The war between Universal and Market-based healthcare

In the world of health care, a war of philosophies has been raging for almost two decades – some could argue longer. If you’re scoring at home, the two sides of this battle are the government solutions warriors and the market solutions champions.

The team fighting for government to control America’s health care system identifies the ultimate goal of their plan as “universal health care.” So we’ll call them the Universals. If they win, all Americans will receive their health care as an entitlement from the federal government, which by definition will be paid for with tax revenue. If you’re looking for an example of this plan in action, consider the European model.

The other team is fighting for market-based solutions, where provider competition and patient portability prevails. We’ll call this team the Markets, and they want individuals to be able to make their own health care coverage decisions, pay for insurance coverage and treatments with before-tax dollars and become health care consumers, not just patients. The fans of the Markets think individuals, not the government, should be able to determine what’s best for them. The best example of success in support of this philosophy is Health Savings Accounts.

The difference between the two teams is actually quite simple: If you want to become a ward of the federal government regarding your health care services, root for the Universals. If you want to have more choices and control your own health care, cheer for the Markets.

Ironically, in 1997, a Republican-controlled Congress, typically on the Markets’ side, passed a bill called State Children’s Health Insurance Program (SCHIP). This provides coverage for children in families often called the “working poor,” households whose family income puts them in a kind of Never-Never-Land between Medicaid and an income level where they could afford to purchase insurance on their own. One argument against SCHIP is that families at the high end of eligibility may drop their own coverage, even when they can afford it, and let the government cover their children.

The health care war is heating up again, this time over SCHIP income eligibility - the Universals want to increase it. If passed as proposed, as columnist and Markets fan, George Will, reported recently, in some states the new family-of-four income eligibility level for SCHIP could grow to over $84,000, which is more than 400% of the poverty line and $30,000 more than the U.S. mean household income.

Adding irony to irony, the Democrats, a.k.a Universals, are using this Republican creation to do an “end-run” around the Markets to accomplish their ultimate goal. Indeed, Universal co-captain, Speaker of the House, Nancy Pelosi, called this increased coverage “a down payment on President Obama’s promise to provide universal health care to all Americans.”

If you favor the Markets’ philosophy, as I do, these are fighting words. Beside greater federal intrusion into my life as my primary objection to universal health care, there is also the prohibitive tax increases on small businesses that would ultimately result to pay for it.

Recently, Grace-Marie Turner (www.galen.org)joined me on my small business radio program, The Small Business Advocate Show, to talk about the health care war and the Universals’ SCHIP weapon. Grace-Marie is one of the world’s top thought-leaders on health care public policy, president of the Galen Institute a long-time member of my Brain Trust and a co-captain of the Markets. Don’t miss this opportunity to hear what this important expert has to say about the future of the American health care system. And be sure to leave a comment.

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