Americans for Prosperity’s Phillip Joffrion’s recent letter (“Bureaucracy solves nothing”) trots out familiar arguments against “Obamacare” comparing it to cell phones, computers and televisions. The intent is evidently to contrast free market innovation with ineffective government bureaucracy. This is a very bad argument for three reasons.
First, it compares apples and oranges. Health care is not an option consumers can embrace or reject. When in need of care, the patient can neither negotiate costs nor forego the service, and, as anyone who has endured a hospital stay can attest, charges reflect the consumer’s helplessness. If you think cell phone plans are unnecessarily confusing, check your hospital bill. We do not negotiate costs when the firefighters or police come to our aid, nor should we when we require medical care. Free market solutions work well when both sides are free to negotiate. Such is not the case in health care.
Joffrion’s charges about “Obamacare” and the government-run health care system are misleading, since the Affordable Care Act is still built upon private insurance and medical provision. He’s right that the law is ridiculously complex, but since health care comprises 20 percent of the American economy, it needs to be if the profit motive is to be corralled in the medical marketplace. According to FactCheck.org, 2011 saw a 9 percent rise in employer contributions of which 3 percent could be attributed to “Obamacare,” down from an annual 13 percent rise a decade before. Some of the increase derived from regulations limiting junk health insurance policies that private insurers had been foisting off on hapless consumers who could not otherwise afford insurance, and some came from pent-up demand from those who had deferred medical care or were denied coverage because of pre-existing conditions.
Most objectionable is the glib assertion that everyone knows government-run health care would never work. Wrong. From birth to death, the U.S. health care system compares poorly against foreign competitors. Our infant mortality rate is 7.0 per thousand. Canada’s rate is 5.1. Britain’s rate is 4.9. Our life expectancy is 77.5 years. Canada’s is 78.0 and Britain’s is 79.5. We pay through the nose for the privilege of these inferior results, spending 15.2 percent of GDP for health care ($4,271 per capita) while Canada spends 9.9 percent of GDP ($1,939 per capita). The British spend 8 percent of GDP and $1,675 per capita. We don’t have to go abroad. In this country, private insurers skim off 12 percent of premiums for administrative costs and profits. The comparable figure for non-profit insurer Medicare is 7 percent. History will judge whether President Barack Obama’s attempt to make capitalist medical care both fair and less expensive will prove successful. But government run? We might hope so.