Healthcare: The Government Out; The People In

[W]e don’t think the government should be in control of all of this. We want people to be in control. said Paul Ryan, in 2010, at a health summit in Washington, DC.

In response, let’s consider the inevitable consequences of following through on the stated principles, and consider the potential for success with a centralized system. The three principles:

1. Healthcare should not be under government control,
2. We, the Republicans, want market controlled healthcare, and
3. People should control their healthcare delivery.

All of these concepts have their advantages. Those people who see the advantages are likely in a corporate structure with the primary objective of making a profit. There may be some objection if seen from points of view other than that of a healthcare business or conservative political leader.

The options are not totally binary. There are benefits from a capitalist free market and social benefits from government administration. Health can be optimized for the nation with capitalism that has strongly enforced protections for the consumer, and there can be optimal health with a socialist system that allows for some profit from competition.

In calculus, we took equations to their limits to get a better analysis of what they meant to do. We can do that in politics. From that conclusion we can measure whether the process will work toward improvement of the lives of most residents with a ceiling on profits or it will improve profits with a limit on healthcare for the people. The issue can be reduced to a balance between people and profit. It can be seen as a conflict of People against Profit.

The two conclusions have been adopted by two political parties. This makes for animated political conversation and even, as a result of human behavior led to some hostility and rudeness.

We will come together when we can discuss how to optimize both profit-from-healthcare and health-from-healthcare. Here are brief discussions of the above three principles:

1. No government control –-
   1. Personal profit view:
      This is the optimal situation. Fraud is illegal, of course. It is to no one’s advantage.Being able to make flashy advertisements to draw clients, and the ability of salesmen to make freewheeling oral statements, and all the methods available to deny claims and write in exclusions, make this the best healthcare system to make a profit. (The Michigan Supreme Court in 1919, declared the function of a corporation it to maximize profit. So it’s legal.)

      Corporations can see that well-paid officers get healthcare.

   2. National health view:
      Corporate officers will be protected by a national healthcare system.The function of insurance is to pool resources to cover losses for the contributors. Insurance can be administered by business structures for any risk exposure or by a central government for broader risk exposures.

      Regardless of who is the administrator, healthcare insurance needs funding collected from healthy people. The result would be care provided for rich and poor people, independent of their ability to pay. The form of the benefits would have to assume some limits to assure claims don’t exceed resources. Care would be limited to standards of successful disease treatment, not untested or expensive cosmetics.

      The role of government would be the most cost effective delivery system for a nation-sized beneficiary group. A government agency is more likely to protect the pooled tax funding.

2. Republican market control –
   1. Personal profit view:
      This political party is the representative of free capitalism.Capitalism is a system where a person in bad economic conditions is free to work their way out. Those with mental limits or physical challenges can get as much financial assistance as they are able to with their own initiative. Businesses have no obligation to society or their employees to offer any services like overtime compensation, healthcare, childcare, sick leave, or maternity leave. In the extreme, death is a natural consequence of starvation, so should not be manipulated by government or business intervention.
   2. National health view:
      The Republican view of healthcare is to put no limits on what a person can acquire for their care. They want all care to be accessible. The care provider is in business to provide those services and cannot do so if they don’t collect enough money to support themselves and some profit for the effort the put into maintaining the business operation. This can be consistent with a “personal responsibility” campaign that has no reason to offer care to those who can’t afford to pay for it.The corporate insurance will maximize their profit when they limit access, either in selling a policy to the destitute or limiting the benefits they pay out for anyone. The popular view when the public is polled is that a great majority wants access to care when they are sick, in pain, or in decline.

      The nation is stronger when everyone is healthy, so there should be very little limitation on access. A tax needs to be collected to provide funding to the risk pool. However, some adjustment needs to be made for the destitute and disabled.

3. People should control the healthcare system: Considering that everyone will need healthcare, a large number of people need to put in their opinion on how they want to access their care. –-
   
   1. Personal profit view:
      Capitalism is a system where competing corporations provide healthcare financing through insurance. The laws of costs and profits will be the foundation for that system. Patients (all of the people) have little control, especially when insurance corporations are lobbying for minimal protections for consumers.
      
   2. National health view:
      The people do not control day-to-day operations of corporate morality or money.The alternative is to have a governmental agency maintaining the funding of the risk pool and administering the payouts for benefits. A broad-based tax would be collected from the healthy and the ill. Adjustments would need to be made for those unable to pay due to incapacity or poverty.

      Universal coverage delegated to their government will include corporate officers and business people. It will cost less because it does not have the obligation to increase profit.

In response to three claims made by U.S. Representative Paul Ryan, this is a cursory review of the pros and cons for a government-administered universal (covering everyone) healthcare system.

Nationwide financial and patient-care outcomes favor a single-payer healthcare system with its broad-based financing rather than
a profit-incentivized capitalist system.