(Editor’s Note: The writer lives in Canada, and is writing from her experience with their government-funded “single-payer” health system. Many Canadians like their system and can’t understand the U.S. system of “the best health care a person’s money can buy.”
Many in the United States, who favor health insurance reform, feel single-payer health care, where individual practitioners, clinics, and hospitals would be paid by the government, would be better. Some Canadians and Britons, who have single-payer health care, aren’t so sure.)
I figure this is heresy, but I’m starting to feel that society would be better if health services were purchased through a free market based on consumer choice — not through a single-payer system, whether managed by government or big insurance companies.
Free Market Health Providers Would Be Accountable
And when you see, say, social workers who come and chat with people for months or years, never leading them to gainful employment, you have to ask why society keeps paying these people to make nothing happen. Could the answer simply be no accountability?
I wonder if it relates to the presence of bureaucracy, and the fact that the workers in the bureaucracy are working for their paycheck, but not personally accountable for the success or failure of the enterprise.
Free Market and Single-Payer Health Both Have Limits
There are necessary services that are far too expensive for an individual to pay for. Some means of paying for these as a society makes sense, though I think we need to look more critically at some of the expenditures in systems that go towards unnecessary or harmful products, procedures, medications, etc.
But a lot of services aren’t that expensive, but aren’t covered by our single-payer health system, even though they’re medically necessary. And the services that health care does cover are often inappropriate and inadequate.
Government Is Often Wasteful and Harmful
Ironically, the lack of accountability in the public system means that a lot of money is spent on things that don’t work, which fuels huge industries that sell questionable products — that harm the environment and human health — while limiting people’s choices.
Now this doesn’t mean I don’t think people should encourage each other, and work together, but this pose about the “system” really helping is just that, often — a pose.
My Experience on Government Welfare
I’ve been in it, and I’ve seen it. I’ve been on welfare.
The rates are so ridiculously low you have no security, yet they claw back so tight that they disincentivize work. You’re treated like crap and end up feeling crappy about yourself.
The only way to move on with your life is to get out of that system, as impossible as that may seem. You’re not going to get anywhere with the “help” of the social worker who chats with you, but at the end of the day just walks away with their decent middle-class income.
Capitalism Might Be Better If….
These criticisms don’t just apply to publicly administered bureaucracies. They also apply to big, impersonal, profit-making corporations. Neither socialism or corporate capitalism is the problem or the solution.
Well, socialism is giving me some pause right now as a system.
Capitalism might work better if we had an economy of independent producers, and a good flow of materials and services through this economy, coupled with high participation encouraged by a culture of encouragement and optimism.
It’s problematic if the alternative to markets is bureaucrats deciding what people should be able to have and do — whether the bureaucrats work for the government or a giant insurance company. At least in a small business, where owner-workers have a stake, they have reasons for making good decisions.
If prices reflected all the real costs (e.g. air pollution), we could have a system where being thrifty also translates into helping the planet.
Let Patients Vote With Their Dollars
It would be better to give patients the power to spend their health care dollars on whoever is actually helping them, even if the health care dollars are entirely from taxes.
Give patients a certain amount they can allocate, based on the amount that the current system already spends per person – and if someone has greater needs that require a higher amount of money, e.g. for a surgery, find ways to apportion that.
That way, bad care would no longer be rewarded, and patients would effectively be voting with their dollars. We deserve better.
Government Welfare for Doctors
Right now we’re engaging in a kind of welfare for doctors. They have professional associations, and power in society, so that whatever they define as an acceptable standard of care is what happens, the patient be damned.
The government just forks over money, simply because they have medical degrees, not because they have proven results.
1. If patients were actually choosing where the health care dollars were going (kind of equivalent to spending their own money), things might correct themselves. In my case, almost none of my healthcare dollars would go to doctors.
2. The way in which medicine is taught and practiced in this country is really problematic, in my opinion. You hear so many horror stories, and you can’t help thinking that if Joe the mechanic can’t get away with returning cars that are still broken, how come high-paid MDs can essentially get away with doing that to people’s health?
3. I think doctors should get paid based on results. Maybe eventually the incompetent ones would just stop practicing medicine. And if that happens to be a large portion of them, so be it. They haven’t earned the privilege.
Why is free market or single-payer health care better for you?