Explore other health-care options

Posted on May 28, 2007 | Type: In the News | Author: Thomas C. Patterson
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State Rep. Phil Lopes is pushing for reform of our health care system. He wants a massive government run public-private partnership to provide health insurance for every resident of the state. We could all visit a doctor any time we wished yet no health care provider would be forced to accept lower payments under his proposed plan.

That's not exactly the way government-run health programs have worked. Patients in Canada and the United Kingdom commonly wait up to a year to see a doctor while providers, especially of primary care, are becoming scarce due to declining revenue. Our Medicare and Medicaid systems are plagued with the same problems while their costs spiral out of control.

Still, Lopes, D-Tucson, is hardly a voice in the wilderness. The Arizona Town Hall, representing received wisdom from around the state, called for universal coverage at their meeting in April. Presidential candidates from Hillary Clinton to Mitt Romney endorse the notion.

The advocates for a top-down, one-size-fits-most system assume without questioning that health insurance is the only way to provide health care for the needy. But is it? We don't provide food for the poor by granting them an unlimited right to shop at any store and buy whatever they wish.

In fact, economist James Smith of the Rand Corp. is among the many experts who conclude that health insurance is vastly overrated in the policy debate. There is no evidence that expanding health insurance coverage would improve the health or longevity of the poor, compared to other approaches that could purchase more health care for the money spent.

Moreover, more health insurance wouldn't improve the quality of medical care. Nor would it reduce health disparities across racial and socioeconomic lines, according to Harvard's Christopher Murray.

Why would expanding health insurance fall so far short of its seeming bright promise? The problem is that we already have a system in which third parties pay 86 cents out of every dollar Americans spend on health care. Since were all spending someone else's money, we demand more than we need and we don't care much whether it is cost effective. Dumping more patients into this dysfunctional system isn't the answer.

Lopes claims that, lacking health insurance, one million Arizonans cant just see a doctor, so they wait until minor problems become a crisis and then head to the emergency room. This is preposterous. Community health centers around the state provide high quality services on an ability to pay basis. Free clinics run by charitable organizations such as St. Vincent de Paul provide medical care for the indigent and the county health system is open to all. Maybe Lopes needs to find out more about how people really live.

Meanwhile, more good ideas are on the way to improve access to health care. Walk-in clinics are sprouting up in Wal-Marts, CVS pharmacies and other retail outlets where minor conditions can be treated for $40 to $60. The staff of these clinics refers patients to higher levels of care when needed. To assure continuity of care, reports are e-mailed to personal physicians. Patients report a 90 percent satisfaction rate.

So what, critics contend, its the costly chronic diseases that cost the big bucks. But innovation and competition can help there, too. For example, the city of Asheville, N.C., cut in half its cost for diabetic employees by contracting with local pharmacists to monitor patients and refer them into care when needed. Health savings accounts, which give patients more self-responsibility and control, are also proving effective at meeting the needs of the chronically ill.

Government could do more to make medical care more affordable, and thus accessible, rather than herding us all into collectivist schemes. We should all be able to purchase health insurance with the same tax benefits that employers get. We should be able to purchase health insurance across state lines, to avoid the costly mandates imposed by state governments. Health savings accounts should be available to all.

Meanwhile, Lopes and the others want us to believe that next time, our experience with centralized, bureaucratic health care will be different than all the other times its been tried. We'd be fools to believe them.

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