Friends, even good friends, do sometimes disagree.
I truly appreciate the time and thought that Dr. Graboyes put into his comment on my recent post on the NFIB's principles for health care reform. Let me try to respond.
The position the NFIB has taken is a pragmatic one. I concede that it may be the best among available pragmatic solutions. I would argue that our health care mess -- we both agree that the current system is a mess -- is a result of decades of pragmatism. World War II was ending. Wage controls that had been put in place to keep inflation in check. The federal government, labor and large corporations decided that offering health care benefits was not a violation of wage controls. So a pragmatic solution was to create a system of employer sponsored health insurance as a way to increase compensation without increasing actual wages. It was a pragmatic economic shift.
Fast forward a couple of decades. President Nixon had instituted wage controls once again to stave off the inflationary pressures in our economy. This time the pragmatic solution was to enrich health care benefits. We moved from a major medical system (what is now called a high-deductible plan) to one of very low deductibles. Again this enhancement of compensation was a pragmatic way around wage controls.
Inflation, at least in health care, is once again rampant. And once again, we hear calls for compromise and pragmatism.
I agree with Dr. Graboyes. Our current health care system is not free enterprise. It is one based on a system of rent seeking behavior on the part of corporate medicine, physician and hospital lobbyists, health insurance corporations, and labor. I would like to see how these principles will take us down the road to liberty.
Dr. Graboyes says, “100% private is not going to happen, and one is hard-pressed to find any market-oriented think tank that advocates total retreat of government from health care.” This is just not true. For example, the Cato Institute is about as market-oriented as they come. Michael F. Cannon in an article published at the Cato Institutes's website said the following:
In a field dominated by lefties and rent-seeking weasels whose unifying goal is to provide health insurance to everyone, it is easy to get caught up in universal coverage fever. Even erstwhile conservatives have been seduced into thinking we can achieve universal coverage in a free-market way.Yet a free market would not provide health insurance to all; some people are uninsurable, others don't want health insurance. National Review made the point nicely: "to achieve universal coverage would require either having the government provide it to everyone or forcing everyone to buy it." Either way, government calls the shots. If conservatives adopt universal coverage as their goal, the left will have already won.
Dr. Graboyes asks for another solution.
Give the consumers control of their health care dollars. Remove the employer from the health care system. What a way to truly put small business on a level playing filed with big corporations. Tear down government barriers to a truly free health care system - deregulate health care. Don't tell me that such fundamental change is not pragmatic or realistic. We can reform Medicaid like we reformed federal welfare. Shift that money back to the state in block grants free of federal mandates. We can deregulate health care just as we deregulated so many other powerful industries during the Reagan era.
Will it be uncomfortable? Yes. Will it be painful? Yes. But we have created a critically ill health care system that needs powerful medicine to return to wellness.
