A View From The Press Box

Regardless of what side of the political fence you're on, universal healthcare, a more "kindly" word perhaps and more palatable to most than "mandated" healthcare, is sorely needed and should be on the forefront of all the politician's platforms.

Let's face it, healh care is getting out of reach for tens of millions of Americans every day. The percentage of income that goes to healthcare keeps increasing, and those working or retired who can't afford it do without, and keep getting sicker until there is a true health emergency, and the cost to treat or cure the ill is many times what it would have been to stem the illness in the beginning.

It doesn't take a brain surgeon or a neurophysicist to explain the economics of that.

On the other hand, we have those who feed off the system and have all the free medical care they want or need and haven't contributed or paid anything for it.

That give-away mentality needs to change, and maybe a universal healthcare system will help even out the playing field so that all can receive some semblance of quality care within reach of their economic means.

And, to take it a step further, maybe make those who are freeloading on the system start paying something for the services they take for granted. That would sure help the taxpayers and also make some politicians look good in the public eye.

I remember a time when we were looking into the reasons for the high cost of health care. Didn't it have something to do with soaring medical malpractice premiums and a need for tort reform? I don't hear much about that anymore.

Now we're going to mandate the consumer to buy the product no matter what the cost. Some powerful lobbies at play here.

Paul Krugman advocates compulsory payment by everyone for "health insurance" as the fix for the "free rider problem." What he's actually proposing is a universal tax. When the government forces you to "buy" it, you're not buying it; they are taking it; it's a tax.

The "free rider" problem exists because the government created the problem in the first place by imposing an earlier mandate. It forces hospitals to provide the best available treatment to anyone that shows up asking for it, regardless of ability or intention to pay.

If you want to solve the free rider problem, repeal that mandate. Mandates that force people to act contrary to their economic interests create more and more distortions in the incentives that drive the ways people act.

So you just have to keep creating more and more mandates. If people don't want to do it, force them! That way lies totalitarianism.

Your Dec. 3 blog entry and Dec. 10 NU column could have been lifted almost verbatum from conversations my partner and I have been having for several years (but I give you full credit for coming up with the ideas on your own)!

It's amazing how few voices have come out in favor of what seems like an obvious "grand compromise." Namely, mandated "basic" health insurance a la Medicare or auto liability insurance and market-based supplemental insurance.

Perhaps the problem is few relish the idea of drawing the lines between what "basic" covers and what it leaves out.

Still, not many lose sleep over all the real cost, pain and suffering that minimum statutory auto limits leave uncompensated. And I'd much rather have people making do without elective surgeries they failed to plan for vs. having so many making do without health insurance at all (keeping in mind that all of us end up paying for it anyway--and at a premium because of greater emergency vs. routine or preventative treatment).

Speaking of which, my suggestion would be to cover both basic preventive medicine AND catastrophic, with a big donut hole (to use the contemporary parlance) in between where the market will offer solutions.

It would be foolish not to create a "use it or lose it" dynamic with respect to annual physicals, vaccines, pre-natal, etc.

Anyway, I have to believe you take a lot of heat for your lack of "orthodox-conservative" views on the subject, given the predominant political tint of our industry.

Chin up, 'cause I think you've hit the nail on the head, and it's really very important to get people to think through and past their ideological insticts to where we can come together to solve real big problems in real sensible ways.

I believe Mikk has it about right. But the sad truth is that the hospitals, although mandated to provide emergency care, only doggedly go after those citizens--and I should underline that word, citizens--who they think they can beat into paying something, whether they can afford it or not.

The others are, as you say, the "free riders," and unfortunately until we fix that system, we'll never have an affordable universal healthcare plan.

I also don't disagree that if the bureaucrats keep wrangling over who will control it, "affordable" will not even be in the language of the governing bill.

Call it a tax or call it a premium, but the bottom line is we need a single-payer system (which we already have for tens of millions of Americans--Medicare), which can provide basic health care to everyone.

Just as a basic education is a right in this country, basic health care should also be a right.

Want better? Fine, buy private insurance.

Medicare doesn't work perfectly, but the concept of a single-payer system is not a bad one.

Obviously, a payroll tax system won't take care of the unemployed, who will have to be helped in a different way.