Health Care Is a Business—or Should Be
By Richard E. Ralston
April 16, 2007
Ultimately all health care is paid for by business activity. Business provides the wages, the return on investment, the insurance, the taxes that pay directly for health care, and the insurance and taxes that fund government programs. When the government manages to provide services at all, it can give you nothing that it does not take from you or others, or from your employer and other employers. The total added value the government creates for your benefit is nothing.
The government now uses your money to pay for 50 percent of health care. That is up from less than 10 percent, forty years ago. The increase in health care costs that has accompanied this process is largely caused by government—the actual origin of the "health care crisis," discovered and proclaimed by Richard Nixon and Edward Kennedy in 1971. Their proposed solution was more government. They got it.
The "crisis" was created by government, not just through its own reckless spending, but through the consequent destruction of much of the free market.
In a free market, if you did not have much to spend on insurance premiums, you could buy a policy that simply covers you for a major illness or a severe injury. Many people worry about the financial ruin that might result from such misfortune and want coverage only for that. They are willing to take their own risk for routine medical expenses if they have reasonable coverage for emergencies.
Such policies are often forbidden by state governments. In California, for example, such policies are not available. Legislators and regulators have imposed 49 specific coverage requirements on all insurance companies. Many states have such requirements. It does not matter if you do not want coverage for chiropractic, or in vitro fertilization, or electronic shock or hypnotherapy for mental illness—you may still have to pay for it. That is, providers in the insurance business are not allowed to offer a policy that you might want and that they would like to offer—they are forbidden. If those restrictions drive the cost of insurance up to more than you can pay, you can thank the government. Insurance policies will get even more expensive in California if the recent proposal of the Governor to require coverage of such "wellness" care as gym and Weight Watcher memberships becomes law.
There are those in the insurance business in other states who could help you with a policy that meets your needs at a cost you can afford. But they cannot, because policies from out-of-state providers are outlawed by your state government. When bills were proposed in Congress to allow for a national market for health insurance, insurance commissioners and other state officials around the country rallied in opposition, because consumers in each state would lose the protection of their state's regulations. It appears that state officials are horrified at that thought of leaving the citizens of their own states to the tender mercy of the regulators in other states.
But relief is on the way. Massachusetts passed a law that you must buy insurance with these expensive regulatory burdens or pay a fine. Isn't that helpful? California now wants to do the same thing and also wants all physicians and hospitals to pay a new tax—not on net income but on gross revenues. That will increase their billings and your insurance premiums further. But who cares?—you would have to buy the insurance, and imposing coverage on everyone is all that matters.
We are told by many government officials that businesses such as insurance companies and medical practices are inefficient and bloated bureaucracies from whom government needs to take control. But government spending on health care has already expanded faster than spending by any private agency. Why? Government-run Medicare now enforces 130,000 pages of regulations. No insurance business does that. But the government does impose the cost of compliance with that paper nightmare on insurance companies, medical practices and hospitals that try to operate in the black as viable businesses.
Our response to this government-generated mess should not be to allow the further growth of government intrusion in medicine. It is time to allow American health care to get back to business.
Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.
Copyright © 2007 Americans for Free Choice in Medicine. All rights reserved.
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