It seems to me that legislatures do everything in their power to make things more complicated than they ought to be. Take healthcare for instance.
Here is the healthcare law I would write:
- The government offers free, single payer health care to anyone who wants it. Walk in, sign up, get an appointment, see the doc.
- The current, insurance based, for profit medical care delivery system is allowed to operate exactly as it already does. Anyone who prefers that system is allowed to use it.
- That’s it.
Let people choose for themselves. If they want to buy insurance, let them buy insurance. If they want to get their care from billionaire corporate owners, let them. If they think the best doctors drive BMW’s and Mercedes-Benzes, let them go to those doctors and pay the bills however they see fit. Provide the minimum regulation required to make it harder for outright thieves to operate openly and otherwise ignore them. Insurance and medical practitioner regulation are primarily state obligations and that is fine. Leave it that way.
If, on the other hand, people are broke or can’t afford to participate in the for-profit system, offer them a complete system at no cost, like the system that Veterans enjoy today.
Insurance companies don’t want to insure sick people anyway. Why should taxpayers force them to take our money when they don’t want it?
Is there a possibility that the free government system might be slower and clunkier than the sleek profit-based system? Yes. And it’s all right. The grim fact is that most people who would otherwise die of their diabetes or cancer are willing to wait in line a little longer, and are willing to have to order their medicines in advance by mail. The alternative is a slow, painful death. It’s not that hard a choice.
The government could start out paying existing for-profit hospitals for care, a la Medicare, but it wouldn’t take long to build up a parallel system. Leave the for profit system alone to do what it does best: separate fairly healthy people from their money. Hospitals are continually closing all over the United States, particularly in rural areas. The Federal government should buy them, refurbish them, and operate them to provide treatment. Staff them with Federal employees.
For profit medicine is opening up storefront clinics and “urgent care centers” in cities all over the country. A single payer Federal system could easily do the same. It’s not that expensive to stock a storefront with a modest amount of doctor’s office equipment and hire a couple of nurse practitioners and some office staff. The truth is that nurse practitioners are, in most cases, better trained and equipped than the MD’s of my earlier adult years. A complete blood lab costs less than a new Chevy and will fit on a table top. Give a homeless person the choice between a friendly nurse practitioner and coughing his guts up under a bridge and I don’t think he’d have much trouble deciding.
This doesn’t have to be that hard. The only thing that makes it hard is figuring out how to get the rich their cut of every public dollar. If we give up on that part, we can do the rest.