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Dave Allen: Health care system fails us all

10:47 PM, Feb. 16, 2013  |  Comments
Doctor rushing in hallway
Doctor rushing in hallway

I'm a car dealer. I'll sell you a car. It could be today or tomorrow or a year from now when you buy. You won't be able to choose exactly when. Let's say that a roll of the dice determines when you will have to buy the car.

Usually, I won't allow you to choose what the components are. I'll choose those components for you when your time comes.

I won't tell you what the car costs. After you drive the car off the lot, I'll tell you weeks or months later what the components are and what the cost is. You pay for the car and the components nevertheless, whether you need them or not. The more components I add, the more you pay. The more components I add, the more money I make.

If you want to find the cost in advance, you have to ask me what the components are; maybe I'll tell you and maybe not. Then you have to call each component manufacturer and ask them the cost of each component and then try to piece together the cost of the car. But the component manufacturers won't tell you how much of a discount they give to me, the dealer.

You have to do all this checking on your own time before I tell you to buy the car. So, in reality, it's very difficult to try to figure what the car costs in advance.

Every car is custom-made so you can't compare the models and components. I won't guarantee the car will get you where you need to go.

If the car breaks down, you're out of luck. I have your money. Too bad for you - no refunds. The car can go really fast, in a straight line. But it doesn't corner well, has very bad gas mileage and is constantly breaking down. Maintenance is very expensive.

Finally, for the pleasure of buying this car, you pay up to a 20 percent administrative fee so I can process the paper.

In a nearby country, cars are sold. They all come with standard components that pretty much work as advertised. In fact, most of the cars in this other country actually work better than the cars in your country. Citizens in that other country can negotiate the price but, because the major components are all standard, there's lots of competition for the buyer's dollars. In fact, in this other country, the total price of the car is 40 percent lower on average.

Usually, you can't go to the other country to buy a car there. Your lender doesn't allow it. Their government usually doesn't allow it. Your politicians say the other country is socialist and that, if you buy cars from them, your own car industry would wither away.

Your politicians say that the other country's cars are unsafe. Your politician's statements aren't true. You wonder why you have to pay 40 percent more for your inferior car than the citizens of the other country pay for their superior cars.

There was a time when this little story actually did reflect how the American car industry kind of operated. The arrival of high-quality Japanese imports, the lowering of trade barriers and the imposition of safety and performance standards allowed the American consumer to have real choice, based on consistent standards.

The result is higher-quality vehicles that are safer, consume less fuel and are more affordable than ever. It's a triumph of free-market forces because the government set a level playing field and required a minimum standards.

Now's the time to apply the same positive forces to the American health care system. In the United States, we obfuscate costs with layer upon layer of bureaucracy.

We encourage over-treatment by allowing doctors to get paid for services they provide, not by results they achieve.

We eliminate consumer responsibility by disconnecting the consumer from the consequence of their decisions because someone else pays for their health care.

We reduce competition in prescription drug pricing by restricting the importation of prescription drugs.

We protect Big Pharma by making it illegal for the government to be a single purchaser of drugs, like the Veterans Administration does.

We allow the health care bureaucracy to waste up to 30 percent of each health care dollar.

We reward people for shifting costs onto someone else, rather than by being efficient themselves.

We refuse to look at the cost-effectiveness of medical practices, lest we risk a shrill cry of "death panel."

And finally, when someone has the courage to lay out the obvious facts that, by and large, other countries have health care systems that are more cost-effective than ours, we shout "socialist" and "liberal," rather than engaging in a meaningful discussion.

A car company couldn't survive by operating as in the little story above. It would go bankrupt. Neither can a health care system.

- Dave Allen is a Grand Chute resident and a Post-Crescent Community Columnist. He can be reached at pcletters@postcrescent.com

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