Coming to Agreement on the Healthcare Problem, Not Solutions

Former Rhode Island Director of Health and current advisor to the mayor of Central Falls Dr. Michael Fine believes in a government-directed, centrally planned health care system, so it’s somewhat surprising to agree with most of what he writes in a very long essay he’s posted on RIFuture:

Understood another way, health insurance has become a form of wage theft, and we have a wealth extraction system, not a healthcare system. Our culture has frightened and bullied people into buying health insurance, though the money they spend for insurance doesn’t have much impact on how long people live or on how healthy we are. Most of the money people spend on health care ( though their insurance) is unnecessary or wasted, but is profit for the health care profiteers – insurance companies, pharmaceutical manufacturers, hospitalists and specialists. None of us actually voted for that money to be removed from our paycheck, although more and more money comes out of our paychecks each year, because of medical care cost inflation. And what we don’t see and so never look at is how much money we would have made as raises and bonuses if our employers weren’t spending so much of the money we earned on medical care and health insurance we didn’t ask for, don’t want, isn’t helping us and is both unnecessary and wasted.

Fine’s entire essay makes an excellent argument for conservative health care reforms that free the system from government meddling, although Fine doesn’t see it that way.  He wants the government, by force, to set up community health care centers that can be carefully controlled — when it comes to prices, services, underlying principles, and so on — from a centrally run, government-managed center accessible through the political process.  (Clarification: accessible to progressives; conservative reforms would be treated as heartless and fascistic.)

Such solutions skirt right past the underlying problem, which is that the people making judgments about and authorizing health care services (the patients/clients) don’t have to consider price directly with each decision.  Fine and his ilk would rejoin authority and price in central planners, meaning they’ll tell people what services they can have and providers what prices they can charge.  That won’t solve the problem; it’ll make it worse, because the decision makers will be disconnected both from the lives at stake and the wallets being pilfered.

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