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King: Follow the money in health debate
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This oft-repeated piece of wisdom is attributed to Deep Throat in the 1976 movie All the President's Men. Surely it's older than that. Money has always been a prime mover in man's machinations.

Understand incentives — and money is one of the strongest — and you solve all kinds of problems. In the 1700s, the British government paid sea captains to transport criminals to Australia as indentured servants. As many as a third died on route, and many more were near death when they reached their destination. It scandalized the British,
and the government tried one thing after another to fix the problem.

Only when they stopped paying for the number of men loaded onto the ships in England and started paying for number who walked off of the ships in Australia did the survival rate change.

In discussing the war in Afghanistan, a commentator asked his guest if he thought the Pentagon really wanted to solve the corruption issue. The guest said no. If the corruption in Afghanistan was exposed, Americans would begin questioning the billions and billions of dollars the U.S. has spent on the war.

People make money from war. If you want peace, the incentives for peace have to match and exceed the incentives for war. When private companies provide security and reconstruction in a war-torn area, they expect to make a profit. They may be experienced and competent people, but they have a vested interest in the status quo, not in a peaceful solution to the problem at hand.

In other words, individual security and reconstruction people want peace in Afghanistan, but the institutions that employ them profit from continued warfare.

The same is true in the political area. Congress is dysfunctional. The public is calling for change, but changing individual members won't help as long the system stays the same.

Congress makes the law. Its members are wealthy and powerful, and once in Washington they rarely leave voluntarily. However, it's pointless to vote them out of office as long as their successors inherit the same status and monetary incentives as their predecessors.

Congress as an institution doesn't want change. It's the same thing with our health system. Our doctors and hospital administrators are caring people. The chemists in our pharmaceutical companies want to make people well. The insurance claims adjustors want to help people, but the nation's medical system is broken.

Why is it that the U.S. is the only industrialized nation in the world that doesn't have universal medical coverage? Other nations do it. Why not us?

Look around. A number of countries have health plans that cost less and cover everybody. No plan is perfect, but most people who have universal health coverage are happy with it.

What do these plans have in common? They all have a single payer. In the U.S. socialized medicine is a dirty word. Perhaps we should look a little deeper. Who tells us that government funded health care means we can't chose our own doctor, that health care will be rationed, that grandma will sent off to die; and who benefits from the U.S. health care system as it is now?

If Canada's single-payer health system isn't doing a better job of negotiating lower pharmaceutical prices than U.S. insurance companies, why are so many American crossing the border to buy their medications in Canada?

This isn't a matter of right vs. left, conservative vs. liberal, Democrat vs. Republican. It's about every American's right to decent health care at a price they can afford. Next time you hear someone discussing the cost of health care, ask where the money is going and why?

Yes, costs are going up. More people are living longer and demanding more complicated and costly care, but we can do a far better job of managing these costs than we are now. Don't let politics and ideology get in the way.

Joan King lives in Sautee. Her column appears biweekly on Tuesdays and on gainesvilletimes.com.

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