People who want to nationalise healthcare are worried that they won't be able to put the cat back in the bag as Health Savings Accounts become more popular. There are already more than 3 million HSA owners, and the Treasury Department thinks that by 2010, HSA plans will cover as many as 45 million Americans. They will have invested billions of dollars to pay for medical costs in the future, and it will be politically impossible to take away this benefit at that point.
If you have a health insurance plan with a high deductible, you can put tax-free money into a Health Savings Account. You can invest in anything from savings accounts and money market funds to a full-service brokerage house. If you invest wisely, you could have well over $500,000 in your account when you retire. You will be able to use that money to pay for your healthcare in whatever way you please, tax free. You can go to the best surgeons or the doc-in-a-box that costs the least. You can also use acupuncture, homoeopathy, or psychic healers to treat a health problem. You should do business with the person who gives you the service you want at the best price for the quality. And since you're the one paying, it's entirely up to you. You can choose your own health care.
If people who want a single-payer system ever get their way, your health care would be in the hands of a government bureaucrat. Look at how health care works in Canada, England, New Zealand, and other parts of Europe that still have single-payer systems to get an idea of what this might look like.
Proponents of a single-payer system often point to Canada or England as examples of countries that provide quality health care to all of their citizens while spending less per person than the U.S. But if we look a little closer, we can see that these publicly funded health insurance systems are breaking down, the quality is low, and the costs can be quite high. When Canadians need health care, they have to deal with the following:
- It's hard to get life-changing surgeries done. If a Canadian is having a heart attack, they will get help right away. But if the surgery is "elective," which means that death is not likely to happen soon, the wait could be months or even years. On average, you have to wait 18 months for cataract surgery. On average, it takes one year to get a new knee.
- Lots of waiting. Every year, hundreds of Canadians go to Detroit and other U.S. cities for treatments like CAT scans, which can be done in just a few days. Most of the time, you have to wait six months in Canada. At the moment, there are waiting lists for medical procedures for 876,000 Canadians.
- The chance of dying goes up. On average, it takes a Canadian eight weeks to see a specialist and another nine weeks to get treatment. This is true even for conditions that will get much worse if they aren't treated right away. For example, the average time for a mastectomy is 14 weeks, which is long enough for the cancer to spread to other parts of the body. In fact, 28% of people with breast cancer in Canada die from it, while only 25% of people with breast cancer in the U.S. die from it.
Things aren't any better on the other side of the ocean. Because of a lack of money and staff, the British National Health Service has to cancel 410,000 surgeries every year. The London Sunday Times says that more than 1 million Brits are waiting for elective surgery right now. Thomas Cook, a British travel agency, is even thinking about putting together "sun-and-surgery" trips to Indian hospitals for British people who are tired of low standards and long waits for surgery.
The governments of Britain and Canada have the power to make health care "free," but they can't control how much it costs. So the costs are longer delays (which could be fatal) and fewer new ideas.
When you think about what's going on, it makes sense. Patients always use too much health care when they have universal health insurance, which always leads to a financial crisis. Because of this, promises about care for everyone and good care will always be broken. Because there are always only so many resources, single-payer systems tend to spend too much on primary care for healthy people while denying those with serious health problems more expensive specialist care. This is because most people (voters) are healthy most of the time, and people who are sick or dying are less likely to be able to organise into a political force.
The "freedoms" we have are what make the United States such a great place to live. Even though our freedoms seem to be under attack all the time, no other country has the same freedom of the press, freedom of religion, freedom of association, or free markets as the United States. Anyone who knows even a little bit about economics knows that free markets encourage competition and new ideas, which lead to lower prices and better quality.
Even though the U.S. health care system is not really a "free market," it is much more free than any single payer system. Our current health care system gives us some of the following benefits:
- Most of the new treatments and procedures that save millions of lives each year come from American companies.
- Almost every patient, from premature babies to older people with cancer, does better with U.S. medicine.
The United States has the best places to study medicine and train doctors.
Canadians might have to wait a year or two for hip replacement surgery, but they can have the same surgery done on their dog in less than a week. This is because veterinarians are competing for this business and coming up with new ways to do things faster and cheaper. Laser eye surgery is another example. This procedure is rarely covered by insurance, so laser eye surgeons have to compete based on price and quality. The price of most medical procedures has been going up every year, but the price of this one has gone down by 80% in the last ten years.
Unfortunately, U.S. healthcare policies still tend to limit competition, limit consumers' freedom of choice, and make people less likely to shop around for the best deal. So, there aren't enough options, and price and quality of service haven't been given much thought. Clearly, the answer isn't more government involvement. Instead, the answer is to let competition and the power of the market drive down prices, improve quality, and make care easier to get.
The answer is health savings accounts.
More and more people are realising that third-party health insurance payers are a big reason why medical costs are going up and the quality of care is getting worse. As more people sign up for HSA plans, the medical market has already started to become more open and competitive. There are now doctors who can be reached by phone, medical kiosks that are being set up in malls, doctors who only accept cash (and charge much less), and other direct competitors for the healthcare dollar.
Don't believe politicians who say the only reason they want a single-payer system is to help people who don't have insurance. If one group (like a government bureaucracy) is in charge of health care, they are in charge of one-seventh of the country's economy. Everywhere in the world where a central government has tried to run the economy, it has been a huge failure.
As reforms to public policy that focus on individual choice continue to spread, the result will be more prosperity, more options, and better value for everyone. As millions of people demand more policy changes that will bring back the values of freedom and personal responsibility that helped build this great country, the culture of dependence and feeling like you deserve things will start to go away.
The market will change as more people use health savings accounts. Innovative service providers will start to compete more on price and quality of service, and those who offer the best value will get rich. And all buyers will be better off.
