Neither Public Nor Private

Meet another red herring in the health care debate: the notion that the U.S. primarily has a private health care system now and is pushing toward a more public one during reform. Functionally we have neither a private nor public system, or at least that’s what you’d have to conclude if you follow the money.

Consider that the federal government spends $1.2 trillion on health care, about 60 percent of the estimated $2 trillion spent annually, with the Feds offering roughly $200 million in tax subsidies for employer-sponsored insurance to boot. Hospitals, private practices, clinics, and businesses like medical imaging, hospital supply companies, surgical device manufacturers and pharmaceutical companies as well as dozens of other for-profit and non-profit entities would be hamstrung if not bankrupt without it.

Had it not been so embarrassingly ironic at the time, the “keep your government hands off my Medicare” utterance might have been handled as a tremendously teachable moment.

As for the present moment, let’s stop kidding ourselves about government incursion into the business of health care when it’s government that makes the business of health care boom.

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