A few years ago, Arnold Kling, an economics professor at George Mason University, presented an interesting description of the type of health care system that Congress is planning to impose on all Americans. With Medicare's unfunded liabilities in the multiple tens of trillions of dollars, it is like the Titanic sailing full speed ahead with icebergs all around. It is ultimately going to sink. There is no avoiding it on the current path. The proposed health system will add many trillions more in unfunded liabilities. It is the equivalent of adding more passengers to the Titanic and more icebergs to the freezing water.
The utopian vision underlying the plan is a world where everybody can have everything without paying the price. Dr. Kling described an "iron trilemma" in healthcare, but I think that it can be modified and generalized for any type of social program. It is like a three legged stool that needs all three legs to stand. The first leg is access. The system must be designed so that nobody is excluded. The second leg is the goods. Participants should be able to get the latest, greatest and best quality stuff available. The third leg is cost. The overall financial burden of the system must be minimized.
It is obvious that you cannot have all three legs at one time. If everybody has access to everything, including the most expensive procedures, goods and services, then the cost will be sky high. If everybody has access and the overall costs are minimized, then, necessarily, expensive goods and services must be cut out, no matter how much some individuals desire them. If, instead, the system provides expensive goods and services, then in order to keep the overall costs low, some people must be excluded from access to those services. Whichever pair is chosen, the stool must fall over. The three legs, universal access, unlimited consumption and low cost, cannot exist together. The claim that the proposed system will increase the number of people covered without decreasing quality and availability medical goods and services to each and, at the same time, significantly cut the cost of health care in America is absurd. It is an impossibility. Something has to give.
One of the assumptions is that, under the government plan, waste and fraud will be cut out and greedy profiteers will be reined in. An obvious question comes to mind. If the government is able to root out waste and fraud and greed, why has it not done so with Medicare/Medicaid, the government monetary system, the military, banking, the education system, the bailout fiasco, cash for clunkers, and on and on. Politicians have not done so, and will not in the future, because they benefit greatly from fraud, waste and greed.
The central planner's paradigm is the fundamental error in the present health care discussions, the idea that some smart person can and should design a universal system which will fit every person in the country. In reality, health care is merely a market for goods and services. Nobody plans a market. It is made up of the billions of interactions of the participants as they attempt to achieve what they value the most. Think about it. Our food supply system is incredibly complex, involving hundreds of millions of people with widely varying tastes and budgets, hundreds of thousands of separate merchants and traders, and vastly different geographic areas. Nobody plans our meals, yet Americans get fed at a very reasonable cost. The overall cost is low because individuals are responsible for their own expenses and decisions. The same could happen with health care if all of the government induced distortions were removed, including pretax employer based insurance plans, mandated coverage, anti-competitive and monopolistic government programs and the use of hundreds of billions of dollars of tax money, which inflate prices and distort the true markets beyond recognition.
Charity is important, and it is right and good for individuals and organizations to help the poor. Health care and charity, however, are vastly different entities. Mixing them confuses the issues of both and hurts the poor more than it helps.
Our three legged stool in health care is tipping over because it cannot possibly stand over time. If health care in America is to stand strong again, we must throw out the stool and the socialist ideals that support it. We must let Americans stand on their own two feet and take individual responsibility to pay for whatever level of insurance or service they desire.
Dan McLaughlin is a columnist for The Post-Journal. Contact him at danmcl999@roadrunner.com. Visit www.aboutfreedom.org/ for more columns and information on freedom and limited government.