I’m listening now to a panel discussion at the America College or Cardiology Health System Reform Summit. The panel’s topic: “Health Care Reform: State Models for Improving Access to Care.” The panelists: Secretary Kimberly Belshe or California’s HHS, John Holahan of the Urban Institute, and Paul Wingle of Massachusettss Commonwealth Health Insurance Connector.
So far, I’ve heard a lot about Massachusetts-style reform programs, which basically break down to mandating that everyone carry some form of insurance and then figuring out a way to help them pay for it—usually this means businesses and governments kicking in a good share of coin.
Given the realities of the health care industry, namely that professional and ethical standards result in nearly no one being turned away when they’re in dire need of care, insurance mandates seem like a sensible policy. In other words, because everyone is going to end up using health care, everyone ought to be paying into the system.
This position is seen by the folks on the panel as the “middle of the road” position—somewhere between free market devotees and those who will accept nothing short of the UK’s NSH. But what isn’t being address are the thousands of pages of regulation that distort the economics of the health care industry, not to mention the distorting effects of Medicare and Medicaid and their blank-check approach to publicly-financed health care.
While Romney-style health care programs appear to be the go-to solution for those involved in healthcare, they also need to assemble commissions both at the state and federal levels to examine regulation and recommend sunsetting on those regulations that are found to shift costs from one group of payers from another, inflate costs through blank-check approaches, decrease price transparency, reduce competition among caregivers, or otherwise distort the market.
As a libertarian, I’d like every industry to move closer to a free market model because of the efficiencies that I believe would be gained to the benefit of all those concerned. But, being a realist as well, I understand that insurance mandates coupled with government subsidies for that insurnace might be more of a gain for the market than for government. However, it seems that is only true if the regulations that have been used in the past to micromanage the industry are significantly reformed.