Engineering Thinking teaches us to challenge our assumptions, because if they are wrong, then our subsequent analysis and decisions will be wrong.
The healthcare challenge — it is commonly assumed — is this: how can the government best ensure that the weakest members of society receive adequate health care?
This is the wrong question. The reason it is wrong is that it is based on the flawed assumption that the government should be making our health care decisions. As discussed previously (see “Feedback, Prices, And Sullen Spouses“), the government is inherently inefficient, and is therefore the last organization that one should ever select to provide a service.
But what is the alternative?
First, remove health care from the tasks assigned to governments at all levels: federal, state, and local. This will substantially eliminate the tremendous waste of dollars caused by having inefficient bureaucrats positioned between patients and their doctors, and — just as importantly, if not more so — eliminate the moral hazard created by providing “free” services to those who may not deserve them, at the expense of diligent and hard-working taxpayers.
So who takes care of the poor, the unlucky, the out of work?
We do. But we do it through our local communities, through our churches and charities and civic associations. This was done before the advent of Big Government and worked well (see “What Would Happen If The Government Didn’t Take Care Of Us?“), and it can work well again. Local communities will be able to evaluate best who deserves help and how much and on what terms, eliminating the moral hazard. The rest of us will continue to pay for our own medical coverage. Government’s function will be reduced to its proper function, that of ensuring that insurance companies operate transparently and honestly in a competitive environment.
Does this sound simple? It is simple. Politicians and their special-interest allies (whose prestige and livelihoods depend on fooling you into providing your tax dollars for their grand and impractical ideas) would prefer that you think that all of this is too complex for you to understand, and that fairness can only be assured by putting your faith in the government.
Are you not yet convinced of my analysis? If so, I doubt I can change your mind, and respect your right to your opinion. But I would ask you one question:
Have you ever been asked by a relative or a friend for a favor, such as loaning them some money? If so, I’m sure that you based your decision on your personal knowledge of that friend or family member. But what if someone on the other side of the country that you don’t even know asked you for a loan? Would you give it to them? No? Then why on earth are you so willing to give your tax dollars to anonymous bureaucrats to give to anonymous people who may or may not deserve those hard-earned dollars?