Care, Not Cards

Elected officials in Washington are poised to begin debate on health care. They can’t wait to expand the government’s role in medicine, citing the need to control costs and guarantee health services to all Americans.

Sad, since the track record of government-run health care systems includes runaway costs, lack of available doctors for patients with the government cards, mountains of bureaucratic red tape, fraud, and inconsistent and ineffective care for those who need it. Doctors don’t receive adequate reimbursement from programs like Medicare to cover their costs, so they limit the number of Medicare patients they take – meaning that people who receive government health care have government cards, but no medical care. They often wind up in the local hospital emergency room for non-emergency care because that is the only place that cannot refuse them. This is the most expensive and least effective way to provide health care.

Everyone knows that this is happening. And government officials sigh, shake their heads in sympathy, and then continue to work on expanding the program that caused this problem in the first place. Because in the eyes of Washington, the only answer to every problem is to give the government more authority and control.

But what if we looked in a different direction? A direction that focused on giving people who need medical services actual medical care, instead of just a medical card.

Consider this. The private health care industry in America is the best in the world. The relationship between the private insurance companies and the medical professionals works, and patients with private insurance have open access to the care they need.

So why is the government setting up its own, competing, medical care system? Why don’t we just provide those who are currently using one of the government medical cards with a voucher to purchase private insurance?

The government costs would be controlled and predictable, eliminating the enormous health care costs to the taxpayer. Right now, if a Medicare patient suffers a major heart attack, the American taxpayer pays for every penny of his medical care. But if the government was providing a voucher to allow that Medicare patient to purchase his own private health insurance, the cost to the taxpayer would be the cost of the voucher, no matter what medical problem the patient might encounter.

There could be no threat of rationed care. The government can’t ration what it doesn’t provide. Patients would be purchasing the insurance that covered them to their satisfaction, and could change companies if they were dissatisfied with the services.

Patients could actually see a doctor instead of being forced into the emergency room. Doctors do not limit the number of patients with private insurance that they see because they get reimbursed at levels that allow them to keep their practice, so patients can see the same doctor regularly. This cuts costs and improves the quality of care.

Such a system would require a few changes in the red tape of insurance, such as removing arbitrary geographic barriers, and allowing those with the government voucher to become a “group”, so they would be guaranteed access to health insurance.

But in all the discussion in Washington, there is not even a mention of a solution that focuses on ensuring that those who need care, actually get care. Instead the debate rages around how fast government can assume more control of health care delivery in America.

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