Candidates promise health care reform

As Americans increasingly look to the government to solve all their problems, health care reform has become major issue on the campaign trail.  It's not just the Democrats with their socialist solutions, Republican candidates are touting it as well:

WASHINGTON, July 5 — There is no better measure of the power of the health care issue than this: Sixteen months before Election Day, presidential candidates in both parties are promising to overhaul the system and cover more — if not all — of the 44.8 million people without insurance.

I guess I'm skeptical of any policy that has the word "reform" or "overhaul" in it.  Somehow it always leads to more government and less freedom.  How about reforming government instead?  How about checking the Constitution before proposing any legislation?    The much maligned Republican candidate for President, Ron Paul, has a pretty good handle on what to do about health care:

As a medical doctor, I’ve seen first-hand how bureaucratic red tape interferes with the doctor-patient relationship and drives costs higher. The current system of third-party payers takes decision-making away from doctors, leaving patients feeling rushed and worsening the quality of care. Yet health insurance premiums and drug costs keep rising. Clearly a new approach is needed. Congress needs to craft innovative legislation that makes health care more affordable without raising taxes or increasing the deficit. It also needs to repeal bad laws that keep health care costs higher than necessary.

We should remember that HMOs did not arise because of free-market demand, but rather because of government mandates. The HMO Act of 1973 requires all but the smallest employers to offer their employees HMO coverage, and the tax code allows businesses – but not individuals – to deduct the cost of health insurance premiums. The result is the illogical     coupling of employment and health insurance, which often leaves the unemployed without needed catastrophic coverage.

While many in Congress are happy to criticize HMOs today, the public never hears how the present system was imposed upon the American people by federal law. As usual, government intervention in the private market failed to deliver the promised benefits and caused unintended consequences, but Congress never blames itself for the problems created by bad laws. Instead, we are told more government – in the form of “universal coverage” – is the answer. But government already is involved in roughly two-thirds of all health care spending, through Medicare, Medicaid, and other programs.

For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high-quality, affordable medical care, and thousands of private charities provided health services for the poor.  Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.

The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone – doctors, hospitals, patients, and drug companies – to keep costs down. As long as “somebody else” is paying the bill, the bill will be too high.

Rudy Giuliani's free market approach is certainly more desirable than Hillarycare:

Mr. Giuliani, currently leading opinion polls for the 2008 Republican nomination, wants to move tens of millions of people from employer-based health insurance to the individual market as a way of giving people more coverage choices. It is an idea he alluded to in Tuesday's Republican debate in Manchester, N.H., and later expanded on in an interview.

[...]

The plan, which Mr. Giuliani said he hopes to unveil in detail this summer, launches the health-care debate among Republican candidates and provides a contrast to the push for universal coverage aided by government subsidies emerging from the Democratic field.

The principles Mr. Giuliani identified for health care mirror President Bush's call for an "ownership society" in which the power of the free market could eventually shore up health and retirement security programs alike. That concept proved a political failure when Mr. Bush used it in 2005 to argue for partial privatization of Social Security. But in the campaign to woo Republican primary voters, it could provide Mr. Giuliani with an issue to appeal to economic conservatives at a time when some social conservatives have misgivings about his support for abortion rights and gun control.

In Mr. Giuliani's view, the U.S. health-care system's major problem is a lack of consumer choice. "It's your health; you should own your own insurance," he said in Tuesday's debate. "The reality is that we need a free market."

He envisions a system where neither state regulations nor federal tax law push people into expensive plans rich in benefits. Rather, health insurance should be more like car insurance, he said, where people pay out of pocket for minor repairs and maintenance.

In the world of "co-pay" this will be a hard sell.  (Employees at my company complain about having to pay even the co-pay.  If it goes up five dollars, the whining begins.)  If, however, Giuliani's approach led to lower insurance premiums it would be a great improvement over the current mess.

Mitt Romney has a little problem with Republicans because of the health care reforms enacted while he was governor of Massachusetts.  While defending the legislation as right for Massachusetts, Romney says it's not what he would propose for the whole country.  Sounds a little problematic to me:

As he campaigns for the White House, Mitt Romney has had to tap dance around the health-care reforms he enacted while governor of Massachusetts. The first bit of bad news was that the plan’s cost was higher than predicted. Then it reneged on its commitment to cover the uninsured. But the latest bit of news about “RomneyCare ” may require even fancier footwork.

The Left is now thanking Romney for making HillaryCare respectable again.

                [...]

By bundling the tax dollars of six million Massachusetts residents, Mitt Romney may have made the largest contribution yet to Hillary Clinton’s presidential campaign.

To make matters worse for Romney, his Massachusetts plan was praised by Hillary, John Kerry, and James Carville:

"To come up with a bipartisan plan in this polarized environment is commendable," Sen. Hillary Clinton told the Associated Press on Thursday.

[...]

"I like this health care bill that's passed," Sen. John Kerry told radio host Don Imus Friday morning. "I think it's terrific. Massachusetts has set a good course on that and I give everybody involved in that credit."

[...]

"It's a feel-good story, this Romney thing. Republican Governor. Democratic legislature," Carville told the AP. "Romney is an ascendant guy."

Not surprisingly Romney is running from his Massachusetts reform:

...Mr. Romney, on the campaign trail, talks generally about getting “everybody inside the health care system,” through “market reforms” state by state to make private insurance cheaper and more available. But not, he says, “with a government takeover.”

Sally Canfield, policy director for the Romney campaign, says that Mr. Romney is proud of his record, but “the Massachusetts plan was crafted for Massachusetts,” and that a national plan would be different. For example, aides said he did not support a federal version of the Massachusetts requirement that individuals obtain insurance.

Whatever Republicans can come up with will be vastly superior to anything the Democrats are proposing, that's a given.  But unless it means (much) less government involvement rather than more we can expect to see costs continue to rise and satisfaction with our health care delivery system to continue to decline.