Neither.

It’s an expense.

Health care is an economic commodity, just like food, clothing, shelter, cell-phones, cable television, and X-box 360s. And the health care system is simply an industry, or rather, an amalgamation of industries that provide preventative, emergency, maintenance, and palliative care; pharmaceuticals and supplies, and insurance coverage.

It might seem a bit of a stretch to compare a “need” such as health care to a video game system, which is clearly a “want.” But consider that most of us put those wants ahead of needs like health care, and instead of putting aside money from each paycheck to cover for unanticipated medical calamities, choose to invest in the latest Blackberry, which like an automobile loses a requisite amount of its value the minute you step out of the Verizon store. Putting money aside for health maintenance and emergencies is the furthest thing from our minds, which is why culturally we have come to rely so heavily on health insurance.

When the rainy day comes, as it is bound to do by the laws of nature, we are quick to curse the weatherman for his faulty forecast when we could have seen the clouds rolling in and carried the umbrella.

We don’t consider food, clothing and shelter “rights” that we are all entitled to. They are, in fact, expenses…needs that we have access to through the labor exchange. If a citizen is unable to exchange work for money, and cannot afford housing, clothing, and food, there are means—some government, read: taxpayer supported—to provide.  There is no need nationalize the food-manufacture and delivery system (although we do subscribe to an interesting system of government implemented agricultural price controls, but that is a topic for another blog). No one in Congress is calling for the nationalization of clothing manufacture, sales, and distribution so that the poor can afford what the middle-class and wealthy can.

OK, I admit that I am stretching the analogy and comparing apples to oranges. The fact is Americans need access to affordable quality health care. They can live with the Wrangler jeans donated by a charity or purchased for $5 at the Goodwill, if need be.  They cannot live well without preventative care and without a physician’s care for maladies. That doesn’t mean that we are entitled to that care. It doesn’t make it a right.

 That doesn’t mean that we can have the Xbox and insist that someone else pay for our child’s immunizations.  It means that we have to live within our means and we have to view medical bills as costs of living.

After talking with my students last night after they read two articles on the subject, I’ve  worked out a therapy plan for the crippled system.

Helen Wheales’ Health Care Plan

Reform the current entitlement programs: All sides in this argument agree that the health-care system in the globe’s most free and wealthy society is not working as it could and should. I know that some on the Conservative side of the aisle and my Libertarian pals will cringe at the suggestion, but the government should start reforming Medicare and Medicaid by expanding them to cover those 45 million people that they claim are currently underserved. This, of course, is in opposition to HR 3299, the Health Reform Act that aims to cure the nation’s malaise by mandating coverage to all citizens, currently covered or not, and creating a utopian, public-sector program.

Ideally, I’d like to see the big-Ms  privatized, which would iron out a lot of wrinkles, specifically where doctor access is concerned. Physicians are increasingly refusing Medicare/Medicaid patients not only because payments are slow in coming, but because they are low. This can’t get any better under the Obamacare consolidated insurance system—a single-payer system—in which salaried physicians are forced to accept a government-agency-determined pre-payment for delivery of care.

–Let market forces work their magic

It’s Econ 101- supply and demand.  Demand is a want or need backed by the almighty dollar. Supply is the ability to keep up with demand. The market equalizes when supply and demand intersect. In the case of health care, this creates a consumer-driven market. Prices should fall for things like a standard physicians visit when physicians are allowed to compete for patients by lowering rates, packaging services, and offering monthly fees and packages.

Insurance prices would be considerably more competitive with carriers competing for consumer dollars in a way not unlike Allstate, State Farm, Geiko, Safe Auto, and Progressive insurance companies compete to cover our autos.

This situation currently does not exist BECAUSE of government intervention in commerce, which prevents interstate competition in the health-care insurance industry. Eliminating this roadblock would be akin to tearing down the Berlin Wall, freeing us to shop around, to use the Internet, to create a la carte plans not unlike what the aforementioned car insurance companies offer. Consumer choice would drive the market.

–Shift away from discussions of Rights and toward discussion of Responsibilities

All of us need to take charge of, take responsibility for, our own health care. That might mean we invest in health care savings plans, and it might mean changing our diets, getting the suggested exercise.reventative care and healthy lifestyles as a matter of choice could (and should) affect insurance premiums, just as our driving record affects our auto insurance rates.
–Tort Reform

Nothing would lighten the costs of most doctors more than an overhaul of the tenuous relationship between the legal and medical professions. Tort reform lifts the heavy load of the excessive malpractice-insurance and liability premiums, which are passed on to the health-care consumer. Instituting reasonable protections, such as an early settlement system for claims against doctors, a “safe harbor” system which protects them from non-evidence based lawsuits, and special “health courts” where judges specializing in medicine would afford speedier trials, lowering overhead and creating a more open medical malpractice system that could even weed out those physicians who shouldn’t be practicing in a manner not unlike that which strips members of the legal community of their licenses when they are deemed unfit to serve.

 It is clear–major widespread changes are needed, but the current proposal making the rounds on Capitol Hill will not solve the problem and create affordable care that maintains, if not exceeds, the current quality of care we expect in the world’s most developed nation. Modest improvements won’t do the job, but neither will nationalizing the system.