The health care reform mission is possible

Dr. Michael J. Pramenko
June 13, 2007

Print Email

    Your mission, should you choose to accept it, is to apply free market principles to a reformed health care system.

    Before you begin, remember that we currently provide open access to our emergency room. Remember the ever increasing state Medicaid responsibility in regards to nursing home care for low income seniors. Remember the need to provide important immunizations and care to our youngest citizens. Remember the average income earner who often can’t afford health insurance yet still pays taxes to fund Medicare and Medicaid.

    Suddenly, the mission seems a bit more difficult.

    How would a true free market system affect the above medical treatments? Would the majority of Americans want a free market approach to these treatments? Let’s examine those questions.

    First, a free market system requires competition. The Medicaid contracts in Colorado have been open to competition in Colorado for some time. Unfortunately, there is only one health maintenance organization that has continued to offer a Medicaid product — Rocky Mountain Health Plans. The other “free market/for profit” companies don’t care to help insure the Medicaid population. Fact is, unless you’re healthy and/or wealthy, the free market does not want to insure you.

    Secondly, a free market system restricts access. If one can’t afford the care, one will not receive the care. If one can’t afford the widget — they can’t buy the widget. So emergency room care, nursing home care or childhood immunization would be restricted to only those that can pay.

    In other words, applying a purely free market approach to health care reform would drastically affect our current health care system. It would change our current dysfunctional system with a rather “cold hearted” approach to medicine. Advocates of an exclusive free market health care system need to explain how they plan to provide basic health care for those who can’t afford the price. There are some that do advocate a pure free market approach. The Independent Institute in Denver is one organization that supports such a system.

    There is a better way.

    If we treat our health care system more like a public utility, we can begin to address the problems with skyrocketing costs while maintaining and improving our approach to providing quality care to as many Americans as possible.

    Some government involvement is necessary. How else do you provide access to care for those that otherwise can’t afford the care? How else do you provide nursing home care for seniors with limited resources? How else do you care for poor children? Fact is, we must share the responsibility of these costs if we wish to continue compassionate care. Nevertheless, there will have to be limits to what the government can provide.

    Currently, we are sharing society’s medical costs through various forms of cost shifting. If you are insured, you are paying the hidden health care tax with higher insurance rates. If you purchase a product made in America, you are paying the hidden health care tax. If you purchase health care out of pocket, you are paying the hidden health care tax. This IS socialized medicine.

    Let’s make these hidden taxes more transparent. By reforming the health care system in a comprehensive manner, we can. More importantly, we can create a better and more sustainable system with comprehensive changes.

    Critics of health care reform remain in denial about our current situation. Some of these critics favor a health care system where the free market decides who receives medical care. We need to keep them honest during the upcoming health care debate.
As I have mentioned in previous columns, we already have a universal socialized system of health care accessed through the emergency room. It just happens to be the most expensive health care system in the world.

    Universal and socialized. Yes — that’s where we are. As with patients, you can’t prescribe the correct medication if you don’t accurately assess their current problem. Health care reform is no different. We must admit where we are now with our health care system before we can make any meaningful changes.

    That mission is possible.