Sunday, April 22 , 2018, 2:46 am | Fair 55º

 
 
 

Harris Sherline: Solving the Health-Care Dilemma

There are simple solutions in terms of policy, but perhaps the core problem with reform is that Americans don't trust those who are leading the way

Just about everyone — left, right and center — seems to be weighing in on the health-care debate: nationalize the health-care system (as in Canada and the United Kingdom), require health insurers to provide coverage for everyone, merge Medicare and Medicaid into one common health-care plan for everyone, provide health care to the immigrant population, reduce costs by cutting Medicare payments to doctors and hospitals, etc.

Harris Sherline
Harris Sherline

The arguments rage back and forth, many anecdotal, others statistical or numbers based, but they all boil down to one basic issue: less government involvement vs. more government involvement in health care.

Having run a hospital for seven years, I have given this problem a lot of thought and would like to offer the following observations.

First, I admit that my bias is against any form of universal or nationalized health care, “public option” or otherwise. My experience has shown that a major cause of the problems with health care today is the extent of government involvement — federal and state — that already exists, such as the costs that hospitals are forced to absorb as a result of government regulation, mandating everything from details of construction and maintenance to cleanliness and the ratio of nurses to patients. One of the principal reasons for high hospital costs is government mandates.

There are simple things that would go a long way toward improving the health-care situation in the United States: tort reform, removing barriers that prevent health-insurance companies from insuring people across state lines, allowing insurance companies to offer a wide range of policies, fewer government mandates on health-insurance policies (such as pre-existing conditions) and medical savings Accounts, for starters.

ABC’s “20/20” co-anchor John Stossel noted: “‘Choice, competition, reducing costs — those are the things that I want to see accomplished in this health-reform bill,’ President Obama told talk-show host Michael Smerconish. Choice and competition would be good. They would indeed reduce costs. If only the president meant it. Or understood it. In a free market, a business that is complacent about costs learns that its prices are too high when it sees lower-cost competitors winning over its customers. The market — actually, the consumer — holds businesses accountable and keeps them honest. No ‘public option’ is needed. So the hope for reducing medical costs indeed lies in competition and choice. Today, competition is squelched by government regulation and privilege. But Obama’s so-called reforms would not create real competition and choice. They would prohibit it.”

Economist Walter Williams said, “President Obama and congressional supporters estimate that his health-care plan will cost between $50 and $65 billion a year. Such cost estimates are lies, whether they come from a Democratic president and Congress, or a Republican president and Congress. ... At its start, in 1966, Medicare cost $3 billion. The House Ways and Means Committee, along with President Johnson, estimated that Medicare would cost an inflation-adjusted $12 billion by 1990. In 1990, Medicare topped $107 billion. That’s nine times Congress’ prediction. Today’s Medicare tab comes to $420 billion, with no signs of leveling off. How much confidence can we have in any cost estimates by the White House or Congress? Another part of the Medicare lie is found in Section 1801 of the 1965 Medicare Act that reads: ‘Nothing in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine, or the manner in which medical services are provided, or over the selection, tenure or compensation of any officer, or employee, or any institution, agency or person providing health-care services.’ Ask your doctor or hospital whether this is true.”

I’m always struck by the disconnect that seems to exist when people complain about how ineffectively the government runs programs, yet they are willing to trust that same government to manage something as big and complex as health care. President Barack Obama summed up the inefficiency of big government organizations pretty well when he said, “FedEx and UPS are doing just fine; it’s the post office that’s always having problems.”

The following commentary on the health-care plan that recently circulated on the Internet sums up the situation rather neatly: “Let me get this straight. We’re going to maybe have a health-care plan written by a committee whose head says he doesn’t understand it, passed by a Congress that hasn’t read it but exempts themselves from it, signed by a president who also hasn’t read it and who smokes, with funding administered by a Treasury chief who didn’t pay his taxes, overseen by a surgeon general who is obese, and financed by a country that’s nearly broke. What could possibly go wrong?”

In the final analysis, perhaps the biggest problem with health-care reform is that Americans don’t trust the politicians who are trying to reform the system.

— Harris R. Sherline is a retired CPA and former chairman and CEO of Santa Ynez Valley Hospital who has lived in Santa Barbara County for more than 30 years. He stays active writing opinion columns and his blog, Opinionfest.com.

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