I am opposed to a national health insurance for all citizens, a so-called one-payer system. As an insurance agent with 30 years experience, I am sure that the present system of competitive health insurance plans run by private enterprise is imperfect but fundamentally superior to a government-run system. I will list some of the reasons:
Competition:
Private health insurance plans must compete for business. As with other things Americans buy, the marketplace has spawned new and varied plans with price competition also, which helps hold down costs. The 50 states of our nation have done a fine job regulating the insurance industry, and do so much closer to home. Regulation of insurance is a matter covered by the 10th Amendment, reserved for the states and not a federal power.
National health insurance would be run from Washington, DC, with the terms of coverage and the costs determined by Congress. There will be no other choices, period. This greatly diminishes personal liberty and decision making, hallmarks of our American heritage.
Care Decisions:
Private health plans for individuals, families and groups offer a certain set of benefits. Purchases are made based on features and costs the buyer likes best. But, the attending physician is the final decision maker as to the care given to a patient, not the insurance company. The insurer may require certain things like prior notification for a planned hospital stay, but the attending physician is the final arbiter of the plan of care. Some confusion can enter the picture when an insured is not familiar with the details of their own insurance coverage.
National health insurance would entail the U.S. government dictating not only the terms of the health coverage, but also decisions about the kind and amount of medical care allowed to be given, rather than the physician. Please note, this is a conflict of interest, to have the payer be the care decision maker. It creates compromise. That is why the grand term one-payer system is not an accurate explanation of what America would be getting.
Inefficiency:
America has advanced much farther than most of the world in areas of housing, personal transportation, through productivity which translates into its citizens spending a very low percentage of their income on food, drinking water and utilities, for example. Our private enterprise system has led to innovation in areas from agriculture to electronic technology. Competition facilitates price stability and affordability. Health care has been singled out by national health insurance proponents as one area of our economy that should not be run for-profit. But there is little justification for this reasoning. Americans spend much more on housing and transportation, for example. Why no outcry that the very houses we live in and the cars that we drive are built by large corporations for profit?
Government-run programs are notoriously wasteful and slow to change. Furthermore, physicians under national health care will end up working for the government directly or indirectly through very tight controls and standards as to treatment, cost of treatment and compensation. The best physicians will get out of medical practice under such conditions, because the incentive to excel, to build a private practice, to make care decisions as a professional will all be comprised.
In conclusion, the debate over health care has become even more confused by national health insurance advocates claiming that access to health care is a constitutional right. It is not. The preamble to the U.S. Constitution touts that our federal government was to " ... promote the general welfare ...," not to guarantee the general welfare. It is not the fault of government that any of us get sick, or that we get aged. But some cry that Washington, D.C., should be our savior in every area of life. The horrible financial condition of our federal government alone necessitates rethinking that philosophy. Let's not surrender any more individual liberties.
