Harry Neuwirth

Harry Neuwirth writes from Salem, Oregon.

In 1925 while I was still mastering the intricacies of infancy, it was not yet reasonable to calculate health care's percentage of gross domestic product, but it was surely less than five percent. We almost never visited a doctor and went to the hospital only for such things as ruptured appendixes and massive injuries. Only the wealthy had a doctor, and as for home remedies, the same bottle of nasty tasting stuff apparently served to relieve sore throat, upset stomach, and earache; it cost little, and lingered in the medicine cabinet for years.

Health care was primitive, but through the 20th century, only modestly inhibited by government, medicine transformed into a highly effective, sometimes miraculous practice: people today having their hearts replaced when necessary. During the period of transformation society redefined health care as a valuable commodity necessary to a happy life, while only recently have politicians made it a government benefit. During those decades of improvement -- and intrusion -- the real benefit of healthcare has grown until its dollar cost is calculated to be sixteen percent of GDP.

No one suggests that we go back to less prosperous days. Costs have gone up as we have the means for longer, more comfortable, enjoyable lives.

There is legitimate complaint over the cost of medical care with Congress ostensibly working hard to make healthcare at its best and most expensive available to everyone. Congress is agitated with the notion that only a bureaucratically managed healthcare system can provide an acceptable level of care to everyone. But the fact is that our legislatures, federal and state, have been, and still are directly responsible for most of the excessive cost and inefficiency of healthcare.

Most if not all states do not permit out-of-state insurance companies to offer health policies. So, while we pride ourselves on the competitive nature of business in America, it just isn't true of the insurance industry. I cite the example of my wife's and my own experience here in Oregon in 2009 where her Medicare supplement costs $2991.69 annually, while my own coverage, unavailable to her because she applied after Oregon slammed the door on out-of-state coverage, is $1935.87. That $1055.82 annual disparity has bled our modest substance for many years now. Congress could overcome state selfishness by applying the interstate commerce provisions under section eight of the Constitution to the insurance industry. Competition would reduce the insurance increment of healthcare costs significantly as surely as it does for the lipstick and motor oil companies. It would inspire insurance companies to develop better, more flexible policies as well.

Similarly, tort reform could address several problems. It will surprise no one to learn that the huge jury awards in medical suits benefit attorneys far more than the clients they profess to represent as they drive medical practitioners into a financial corner by requiring them to carry more and more expensive malpractice insurance as an act of professional self-preservation; doctors have to run unnecessary tests on expensive equipment to meet unrealistic demands. The attorneys resort to snake oil advertising in the media to attract the gullible. Eliminate waste by means of tort reform? Congress could do it in a minute.

Divorcing health insurance from employment would be another great help to citizens in need of health insurance sold competitively. But Congress insists that only employers receive tax privileges in establishing coverage, providing insurers with breadth and depth of coverage; pools that could just as easily be formed by occupational groups (such as the United Commercial Travelers which Oregon denies to my wife), neighborhood alliances, church affiliations, etc. Such allegiances typically travel with members through life, unlike employees who are frequently laid off or who seek more appropriate employment, while voluntary associations reinforce social stability and establish insurance pools.

We ought not be concerned over an industry that is absorbing an ever-greater percentage of GDP so long as that increase is the result of customer demand coupled with progress without waste, misappropriation, or congressional legerdemain.

Why hasn't Congress raised a stabilizing hand over a burgeoning society with legislation that would not have disrupted free choice nor laid an unconscionable tax burden upon us, and our grandchildren? They might also have, as an increment of qualification for grants and funding, laid a restraining hand upon society through the schools and the other myriad grantees by asking them to inspire and educate Americans in the pursuit of healthier lifestyles.

Politicians are driving talented people away from becoming doctors and nurses; talented people who would have been assets to the profession and have provided a downward pressure on costs. Congress has claimed an undeserved reputation for hard work on behalf of their constituents when in fact Congress, past and present, is the culprit whom we continue to reward at election time! *

"In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself." --James Madison, Federalist No. 51