Playing Politics with Your Health

By Marc Kilmer, posted July 27, 2009

One of the biggest misconceptions in the current debate over health care reform is that somehow our nation has a free market health care system. In fact, government already pays for around half of the health care spending in our country. At both the federal and state level, government imposes heavy regulations on the industry. What drives both this spending and these regulations is not a search for quality patient care or efficient medical spending. Instead, the pressure to please interest groups is what has largely shaped the government's role in health care. This won't change if President Obama gets his way and establishes a huge new government health insurance system.

Even a cursory look at Medicare, Medicaid, and the regulation of health insurance will illustrate this. Take Medicare. For over forty years, the federal government paid doctors when they performed medical errors. Instead of penalizing doctors when they did a bad job, Medicare rewarded them. Only in 2008 did the federal government take steps to stop this practice. Why did it take so long? The doctors' lobby is strong in Washington, D.C., and doctors will fight any efforts to reduce their payment, even if that payment is for a botched procedure.

Another example of the shaping of health care policy in order to benefit special interests is states' demand that health care providers obtain a "certificate of need" from the state before opening a new facility. In Ohio, if a long-term care provider wishes to open a new facility, it must go through a process where the state considers "the impact of the project on all other providers of similar services" in the area, as well as its "financial impact" on other providers. Essentially, this certificate can only be obtained if the new provider won't hurt long-term care facilities that already exist. That lack of competition is bad for patients but good for the established health care providers.

Government involvement in health care is full of these types of laws and regulations. That's because health care is a huge industry in our nation where companies make billions of dollars. These companies are not going to sit idly by while politicians write rules that affect them. They are going to be actively engaged in the process, ensuring that any laws that are written will protect them and their profits.

We already see this in the health care legislation moving through Congress. The pharmaceutical industry has pledged its support for health care reform. Perhaps not coincidentally, Senate legislation made it more difficult for generic drugs to make it to market.

This isn't to say that members of Congress are corrupt or on the take from these industries. The businesses represented by the lobbyists in Washington, D.C., employ us, provide us goods and services, and make our economy work. It's only natural that a member of Congress from a certain state will look after that state's businesses which employ and serve so many of his or her constituents. But that doesn't mean this system results in good laws.

Health care "reform" that emerges from Washington, D.C., isn't going to be real reform. It's going to be legislation that inserts politics even more firmly into your health care. Given how poorly Congress has managed the current health care programs (or the budget, or the economy or any number of other things), you will likely be getting the health care that lobbyists want you to have, not the health care you desire.