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Isn't the whole health care debate a Catch-22?

First, let me present some insight borrowed from a writer on Open Salon... "In rough terms, the people who support the free market solution also support reduced government control. Yet the problem is that in order to use the market, the entire incentive structure for what the market seeks to achieve needs to be revised. The present system incentivizes a number of specific practices that allow insurance companies to make money by clever games of finding people who are cheap to insure and getting the most money out of them, and trying hard to exclude people who are expensive to insure. In order for health care to mean “health care for all,” not just “health care for the employed” or “health care for the healthy,” we need to revise the rules. But if the people who are promoting a market-driven approach are opposing regulation, that can’t be done. Those people need to decide whether they want to really help, and if they do, they need to make some serious concessions toward appropriate regulation. The market will not do to this on its own. It has no incentive to. And markets are everything about incentive." Source: http://open.salon.com/blog/kent_pitman/2009/08/22/medical_care_and_the_free-market_catch-22 Also: "the notion that free markets are efficient is simply absurd. they might be better than markets controlled by the wealthy, but free markets invariably become controlled by the wealthy." "The focus by some conservatives is on the loss of a certain freedom in the market, but that freedom is only there for people with a lot of economic power. Many just take the one health care plan they can afford at the one job that would hire them, for example. Some don't even get a health care plan where they're hired. Some aren't hired, and so don't have the “freedom to work.” Some have to work at a crappy job that might not even use their skills or pay otherwise well because it offers the health care they need. The point is that as some freedoms are secured, others are lost, so it's not as simple as those would describe who think that “government care means definitively less freedom” and “private care means definitively more freedom.” The most important freedom in our world is “having enough money” and if one cannot find well-priced health care, there is no money left for the exercise of any other freedom, so the matter is one of pure and uninteresting philosophy to many." "I have a difficult time understanding how people think an institution established to offer a service to others – a public service -- is more efficient by virtue of making a profit. It seems like an illogical assertion. It’s sort of like saying, “I can give you more if I keep some for myself.” It would seem to defy the laws of physics. Of course, there is the moral dilemma of profiting from the misfortune of others." "The idea is that if a private system has to compete with another private system, the only profit it can take (absent situations that are supposed to be illegal under antitrust legislation—enforcement of which is another missing pillar of the modern competitive marketplace) is that which still keeps it competitive with other players in the market. The theory is that the desire to make this profit is so strong that it will drive efficiencies even greater than what the public system will because there is an incentive to innovate in order to achieve better profit." In a nutshell: public-run institutions lack the motivation to innovate; however, private profit-run institutions seek only to create profits through any means necessary. Usually this is done by insuring the healthy, who are a source of income for insurance companies, and denying coverage to those whose poor health would make them an unprofitable investment. It's really simple economics. Insurance companies evaluate risk and determine coverage and premiums based on a person's likelihood to use said coverage. A good example would be flood insurance. Insurance companies have decided that those who live in flood plains, i.e., high risk customers, are not eligible for flood insurance because they pose such a high risk. So those who are likely to need flood insurance are not able to find affordable coverage. On the other hand, people who live in areas with very low risk of flooding may be wary to purchase flood insurance, seeing it as an unnecessary bill. Just as healthy people who can afford health insurance will oftentimes decline to purchase it. But the only way insurance companies can be profitable and still provide affordable coverage is if every person is covered -- that is, those who are at risk along with those who are not. So essentially, people who do not need or use the service end up paying for those who frequently need or use it. We see the same problem with the uninsured in our current system. The insured inevitably end up paying to cover the uninsured through higher insurance premiums. Requiring all people to have insurance The rest of my long-winded argument got cut off, and unfortunately I lacked the foresight to copy and save it in case I had to re-post or add to this (hindsight is 20/20, after all). But I think you can get the general gist of my argument, so this should suffice for now. Basically, aren't both options ultimately bad? Public government-run insurance versus private profit-driven insurance -- one seeks only to increase in size and funding, with no real incentive to improve (government), and one seeks only to amass profits for their shareholders (private insurance), with no real incentive to provide quality affordable health care to those who truly need it.

Public Comments

1. The whole debate is not a catch-22 problem as Obama is offering a solution to this. If more knew the facts, then things might change. FACT - Insurance companies in the USA admit to pushing up prices, buying politicians and not paying out claims when they should FACT - PER PERSON the USA spends more on healthcare than any other nation on the planet FACT - Obama debated his plans before the election for healthcare FACT - the chance of a child under five of dying in the USA is greater than industrialised nations with universal health coverage FACT - Obama was elected by the American people to bring in change FACT - Obama wants to stop insurance companies from screwing the American people FACT - The reforms Obama wants work in the Netherlands and Switzerland
2. Democrats will eat their on health care at this point, and cant reform health care without some form of rationing limited resources to care to people gain the most benefit from it. Both sides in health care are wasting time without cost controls on care the bill the cost will continue to explode. Example one why does provider A charge 900 dollar for a colonplosy while across the road the other provider charges 3000 dollars for the same procedure. Example two have Partrick Swazi has cancer with survival rate of 5% and $50,000 dollar medication only prolongs life by six weeks. These items need to be addressed before we cant start to bring costs down.