Thoughts on Health Care

The health care debate continues to generate a lot of noise, which has caused me to stop and ponder what will work and what will not. I approach this from a number of different angles: as a business owner, as a matter of faith, and from my own education in the area of government and economics.

From a purely economic perspective, the idea of a single-payer health care system is a disaster waiting to happen. A government monopoly (or any monopoly for that matter) will become bloated, costly, inefficient and unresponsive. There is no incentive to behave otherwise. The beauty of competition is that keeps people sharp, ensures maximum effort, and keeps costs low. So when I hear the President or anyone in Congress tell us that a single-payer health care will save money, I don't know whether to laugh hysterically or hide my money under a mattress. A look at other government monopolies such as Medicare for the elderly, or the Post Office tell us that their history of operating monopolies is not good.

The other truth about government subsidies is that when a government subsidizes something -anything - you get more of it than you ever planned for. We subsidized retirement with Social Security, and now we have more retirement than we can handle as a society. We fought a "war on poverty" under the Johnson and Nixon Administrations with welfare - and poverty won! If the government subsidizes healthcare, we will get more demand for healthcare services than our system can handle. This will result in long waits for some procedures, and yes, it will inevitably lead to rationed healthcare. From a purely economic standpoint, single-payer healthcare is a loser.

But what about from a faith perspective. I was particularly intrigued when the pastor of my church, Adam Hamilton, urged the congregation to think about this from the prespective of Jesus who would admonish us to care for the sick and the poor. I do not believe that Jesus would have any comment about the economic ramifications, or the evils of single-payer healthcare. He really didn't have much to say about government, except pay your taxes. I have to admit, this is where I struggle because I do not know what contribution I can make. Perhaps my role as a business owner helps. I do offer my employees, and their families, health insurance. Not all of them take it. Under the Obama plan, my business would have to pay a 2-6% payroll tax, which would be crippling to my business.

Conservatives are right to criticize the President's plan. I do not believe that a government-run system is the answer. Opening up competition to more insurance companies, on a state-by-state basis, would be a good first step. The best way to reduce costs is by increasing competition. But what about increased access? Millions still cannot afford health care services. This conundrum between economics and faith leaves me twisted on the subject. If I follow my faith 100% on this, I would neglect the economic side. With the economy in a very weakened state, the added burden of increased healthcare costs could sink the entire system. But if I follow my purely economic instincts, then I am just plain cold hearted.

Bottom line, increasing access to the system will increase costs to society. It will also stress the healthcare system. We have addressed the subject of increasing access, but what about increasing suppliers of healthcare services (i.e. doctors)? If you are looking to cut health costs, it seems to me there is little incentive to go become a doctor, particularly a primary care physician. Increased demand combined with steady supply leads to shortages, long lead times (waiting 6 months for an operation), etc...and ultimately to rationed care.

There are no easy answers. Right now, I do not have the answer. I think I have a better idea of what I do not want to see versus what I do want to see.