. Nurses,
doctors, hospitals, drugs and soon have to be paid by somebody. But everybody
expected this “somebody” to be somebody else. At the very least, everyone
expected that under a free’ health service the taxes of the rich would pay for
the health care of the poor. There are, of course, never enough rich people to
carry the burden of any general service.”
greatest factor in the disenchantment with government is that government has
not performed. Government has proved itself capable of doing only two things
with great effectiveness. It can wage war. And it can inflate the currency.”
best we get from government in the welfare states is competent mediocrity. What
is impressive is the administrative incompetence. Every country reports the
same confusion, the same lack of performance, the same proliferation of
agencies, of programs, of forms, and the same triumph of accounting rules over
things are difficult for government. Being by nature a protective institution,
it is not good at innovation. It can never really abandon anything. The moment
government undertakes anything, it is entrenched and permanent. Every
beneficiary of a government program immediately becomes a” constituent.”
“Government is a poor manager. It is, of necessity, concerned with procedure,
for it is also, of necessity, large and cumbersome. It must administer public
funds and must account for every penny. It has no choice but to become ‘bureaucratic.”Every
government is, by definition, a ‘government of forms.’ This means high costs.
For ‘control’ of the last 10 percent of
phenomena always costs more than control of the first 90 percent.”
Only history will tell if government is up to the job. History is not
Post a Comment