Possibly the most concise and readable explanation of why health care and insurance have become so expensive and beyond the reach of many is contained in a new book by Sally C. Pipes, president of the Pacific Research Institute, a think tank based in San Francisco: "Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer." Pipes is a Canadian who lives in the United States. She fears, "If (the United States continues) on the present path of giving more and more power to the state, this country will suffer the same problems as are being faced north of the border."
The book is a short but well-researched and well-reasoned critique of the American and Canadian health care systems. Pipes writes, "The public needs to know that it can safely move away from a tax system that encourages employer-provided health insurance. In Canada, the public must be weaned off a system in which public health care brooks no competition. In both instances, less government intervention can yield greater affordability, access and quality."
Preferential tax treatment was given to employers as a concession following World War II when wage and price controls were in effect. The controls are gone, but the preference remains.
Pipes also believes true medical reform must include giving individuals a chance to purchase health care with pre-tax dollars, whether or not they have a job. "Such a legislative change," she writes, "would break down the third-party payment system and reform the way health care costs are paid. Health insurance would be returned to its proper role of providing coverage for catastrophic events. Individuals could join all manner of voluntary groups, seeking the best deal and the health care plan that is right for them."
There is much more in Pipes' book, including recommendations for moving away from the dominant system of insurance in the United States - managed care - and toward a system directed by consumers, such as Health Savings Accounts, which empower individuals to make decisions affecting their health.
The Bush plan fulfills more of Pipes' recommendations than the Kerry plan. Armed with such information and given the power, individuals can make their own choices - for better and more affordable health care, and for a president who will allow them to have it.
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