David Haugen and Susan Musser, ed. Health Care: Opposing Viewpoints. Greenhaven, 2012. See here to purchase the book.
I decided to revisit the Opposing Viewpoints series. I read these when I was a kid. Although my mind was usually already made up when I read those as a child, reading the books gave me a more rounded perspective of the issues. The series includes articles from across the political spectrum on controversial topics.
This particular book is about the health care debate. Published in 2012, it talks a lot about the Affordable Care Act, but it also discusses the universal health care policies of Canada and Great Britain.
Here are some thoughts and observations:
A. The book has the typical saddening and heartbreaking stories about people in the U.S. who have suffered at the hands of the American health care system. Due to its costliness, people delay care until it is too late, they forgo care, or they get stuck with heavy medical bills. That said, conservative contributors highlighted where the American health care system is superior to that of other nations. The American system has a greater abundance of technology and more longevity for people with cancer and diabetes.
B. The introduction succinctly summarized the issue and the different positions on it. One of the causes of medical inflation in the U.S. is that demand exceeds supply. There is a shortage of primary care physicians, as many medical students gravitate towards more lucrative specialist fields. Conservatives have argued that, if there is universal health insurance, that will drive up the demand and thus health care costs, even as the supply remains stagnant. The Affordable Care Act has sought to incentivize primary care physicians, but people question whether the supply is expanding quickly enough, and some even contend that Obamacare has inadvertently driven doctors from the medical field.
C. Joe Flower and Carol L. Owen effectively explain why competition may not work its magic in the health care sector. Essentially, people trust their doctors, and the doctors refer patients to services that the doctors’ institutions themselves provide. The doctors have a financial incentive to overtest and overprescribe, and patients lack enough knowledge of their options to go elsewhere. Deductibles and copays give consumers some power, as consumers use their own money for care, but the costs are so high that many delay or forgo care. Health savings accounts are good, but only for those who make enough money to set them up. That said, the conservative voices do well to raise the argument that the current system suppresses competition and thereby elevates costs. Are medical and health insurance cartels truly necessary? And perhaps, in this age of the Internet, consumers can evaluate their options a lot better.
D. People across the spectrum agree that there are inefficiencies and redundancies in the American health care system. More than one contributor recommended an independent panel that would recommend cheaper and more effective care and treatments. Conservatives, of course, cried that this was rationing. Would not one expect conservatives to support such a measure, though, since it entails removing waste and saving the government money? Their opposition to cutting government funds to Medicare Advantage and Medicare is, likewise, odd, considering their usual criticism of the government doing things for people. At the same time, one conservative contributor makes an astute point when he states that the Obamacare cutbacks on Medicare fail to sustain Medicare or take care of the Medicare deficit, since they simply use that money for Obamacare.
E. Not surprisingly, the book is rather dated. It was published in 2012, and the Supreme Court decisions on the Affordable Care Act had not been decided yet. Advocates of the Affordable Care Act are predicting lower premiums and lower deficits; the lower premiums did not take place, as far as I know. Conservative Michael Tennant’s contribution reminded me of one of my problems with the right during the Obama years. They criticized Michelle Obama for pushing policies to encourage nutrition. “How dare she tell us what to eat?”, they yelled. But something needs to be done in that area, since poor eating results in high health care costs.
F. Michael F. Cannon offers a noteworthy defense of bringing free-market competition into the American health care system. He proposes a tax credit for individual purchase of health insurance. Interestingly, he does not propose raising taxes on health insurance that companies provide, as Republicans during the Bush II years did as a way to pay for the tax credits for individual purchase. Cannon seems to support tax credits for both. He appears also to have faith that enough individuals will purchase insurance to create a sizeable enough pool that spreads out the costs. Cannon, like others in the debate, has problems with the current system, which ties having health insurance to working for a company; what happens if that person is fired?
This is a worthwhile book to read. I knew a lot of the material in it, even though it was not organized in my mind. From the standpoint of a reader, the book is not as satisfying as a full book from one author expressing one position—-one just feels as if one has eaten a meal with such a book—-but it does present an overview of the different perspectives, for those who do not have the time or energy to read entire books devoted to particular viewpoints. The book would have been better had it discussed the positives and negatives of tort reform, but perhaps other books in the series do that.
I checked this book out from the library. My review is honest.