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An American Solution To Health Care Financing

Currently, two political polar opposites are touring the nation in service to a single cause. Newt Gingrich and and Al Sharpton, working with the Obama administration's Department of Education, are visitings schools around the country to see what problems they are facing -- and how some failing schools have turned themselves around. What they are trying to do is figure out what works, and spreading the word about what solutions they find.

The situation is there are thousands and thousands of schools across the nation, and while the problems are universal, there is no overarching authority to impose those solutions that work.

As they say, this is not a bug, but a feature.

The problems schools face are, generally, similar, but with particular elements that are unique to each. This means that "one size fits all" solutions often won't work -- at least, not without some adapting. And we have all these laboratories where we can try different solutions, all at once, and figure out what works -- and what doesn't.

What Gingrich and Sharpton are doing is helping the Department of Education do what it is supposed to do -- collect information and disburse resources, assisting schools and school districts improve themselves.

Critics of the Department of Education like to point out that it, for all its spending, doesn't educate a single student. Again, this is not a bug, but a feature -- we don't want Federal Schools. They should remain in the hands of local authorities, with the federal Department of Education coordinating and assisting and providing resources, but not controlling things.

So, what does this have to do with health care insurance reform?

The Obama administration is working towards a "one size fits all" solution -- one national program that covers all Americans. Critics are pointing out the flaws in the various and sundry plans, and the hysteria on both sides is getting rather tiresome.

What it seems most people are overlooking is that we have a tremendous resource available for us to get past the debates and gather some actual real-world data on how these solutions might work -- or not work.

Thanks to our federal system, we have fifty semi-autonomous states that have clearly-defined powers and responsibilities separate from the federal government. (51, if you count DC -- but I wouldn't recommend doing so in this case. Or any other, for that matter.) And some of these states have already been conducting "experiments" in health care coverage reform, and we can look at those states and see what works -- and what doesn't.

For example, Hawaii, Maine, and Massachusetts have each tried out systems that have been less than stellar successes. What can we learn from those programs? Well, in Massachusetts, quite a few doctors looked at how the state was dictating to them on how much they can charge for their services, said "screw this," and left the state or retired. People who suddenly found themselves with insurance started hunting for a primary care physician -- and discovered that the state simply didn't have enough primary care physicians to go around. And some businesses ran the numbers and found it was cheaper to either fire enough people to get below the threshold or just pay the fine instead of providing insurance.

Why not ask the legislatures of the several states to each take a stab at reforming health insurance coverage? Some states will tell DC to go pound sand, but most states would probably be willing -- hell, quite a few have done so already. Let them try their various approaches for a few years, then have the federal government pull the data and see what is working, and what isn't.

Further, the states are considerably more responsive than the federal government. Should problems be discovered, the states can work on fixing them faster than the federal government. And if you have a problem with the system, it's a hell of a lot easier to get hold of your state's elected officials than your Representative or Senators -- they're becoming experts at hiding from their constituents.

And let's not forget that many of the European nations often cited of examples of "civilized" nations that offer universal health coverage are smaller (both geographically and in population) than a lot of our states.

Finally, the nation is incredibly polarized right now on the issue of health care. (Well, especially on health care, but on most everything right too.) Things aren't nearly so bad at the state level. There's a far, far better chance of meaningful reform getting passed in the several states than at the national level.


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Comments (6)

This is what I have been ad... (Below threshold)
JustRuss:

This is what I have been advocating in my comments for over a month now. We don't need a federal one-stop program. Let the states handle it with some guidelines from the fed.

One problem though. It might fix the problems with healthcare but it will not solidify all of that power in DC. So Progressives will never allow it.

Only problem, JT, what if I... (Below threshold)
GarandFan:

Only problem, JT, what if I DON'T WANT TO BE EXPERIMENTED ON?

Ok first of all you are ask... (Below threshold)
jim m:

Ok first of all you are asking for State's rights = RACIST!!!!

But seriously, the purpose of Heath Care reform is not to make health care better (we already have the best quality system available anywhere), but to consolidate power under the federal government. even if you had 50 states pass single payer systems the current administration would not be satisfied because they want centralized control.

Second, you left out Oregon, which is arguably the biggest failure of them all.

Last it does not address the need o pool risk across state lines which would allow insurance companies to spread risk across more members and thus offer more services for lower premiums.

Otherwise allowing the states to solve problems in their own way has a lot to recommend itself. You can have 50 experiments in reform and 49 more chances to actually try something that will work vs the current me too Canadian plan that is in the House.

The first step to reforming... (Below threshold)
Mac Lorry:

The first step to reforming healthcare is to understand the fundamental problem. It starts with the realization that no system can provide unlimited state-of-the-art healthcare to everyone on a sustainable basis. I challenge anyone to name a nation or a state that does so.

Every nation that has the single payer system uses the "long lines, long delays" means of rationing access to non-emergency healthcare. The U.S. uses limited access to insurance and high costs without insurance as a means of rationing access to non-emergency healthcare. Cuba uses poor quality obsolete healthcare to ration healthcare expenditures.

What we need is a means of rationing healthcare that puts users in charge, puts free market pressure on healthcare providers, avoids long lines and long delays, stimulates healthcare innovation, and yet controls costs. I've laid out such a system on these pages before, so there's no point doing it again.

Maybe I should write one of my senators. Na, that would be a waste of time because I don't think my senators can't read. They sure don't read the bills they vote for.

JT, the problem with this i... (Below threshold)
Alan:

JT, the problem with this idea is that it is still the government interfering in healthcare. We don't want the government building cars (ever hear of the East German Trabant?), why should the government do ANYTHING that private enterprise can do better?

There are two problems with the government in healthcare (or any enterprise):

1. Private enterprise can be nimble and decide that things aren't working and quickly change direction. Government has to go through a convoluted bureaucratic process to make changes, because its a bureacracy, to CYA and because changes to gov't should go through a public process.

2. Government is unaccountable. You can't sue Medicare for not doing something right. You can sue an insurance company. The government can't be the provider and arbiter at the same time. They are separate roles and should remain so.

What we need is to reduce the amount of current government interference in private insurance plans (so that there are more options), allow them to compete nationally (more options), give the same tax breaks for purchasing insurance personally as businesses get for providing it to employees, and put limits on malpractice suits. Make the market do the work!

There are many medical heal... (Below threshold)

There are many medical health care centers in America and they are in operation in order to provide medication, therapy, counseling and relief to people suffering from various diseases.




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