Not to toot my own horn, but I’m going to toot my own horn. I applied my not inconsiderable intellect to the problem of this broken healthcare system we have in the United States and spent a couple of months ruminating until I solved it. I really did. I designed the perfect healthcare system for the United States of America.
That’s a pretty hefty promise. But wait, I have more.
I guarantee that my healthcare system will provide the highest possible quality free healthcare to every single human physically in the United States. (By “free” I, of course, mean “taxpayer funded.”)
I guarantee that my healthcare system will provide the highest quality healthcare possible for the poor, even compared to a medicare for all or national health service system.
I guarantee that my healthcare system will provide the highest quality healthcare possible for the middle class.
I guarantee that my healthcare system will provide the highest quality healthcare possible for the rich, even compared to laissez-faire capitalism.
I guarantee that my healthcare system will cost the middle class less per unit of benefit, including the tax burden, than the current system.
I guarantee that the majority of the tax burden will fall on the rich.
And I guarantee that this system will never, ever be implemented. And that is for three reasons:
First and most obviously, it will throw the entire healthcare industry and anyone who uses it (i.e. everyone) into utter turmoil for years if we rip the bandaid off, decades if we attempt a gradual shift.
Second, it will upset the conservatives because it will be ludicrously expensive. Possibly even more expensive than medicare for all, but I don’t think so.
Believe me when I tell you, conservatives, libertarians, and assorted right-leaning individuals: I get your point. The federal government spends more than it makes, and it makes more than it has any right to make (plus the corruption and special interests and all that jazz). The federal government is not the best tool for nearly any of the jobs it does. But what it really comes down to is this: If we were to do the economy a little more your way, we’d be able to afford this program and it sure would be great to have huge amounts of free healthcare all across the country. The free market consistently lets the most vulnerable among us slip through the cracks. And no one wants that.
Third, it will upset the progressives because the quality of healthcare available to the rich will be astronomically higher than that available to the poor.
And believe me when I tell you, progressives, liberals, and assorted left-leaning individuals: I get your point too. Inequality isn’t just dangerous and destabilizing, it is a sign of the degeneration of human caring and community values, and everyone would be better off if we all came together to sing Kumbaya. But SOME inequality is the price for progress. In 1895, only the richest people in the United States had electric lights in their homes. And it cost them a fortune to put them there. But because they were allowed that staggering inequality, 50 years later, most Americans had electric lights in their homes. The same thing happens with medicine. If today, the super rich are able to save their own lives with ludicrously expensive pills and surgeries, in 50 years my system will have those pills and surgeries available to the poor for free. But not for 50 years. And if that’s too big a price to pay, many of those pills and surgeries won’t exist at all and we can all continue to die equitably as a result.
If you can live with the turmoil, price and inequality, my system comes in two parts.
Part 1: Market solution
End medicare, end medicaid, end social security and abolish any bureaucracies associated with them. Massively de-regulate the healthcare industry. End the health insurance mandate. Allow healthcare providers to compete for business. And require (this is the only new regulation I want in place) transparent pricing. Everyone who goes to a private healthcare facility has the right to know how much anything will cost before they consent to paying for it. I cannot believe that we currently live in a world where, not only do patients not know how much they will be charged until a week afterward, but even the doctors themselves don’t know how much their patients will be charged.
Part 2: Free healthcare
The federal government will provide, let’s say, a national health service. Healthcare centers will be able to provide everything the private system provides (with an appropriately bureaucratic lag) from primary care and annual check-ups to emergency care to cancer treatment to retirement homes, with the obvious exception of blatantly cosmetic surgeries, etc. These facilities will ideally be run taking its cues from the most successful private facilities in administration and operation. The only difference is that in the government centers, you go in, you get what you need, and you walk out. No insurance. No credit information. The government pays the bill. The end.
I just spent two paragraphs describing a multibillion dollar healthcare system that would be used by hundreds of millions of people. There are a lot of details to iron out. Which healthcare regulations stay in place and which ones go? How will insurance enter into the equation? How will emergency services know who prefers a private emergency room versus the government emergency room? Should government medical centers be operated independently, by county, by state, or by a federal agency? How will funds be allocated? How many government centers should there be?
Like every issue, healthcare suffers from partisanship. The single entity of the government can only move in one direction at a time, and sadly it is part of both party platforms to fight against anything the other party wants to do, regardless of whether making the enemy suffer is necessary for the accomplishment of their own goals.
There is a way for free-market healthcare and socialized healthcare to coexist if we can just find it in our hearts to let the other side have some of what they want.
