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Many liberals are up in arms these days over the USA PATRIOT Act and other recent assaults on our civil liberties. Hurray! Alas, many of these same liberals are chomping at the bit to implement even more intrusions upon our privacy. They want the government to know about your every throat swab, hemorrhoid exam, and AIDS test. That is, they are calling for some form of socialized medicine.
Message to liberals: please reconsider!
Seriously, do you really want people like Dick Cheney to have access to your medical records? With any form of single-payer health care they will.
You are probably envisioning single-payer health care as part of an
overall victory by your party, and it would be — temporarily. But even
if the Republicans get a drubbing this fall, at some time they will be
back in power, and then they will have access to records of every
psychiatric exam, birth-control prescription and abortion. Is that what
you want?
Worth the risk, you say? Better to lose some privacy than to continue
our current heartless and inefficient health-care system? You might be
right if those were our only two choices. They aren’t.
Alternatives exist. If we so desire, we could have a healthier nation,
with affordable, patient-driven health care. But it does require
opening our minds to many different ideas. The solutions to our dilemma
consist of many tweaks to the existing system.
U.S. health care is bad for many reasons: Drugs and doctors are
expensive, insurance and managed care are fraught with moral hazards,
poor people fail to get cheap early care and then clog the emergency
rooms, and Americans in general are unhealthy.
That’s right; our health-care system is bad in part because we are
unhealthy — not the other way around. Better diet and exercise would do
much to reduce the incidence of heart disease, depression, diabetes and
other expensive-to-treat maladies. Reduce the incidence of expensive
diseases, and the cost of insurance goes down. Cut the cost of
insurance, and more poor people could afford insurance, which would
unclog the emergency rooms.
(Read my column from last month for ideas on how to improve America’s diet.)
But even if insurance costs go down by a factor of two, health
insurance would still be expensive for many. One solution would be a
tax credit for getting health insurance. Unlike a tax deduction, a tax
credit would be valuable to the poor, the very people who most need
health insurance.
Such a tax credit could go to the individual instead of the employer,
putting an end to corporate wage serfdom. The tax credit should be a
fixed amount. If you can find adequate coverage that costs less than
the credit, you get to pocket the difference. This gives consumers an
incentive to shop, which is very important in reducing moral hazards.
But we wouldn’t be thinking so much in terms of insurance if doctors and drugs were cheaper.
Doctors are so expensive because we have a cartel in place: Doctors are
required for many tasks that could be done by health practitioners with
lesser degrees. Imagine if it required a Ph.D. in computer science to
put up a Web page.
Drugs are so expensive in the U.S. because our FDA is far more cautious
than equivalent agencies in other First World countries. We could cut
drug prices by simply approving drugs that have been approved in other
First World countries. If we wish to be cautious, we could require that
such other country approvals be in place for several years to take
advantage of their post-market monitoring.
Health care in the United States can be fixed without resort to a
single-payer plan. But health-care advocates have to want it.
Otherwise, we are stuck with the choice between big corporations and
Homeland Security having access to our medical records
Let me end by conceding one advantage to single-payer health care: Roe
v. Wade becomes moot. If the federal government has a record of every
health-care transaction, no one can argue with a straight face that
medical decisions are a matter of personal privacy. Whether abortion is
a legitimate medical procedure becomes a matter for legislatures to
decide.
What? You don’t like this feature of single-payer health care? Too bad.
The Religious Right will be aware of the line of reasoning above the
moment single-payer gets implemented. I will make sure of it.
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Carl S. Milsted Jr., former chairman of the Libertarian Party of
Buncombe County, may be contacted at cmilsted-at-holisticpolitics.org.
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