 |
The Cure: How Capitalism Can Save American Health Care, David Gratzer, MD, 2006, Encounter Books, New York, 233 pp., $25.95. |
This book presents a three-part vision for revolutionary change of the U.S. healthcare system. First of all, healthcare must be individual; secondly, the FDA must be reformed and downsized; and thirdly, today’s workers must be allowed to save for the healthcare expenses of their elderly years.
We’ve Done Everything Wrong
Dr. Gratzer documents well our past failures and supplies the history of
how our present system evolved. His conclusions: We have done everything wrong.
Giving choice to government and corporate bureaucrats has robbed patients of
choice and flouted the laws of basic economics. Modern American healthcare,
which began only six decades ago, is an accidental system that largely arose
from a fluke tax ruling during World War II. That’s when our employer-based
health insurance system began, a system which does not tax employers on employee
health insurance costs. This employer-based system has robbed individuals of
choice and sent costs spiraling into the stratosphere. To this point, four
decades of attempted reform have been disastrous. Every federal law passed
has had unintended consequences. Federal meddling has led to rationing and
price controls.
Dr. Gratzer does not believe that there are 46 million Americans on any given day without health insurance. He thinks that 93 percent of Americans either have insurance or have ready access to insurance and that the government’s efforts to help the remaining 7 percent of people are deeply misguided. His documentation of his statistics is footnoted as a story told him by a colleague.
Healthcare costs have escalated because state governments require so many things to be covered. As a result he recommends a national market for health insurance and just state voucher programs for dealing with the uninsured. He believes that Medicaid is a failed experiment that should go the way of other federal welfare programs.
The Medicare Disaster
Medicare is also a disaster that must be reformed. If you have never been
an admirer of Rep. Wilbur Mills, you will enjoy Gratzer’s ridicule of
this former chair of the House Ways and Means Committee and the father of Medicare.
The problem with Medicare, says Gratzer, is that it is inadequate, inefficient,
inequitable, and insolvent. Combine these four I’s with poor physician
participation, regulatory excess, and uneven service and you have a program
that needs to be junked. Gratzer’s solution is to immediately replace
Medicare with a system like the Federal Employees Health Benefits program that
would give older Americans choice, competition and minimal regulation. He also
does not think anyone under 70 needs to be covered by such a system.
Because pharmaceuticals are costing so much, this part of healthcare also needs reform. The FDA is identified as the problem because is takes too long to approve new drugs. The solution is to get rid of hungry trial lawyers and Washington bureaucrats, make the approval process for pharmaceuticals quick, just evaluate safety (don’t worry about whether a drug does any good) and the result will be more and cheaper drugs produced.
Learn From Others’ Mistakes
We can learn from mistakes made by Dr. Gratzer’s home country where
rationing is draconian and patients in need of healthcare have to travel to
the United States. Although he deplores a single-payer system, Gratzer believes
that the European-style mix of government and private universal healthcare
is no better; all healthcare systems except ours are anti-innovation.
His prescription for America: By making health insurance an individual responsibility, employment will be taken out of the equation and insurance made truly portable. By allowing individuals to direct their own healthcare and by promoting health savings accounts, healthcare in the United States can be saved. Bring competition back to American healthcare.
Dr. Gratzer closes this book with these words. “Capitalism is not the cause of America’s healthcare problems. It is the Cure.”
And if you believe this, I’ve got this great piece of property in Colorado for sale.
Gary Vander Ark, MD, is clinical professor of neurosurgery at the University of Colorado Health Sciences Center. He is the 2001 recipient of the AANS Humanitarian Award.