One serious problem with many health policy discussions is a failure to define terms.
Health is a broad and amorphous term that can be expanded or contracted depending upon one’s feelings towards one’s interlocutor. It is a state that one goes into and out of based upon the exchanges and transactions one makes with his fellow man that has nothing to do with the benefit structure in an accident and sickness insurance contract.
See also: Gross, but adjusted
Competition is required for property to evolve. In the United States, competition is lacking in the market for the primary contract for accident and sickness insurance for oldsters and those with end-stage renal failure.
Competition is also lacking in the market for delivery of medical education, and for the delivery of practical medical training in a controlled environment — a teaching hospital.
Giving Americans a stipend to buy the accident and sickness insurance contracts that satisfy their needs, rather than a bureaucrat’s wishes, will lead to efficient use of funds while making the provider deliver medical care in an innovative manner.
Everyone knows Medicare has too much first-dollar coverage and not enough catastrophic coverage. But eliminating the tax-exempt status of medical schools and hospitals while telling 55 million Americans that Medicare should be changed would be political suicide. The only way medical schools and hospitals will evolve is by changing their corporate structure.
Genuine health care reform requires term limits for politicians, an appreciation in Washington of the importance of private property, and an honest discussion about legislative mistakes. This is impossible given the current poisonous cultural atmosphere.
Advocates of government intervention often criticize the free-market approach by using the slogan “Profits before people.”