We Need a Game-Changer
If there is any issue that should unite our divided nation, it’s health care. Mortality limits every one of us; even those blessed with good genes and good habits are one accident away from dependency. And we all have relationships that change quickly – or cease to exist – if either party is seriously ill. Most of us spend an enormous amount of money on health insurance – or earn what our employer pays for it. Instead of appealing to our interest, the industry and our own Congress have taken advantage of us.
Dr. Rosenthal pulls no punches in applying her medical knowledge and journalism experience to exposing the collusion among health care providers, insurers, and politicians that has us in such an unenviable financial and moral predicament. As an economist, I was impressed with her “Economic Rules of the Dysfunctional Medical Market,” which are carefully linked to examples that I could easily relate to as a consumer. And I especially appreciated her documentation in Part I of how we got here (“The Age of” Insurance, Hospitals, Physicians, Pharmaceuticals, etc.). What comes across quite clearly is that it is indeed a systemic problem. As she notes in the Introduction, the rules that govern delivery of health care in the US are no accident, and it’s up to us to change those rules.
Of course, we’re a few Davids taking on many Goliaths. So in Part II, Dr. Rosenthal provides thoughtful measures for personal and political action to incrementally address the dysfunctional relationships we have with insurance companies and providers. Each is worth considering and sure to benefit some of us, and taken together, they are a good start toward reform. However, I don’t think we’ll see real change unless we amputate the “invisible hand” on the till that she refers to in the Introduction. The Affordable Care Act was stillborn because the health care industry made sure it posed no real threat to their market power. In my view, we will never win control of our own health care by working within a system designed and controlled by special interests. We need something radical like single-payer, but I would prefer something that restores a free market – like eliminating tax deduction of health insurance premiums by employers and making all health care expenses (premiums and out-of-pocket) deductible for individuals. That’s not a new idea and it’s not the only solution, but it would be a game-changer.
Steve Richardson is a founding member of the Virginia Independent Voters Association and serves on IndependentVoting.org’s national Election Reform Committee.