Wednesday, August 12

How to improve health-care without spending other people's money

John Mackey, CEO of Whole Foods, offers 8 ways to improve healthcare, with no effect on the deficit:
Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed in America

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

1. Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

2. Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

3. Repeal all state laws which prevent insurance companies from competing across state lines.

4. Repeal government mandates regarding what insurance companies must cover.

5. Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

6.  Make costs transparent so that consumers understand what health-care treatments cost.

7. Enact Medicare reform.

8. Revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
Ezra Klein is dismissive and wants to talk about the effectiveness of subsidies. Done properly, subsidies are useful for making sure the poor have some minimal level of care, but I fail to see how they would improve care for the vast majority of (non-poor) people.

Which is probably why, as Wilkinson points out, Ezra doesn't normally spend a lot of time talking about expanding Medicaid in the context of reform, because it's a separate issue.  The problem of poverty, while important, does not bear on the problem of reforming care for the rest of us--which is also important.

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