A mandate: not the way to bring down health care costs

Pundit Mom has a very thought-provoking post this week about providing universal health care. At the end of the post she says, “Is it so crazy to think that maybe we could take a little money from the tax breaks for the Halliburton gang and put it toward resolving the health care crisis we face?… Any good answers, anyone?”

Actually I think I have two good answers. If not good, at least sincere and food for thought. First, some thoughts about the issue of demand. Health care costs so much because insurance programs create high demand (by encouraging us to run to the doctor every time we sniffle or cough) and because we have come to expect nearly every business to offer health care insurance as a benefit. These two forces have created huge demand for health care services, which in turn (because of the perception that ‘business can afford it’) has contributed to the astronomical costs.

So here is a thought: Could the answer possibly lie in businesses NOT offering insurance as a benefit? In other words, if businesses stopped offering health insurance as a benefit and instead, competed for workers by raising people’s wages by, say, 25-30 percent, this would do a few significant things: it would give businesses some control over their operating costs, since they have virtually NO control over escalating health care costs but have SOME control over how much they pay in wages; it would put the income into the hands of the people, who could decide how to spend it; and it would immediately lessen the demand for health insurance because a). some people would just elect to spend their raise elsewhere and b). at first, most folks still could not afford it even with their increased wages. This lessened demand would force providers to find ways to lower fees, and insurance providers to lower premiums, to make the product more attractive on the open market of individuals.

As far as paying for care for those who can’t afford it: PunditMom’s suggestion was taking “money from tax breaks.” The problem is, a tax break isn’t cash. It’s a reduction in taxable income, and therefore a reduction in taxes paid. So you’re essentially asking the government to pay for health care even though it’s taking in less money in taxes. (Certainly one can argue that they shouldn’t be giving the tax break in the first place, but that’s a discussion that goes way beyond just health care. And I’m frankly not willing to concede that tax breaks to corporations are always a bad thing.) We might perhaps reasonably expect the companies getting the tax breaks to contribute some of their untaxed income to the cause, but then we are back to asking business to bear the burden.

So here’s an alternative: Have there been any new medical facilities built in your community? We’ve had some recently here, and let me tell you, they are whoppers! Architecturally stunning, equipped with state-of-the-art technology, and staffed with caring and capable professionals. But, if the hospital here had taken one-tenth of the money they spent on building their newest patient wing and re-allocated it to health care services for the poor, then we as taxpayers wouldn’t have to contribute a dime. This particular hospital, run as it is by a church, should have been more than eager, more than willing to serve the poor instead of just the insured. They could have certainly built a state-of-the-art addition, minus, perhaps, some of the archictectural drama, and still financed health care for the poor many times over!

As a taxpayer, I am not willing to elect people who promise to force me – a working, middle-class taxpayer – to pay for health care for the poor until the hospitals themselves start putting patient care for the poor above “beautiful facilities” on the priority list. Next time a hospital starts fund-raising in your community to build something new, and you gasp at the beauty of the architectural concept drawings, it’s time to step back and ask them how much of their budget is being used to provide free services to the uninsured. (This is also a good way to get “the richest one percent” to pay for health care for the poor, by the way, because these fund-raising campaigns always rely on the well-to-do families in every community to donate the millions.)

It may seem like I’m being a smart-aleck here, but I’m not. Providing free health care is not the government’s job, and it’s not something I want them handling anyway. You need only look as far as the Veterans’ Administration to see how the US government manages health care. And if you haven’t looked lately, just email me for a few details that are guaranteed to scare you off government-run healthcare for good.

Editor’s note: This post originally appeared in 2007, however Pundit Mom’s blog archive doesn’t go back that far so I’m unable to restore the link to the post I had read there. Even though we’re on opposite sides of the political fence, it’s still a thought-provoking and well-written blog!

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