Why government cannot cure our health care


There are few things more important than our health and our health care. Solving health care for everyone is critical to becoming a healthy, vibrant society. Because our government has controlled our health care for two generations, election realities and political rancor obscures our ability to collectively solve the problem. Allow me to use a fictitious government program, “Foodaid,” to defray the noise and illustrate how government-control of our health care is the problem and not the solution.  Thankfully, the private sector is showing us a way forward.

Imagine if our government managed how we purchase food like it does our health care industry. That is, instead of food stamps, where individuals use vouchers to buy food in a transparent and competitive marketplace, the government controlled the entire industry. Foodaid (for our most needy) and Foodcare (for seniors) would manage all transactions; real prices for food would be unknown. Those lucky enough to be employed may have FoodCross and FoodShield cards that allow them to shop at Trader Joe’s and Whole Foods. All others would be in a single check-out line staffed by TSA types that make certain that you are “buying” your mandated rice, fish, and kale that industry lobbyists were able to foist into your shopping cart. Grocery stores would be massive with wonderful marble entryways and maybe even a water feature.

Ridiculous? Yes, absolutely.  However, this is essentially how our government has controlled our health care for 50 years. This third-party government control of the industry makes the provision of care costly and inefficient and it opens the door to all manner of fraud, waste and abuse. This may be one of the reasons that, per capita, Massachusetts is one of the most expensive places in the world to obtain health care.

The real problem with government control of our health care is that political realities trump the needs of the citizenry.  That is, inside the beltway, contributors matter much more than constituents.  Ryan Grim wrote about these realities regarding the VA scandal recently in the Huffington Post. He writes that the average politician must spend 4 hours per day fundraising. It should come as no surprise then that as the deliberations of the Affordable Care Act (ACA) were proceeding during the recession of 2009, lobbying contributions reached an all time high with health care leading the way. Even more telling is the revelation by Glenn Greenwald in the Guardian that much of the ACA was written by an insurance industry lobbyist.  This may help explain the ACA’s lack of a public option and a reinsurance tax placed on every American as a hedge for, you guessed right, the insurance industry.

John Mackey, the CEO of Whole Foods, had our answer to health care in 2009. His decentralized, collaborative and empowering model for care solves both our cost and access challenges. By  self-insuring their health care employers have embraced these account-based health plans that is the basis of Mackey’s solution.

This will drive transparency and competition in our health care sector and begin the dismantling of our overpriced government health care industrial complex. That is if politicians (and lobbyists) don’t intervene.

Matt McCord is an anesthesiologist. He is founder, Michigan Alliance for Sustainable Healthcare, and can be reached on Twitter @MattMD.


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