Health Care Debate: Health care reform via an open and respectful debate.

Although this was certainly the closest fit to how America should address the health care problem, I am not sure I would terminate health insurance companies completely. Everyone should have access to health coverage, poor or wealthy. However, if you have money to pay for better coverage, I think this should also be an option if possible.

An interesting thought. The internet has managed to kill off all kinds of middle men out there, perhaps the insurance companies are next? You have to ask yourself, why do they exist? What benefit do they bring to the table? So far, it seems that they do a good job of hurting both sides. Any thoughts on that?

Insurance provides a very valuable service in all kinds of industries by providing financial protection from in-frequent and unusually expensive events. I enjoy a lot of piece of mind because my home is insured against fire and my family is protected if I died or were disabled while they are dependent on me.

Insurance increases the total cost of any system - you are introducing a third party into the provider - customer equation. More money is spent in total dealing with home fires because of insurance - they pay the costs of dealing with the fire, plug cover operating expenses and make a profit.

In health care - EVERYTHING is covered by insurance, this drives up the cost of health care. This makes as much sense as having gas insurance - just in case your car needs a fill up.

Take a look at the few areas of health care that are outside the blanket of insurance - Lasik eye surgery has gotten cheaper, better, and more available during the last 20 years.

The UK has a serious shortage of dentists. There are actually news articles about people using do-it-yourself dentistry and using pliers to pull out teeth. I've read where UK dentists will pull out all of a patient's teeth and fit dentures rather than try to save the healthy teeth.

I want my health care professionals working form my interests, not an unaccountable government bureacracy.

Lots of folks argue that the health systems in Canada and the UK are wonderful. They are wonderfully free to use, but don’t think for a minute they are without cost. The biggest confusion comes down to two distinct issues:

* Delivery of health care services

* System of payment for health care services

When my friends from Canada and the UK suggest their health systems are great I pause. After a longer conversation I learn that, well, the fact that they don’t have to pay for health care is great. The delivery of the health care services leaves a lot to be desired. Canada’s admits their system is imploding. In the UK each year more than 4,000 mothers can’t get hospital beds and are forced to have their kids on elevators, offices and on toilets. These socialized systems have their share of mistakes as well.

Now when I talk to various people from the U.S. (Democrats and Republicans) I ask them about their health system. The Democrats all will tell you it is terrible. The Republicans will tell you it is the best in the world. What is the disconnect? It is actually a very simple disconnect, but often hard to uncover while everyone is yelling at each other (i.e. you are unamerican, you are a racist, yadda, yadda and so on).

When you actually scratch the surface of the debate between Democrats and Republicans it is clear that everyone thinks the health care delivered to them is great. They like their doctors. They like the medication they receive. They like their hospitals. In fact both Democrats and Republicans seem to LOVE the delivery of health services in the US. Now ask either a Democrat or a Republican about our system of payment for health care services and both sides agree 100% that our system sucks. Ironically, we agree – we have the best health system and the worst payment system.

Now this is where the debate gets sticky (i.e. Democrats and Republicans disagree). Conservatives want to fix the existing insurance system to better deliver the existing health care services. The Democrats want to scrap the existing insurance system for a single payer system (i.e. government run). The good news is that NO ONE wants to lose the existing system of delivery of care. We all want to keep our doctors, the cool medications, the advanced surgery centers and so on.

Conservatives aren’t heartless bastards who want millions of Americans to die, instead we are just like Democrats. We want to keep our world class health care system. Our biggest concern is that a single payer system (i.e. government run option) would preclude us from keeping the current delivery system. We believe that the current payment system (private insurance) can be reformed. Lots of us have plans. Conservatives don’t want to risk our health care delivery system. I think Democrats would agree with us. Now if we could just come up with a set of reforms that fix our current system and expanded access to those who need it most.

Let's hear from some people who have actually LIVED in countries where there is National Health Care. These scare stories are, I fear, greatly exaggerated. Even the scare stories rate higher than the nightmare scenarios so common in the US due to the complete ABSENCE of a National Health Care system.

I have lived in the UK and both of my children were born there. I have never heard such stories nor have I experienced anything negative in hospital there. Most Britons are PROUD of their health care system and regard the US as inferior in this regard.

I also lived in Japan for nineteen years and I must say their health system is superb. Our monthly premiums for a family of four were the equivalent of $300. For medical treatment of any kind, my husband paid only 10%. My two children and I (his dependents under our family policy) paid 30%. I won't say it was perfect in every respect. My opinion is that medical TRAINING of doctors in the United States is better than in Japan, but I believe the health care SYSTEM is excellent. No one goes without care. Care is affordable. Drugs are not expensive. Children's vaccinations are free. Japanese people regard these things as a human right and a basic common-sense practice of a civilized people. Being a very polite people, Japanese keep their opinions of American health care to themselves. But it's not hard to guess.

We hear so many scare stories and nightmare scenarios of doom and gloom regarding the adoption of a National Health Care system. Take the time to communicate with actual people who have lived with the benefits of National Health Care. They will probably tell you they would be reluctant to give it up... and they wouldn't trade places with YOU for all the world!

As an economist, my general belief is that competition facilitates inovation and reduction of net cost in real dollars. There are instances however, where competition is actually counter productive. We refer to these anomilies as natural monopolies. An example would be natural gass before deregulation. It's far too expensive to run two gas lines into every home, so a single carrier is provided and then regulated. After deregulation, only one carrier maintained the physical lines, but multiple companies vied to provide the service, still in conjunction with the original carrier. The end result, while offering competing providers, caused the price of a single therm of gas to jump almost 700%. Ironically, NG production is saturated with reserves now, but competition has caused what we refer to as an economic rent.

In many ways, private health coverage has produced the same quagmire, mainly because current health providers are for-profit industies that must return a share of those profits to the stock holders, either through dividends or appreciation. A government plan, of course, would not be constrained with this, so the excess money can be used for provider salaries, upgraded facilities, and improved patient care. And if you have doubts about the federal governments ability to implement such a system, I'd direct you to the US Postal system, which is both efficient (650 million pieces of mail a day) and self supporting (except in 2009). Few, if any, private insuers will be able to compete with this business model.

Lastly, if you compare GDP expendetures on health care in the current system with Average Life Expectancy, you'll see that the United States spends 14.6% of nominal GDP (# 1) while achieving an A.L.E of 78.2 years. (#42). By contrast, the UK has and expenditure of 7.7% with an A.L.E. of 79.4. In laymans terms, they spend half as much and live about a year older. There are other comparisons as well, but I digress.

Thank you for taking the time to read through all my economic dribble. If the numbers pointed a different way, I would oppose the current house measure, but in my studies, they simply do not.