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Dr. Taylor Dickinson's articles and essays discussing his ideas on tax-preserved Universal healthcare...

Health Care Reform Redefined: The Problem

Posted: Wed, Aug 12, 2009

By Taylor Dickinson

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The mantra driving healthcare reform is cost. But there is another common thread. The introduction of private health insurance significantly altered medicine. The new players, Medicare, Medicaid, private- sector insurance and managed-care organizations all function within their own self-interest. Their common interest requires the control of cost. Increased cost threatens their profit and control of medicine. But their self-interest has failed to produce a viable healthcare system. Why not?

When viewed in toto the incentives which motivate the health insurance industry, government entitlement programs, and providers of care are clearly quite disparate. The first protects its profit margin as it sells to business. Business facilitates this effort by ignoring the consequences of restricted access to care on its employees. Government entitlement programs protect the political interests of their tax revenue sources. To them, health care is a line item in government's budget considerations. Thus the two major funding sources for healthcare have incentives to curtail its supply. On the other hand providers of care have no economic focus beyond their responsibility to their patient's well being. Each reduction in funding or access to treatment will result in attempts to compensate for this infringement upon their ability to provide care. As economic pressures increase their incentive degenerates into a pattern of frenzied service to their patients colored by their ligitimate need to earn a living. Given these divergent incentives no rational medical marketplace exists. This is economic chaos.

Without a rational marketplace, costs will continue to spiral out of control while access to care slowly disassembles under the pressures created by inappropriate fiscal policies. The healthcare debate will degenerate into a power struggle over the protection of corporate profit and the government's monopoly. This government has the opportunity and responsibility to change this dynamic.

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