During the protracted debate on health care, President Obama encouraged action by asking Congress not to “make the perfect the enemy of the good.” While a clever rhetorical device, the statement is based on the tacit presumption that the health care reform bill was, in fact, “good.”

During the protracted debate on health care, President Obama encouraged action by asking Congress not to “make the perfect the enemy of the good.” While a clever rhetorical device, the statement is based on the tacit presumption that the health care reform bill was, in fact, “good.”


The reality is that Republicans did everything in their power to make the bill as unappealing as possible, and Democrats promptly obliged them with a series of odious political maneuvers and the kind of quid-pro-quo backroom deals that would make a prostitute blush.


When it comes to health care reform, Democrats and Republicans can’t even agree to disagree.


When Bill Clinton endorsed a single payer system in 1994, Republicans countered with a proposal to mandate the purchase of private insurance. In 2006, with the support of then-state Sen. Scott Brown and then-Gov. Mitt Romney, a plan similar to the Republican proposal was passed into law in Massachusetts.


During his presidential campaign, Obama explicitly opposed the concept of an insurance mandate, but subsequently signed a national mandate into law in the name of political viability. Conversely, both Brown and Romney now feign to oppose what is essentially the same plan they helped to implement in Massachusetts.


Regardless of its pedigree, the new law will ultimately fail for one reason: It won’t control costs.


Medical costs are crippling the nation. For every additional dollar we pay for health care, we forfeit the opportunity to invest in new business, repair our decaying infrastructure, educate our children and foster the growth of new energy sources to help limit our dependence on foreign oil.


Replacing the current plan with a single payer system would reduce some administrative costs, but single payer itself is not a panacea. The typical governmental response to rising costs — the imposition of artificial price controls — tends to distort market forces and exacerbate price inflation.


For example, when Medicare caps fees for expensive tests, physicians have been known to compensate for the loss of revenue by ordering more uncapped, less expensive tests that result in higher overall costs.


Complicating the situation is our irrational reliance on the insurance industry as the primary means of financing health care. Insurance is intended to provide a hedge against individual catastrophic loss, not serve as a payment mechanism for regular expenses. Using health insurance to pay for all medical care results in uncontrollable price inflation.


When money is tight, prices drop to meet reduced demand. When money is readily available, downward pressure on prices is lifted and inflation results. One hundred years ago, health insurance didn’t exist and Americans paid for their own care as needed. The wealthy typically advised their children not to become doctors because there was no money in it.


By the middle of the 20th century — when health insurance became the norm and providers were paid by the deep pockets of the insurance industry — prices began their inexorable climb and a medical degree became a status symbol.


Rather than focusing on the unique needs of millions of individual patients, providers now serve the financial interests of their true customers: insurance companies and the government. Patients ignore treatment costs and focus on their co-payments instead of the bottom line. This lack of direct financial accountability eliminates any incentive to control prices.


The new health care law not only retains the status quo, it mandates our participation and directly subsidizes a failed system with tax revenue.


Here are a few things the government should do instead:


· Retain modified versions of Medicare and Medicaid for seniors and the indigent.


· Implement a single-payer, universal health care system to cover all expenses associated with catastrophic illnesses. No American should ever have to face bankruptcy due to illness.


· Use the universal health care system to leverage subsidies for preventative measures and the treatment of those with chronic conditions. The economy of scale established by the creation of a national pool will provide tremendous purchasing power and drive down the costs associated with chronic conditions like diabetes. Preventative care, including vaccinations and regular check ups, improves health outcomes and decreases costs.


· Rely on the marketplace — not insurance — to establish competitive prices for all routine treatment that is not subject to universal coverage. Prices will drop as the market responds to the creation of a truly open and competitive system.


· Require the health care industry to provide transparent pricing information to help consumers make informed purchases.


· Provide tax credits designed to encourage consumers to choose the best care at the most competitive prices.


· Make Health Savings Accounts (HSAs) more accessible and consumer-friendly. Allowing more Americans to accrue tax-free savings for uncovered medical expenses will encourage personal responsibility and increase industry accountability.


The current health care reform law may be a small step in the right direction, but the need for further action is obvious. While the perfect may indeed be the enemy of the good, most of us would settle for the adequate.


Read more from Matthew Casey at matthewcasey.net.