GI health care is DOA

[Originally posted by Keith Murray on August 1, 2009 on Google's BlogSpot]

If one dispassionately considers--from a secular, world-of-business perspective--the idea of government issued health plan for all who live within America's borders, such a plan ends up DOA--the call is not even a close one! This is the case for a variety of reasons, but some of the more obvious ones--from a marketing professional's point of view--follow:

1. First--and what is most obvious--free universal health care won't be free! This obvious reality is surprisingly unquestioned by most people on the street, but the simple issue is...how could any sophisticated health care delivery system be free, really? To the contrary, it'll be paid for by a lot of people in different ways, i.e., via new taxes, but it will certainly not be free! It is stupid for anyone to refer to it as free--that is simply not going to be the case.  In marketing representations, there's the potential for statements that are clever, sometimes-the-case claims [usually modified with small print...but likely not a good idea in the first place]--and then there's misrepresentation.  "Free health care" is the latter for most consumers of the product.  

2. Not only will it be not be free--it'll be more expensive! The price [read "cost"] of universal medical care will be more, not less; this is because there enormous inefficiencies inherent to all socialistic programs and also will have added overhead in the form of government regulation and bureaucracy. If the heretofore recognized reality of "crisscrossing" rate of tax dollars were to apply, current shrinkage from payer-to-Treasury-back-to-beneficiary by 50% in most other programs will certainly be true for health care taxes-to-recipient as well. In terms of the current proportion of GDP devoted to health care--this reality will have a profound impact on final medical "costs"; for current levels of service they will most certainly increase, not decline.

3. The vast majority of citizens currently have health care coverage of one kind or another--and, by most estimates, are generally satisfied. By the calculation of none other than the Congressional Budget Office, 85% of Americans presently have medical coverage. Of the remaining 15%, it is estimated that up half of them are young people who have made a conscious decision not to purchase coverage, preferring, instead, to spend their financial resources another way. Most of the balance are thought to be illegal citizens who otherwise already receive medical care in emergency situations or when called for. 

Never in a million years would a thoughtful management decision be made to swap out a market offer that in one way or another appeals to the dominant majority of the market for an untested, unproven, and unknown product substitution. From a secular, business POV, to make such a change would be unthinkable; never would a firm contemplate introducing a product replacement costing many trillions of dollars more in the face of such market acceptance and satisfaction--in effect, to re-formulate the entire product offering to serve the questionable interests of less than 15% of the of entire market!

4. The delivered health care services are bound to be inferior. The envisioned health care change advocates point to will most surely be of lesser quality. In effect, health care delivered by government employees--even when they are physicians and nurses and physical therapists and others--will amount to services rendered by shift workers. No one in any large metropolitan area today who has need for and can afford the services of a marriage counselor, social worker, or child worker seeks to procure those services from city, county, or state agencies; instead, services rendered by private professionals are universally acknowledged to be superior--categorically. A universal health care model, in effect, makes everyone the client of vital services otherwise provided to those who have least ability to afford and appreciate them.

From a secular business perspective, one size never fits all. The competitive marketplace in the U.S. has proven to supply superior product alternatives in aggregate for cars, clothes, electronic devices, entertainment, airline services, whatever you might name; one is challenged to name a part of our lives where the free-enterprise system has shown itself to be inferior to government services when it comes to the delivery of services to its rank-and-file citizens.

Indeed, the government has yet, despite efforts and claims to the contrary, to provide quality commercial services in terms of railroad transportation [think Amtrak] or mail and package delivery [think USPS]--why should it be different for medical services? Even today, people avoid VA or county hospitals except as a last resort for affordable care--the scale effects of universal health care provided by government will compound the reality of these inferior, already existing health care "products."

5. A single-payer health care system would wipe out private competition insofar as services and funding alternatives are concerned. The simple reality is that private health care services--and the insurance plans that make those possible for the majority of Americans--will go away. Employers will seek to off-load health care costs to the government; government provision of services or any feasible government reimbursement plans will--for lack of funds and interest in preserving a private, alternative system--make it impossible for non-government service providers or private insurers to offer services.

A way of looking at how government control of health care services would be like is akin to when a family seeks to provide a private education for their offspring. Families who pursue this objective have to pay twice for the education of their children--first to support the public school system their child could be a part of [but which they think or know to be inferior to another private vendor] and then pay again for educational services from a private or religious provider of educational services. The government has consistently shown itself to resist supporting a voucher system in education, so it is unrealistic to think that such a plan would be endorsed for health care either. With the exorbitant taxation required to support a national health system on the part of citizens who pay taxes, the opportunity to find discretionary financial resources on top of that enormous tax burden, would be prohibitive for almost all who otherwise would like to seek health care services from non-governmental sources.

America's competitive, free-market has been the perfect model in innovating, creating, and refining the delivery of goods and services in virtually all sectors of the economy; indeed, the government has historically focused on bringing down so-called monopolies--simply to foster healthy competition and create a marketplace for getting superior goods and services to buyers.

When it is observed that the U.S. health care system is inferior to other models throughout the world, proponents of that point of view are hard pressed to provide compelling evidence of this claim; citizens from countries [frequently singe-payer plan countries]--those bordering the U.S. as well as those on the other side of the world--come to the U.S. for superior care, not the other way around. Few depart America for better treatment, most arrive with exactly that as an explicit objective.

In short, from a secular, business-world perspective, government-sponsored health care simply is fatally flawed. That everybody gets the health care they need is a very worthy public policy goal--one, incidentally, that is currently being provided to Americans universally in addition to illegal resident aliens as well! That everybody could get an improved-but-undefined health plan that will be better and cheaper is simply an implausible proposition, one that defies all the financial, commercial, marketplace realities that have been "in-play" for a very long time in the world we know.

The discipline imposed by a free-market, private enterprise system in health care is essential to continue the benefits of a great if not perfect system of health care delivery. To think differently is to defy economic reality and flirt with what in the secular world of business would be considered a genuinely crazy, unworkable idea.