Health care mess |

Health care mess

Since I began writing about Medicaid expansion we’ve received a lot of calls and emails about health care in general. The common theme is anger. People are upset about what the federal government has done to the health care business in the United States, and I don’t blame them.

People also want to know what can be done about it. From a state senator’s perspective the answer is — not much. States really are at the mercy of the federal government when it comes to this. I often direct people to our federal congressional delegation (Rep. Adrian Smith, Sen. Deb Fischer, Sen. Ben Sasse) to help answer that question, but they are just three of 435 members of congress. The bottom line is simple; the more the federal government is involved in health care, the worse it will be. Obamacare was supposed to be the solution to this mess, but like every other government health care programs before it, it just made things worse. Why is that?

Because the government is a third-party payer.

When you buy things with your money for yourself, you are a first-party payer. You are very careful about price and quality. You want the highest quality for the lowest possible price. If you buy something for someone else, now you’re a second-party payer. You’re still very careful about price, but quality isn’t quite as important. This also works in reverse. If you are consuming something that someone else pays for, you are really concerned about quality, but couldn’t care less about the price. Any father (like me) who ever got roped into paying for an open bar at a wedding reception understands how this works. Nobody ever orders the cheap stuff when it’s free.

Now when it is not your money paying for something, and you aren’t the end user or consumer of the product or service being purchased, then you are not concerned about either the price or the quality. This is a third-party purchase. By definition, everything government buys is a third-party purchase. The government spends our tax money on things it won’t use. It doesn’t care about the price or the quality. This is how we end up with $640 toilet seats and $7,600 coffee pots, and any number of other shocking examples of government waste. This is why Abraham Lincoln said “government should do only those things that a man can’t do better for himself.”

I think we should give President Lincoln’s suggestion a try. What if Americans were able to buy health insurance for themselves just like they buy anything else, like home owners insurance or car insurance? Insurance companies, hospitals, clinics, doctors would all be working night and day to get our business. This is just eighth grade economics. Every single time you introduce competition into a system, whatever that system provides gets better and cheaper. Every time you get the government involved, you get increased costs, reduced or denied medical service, and waste and fraud.

If Medicaid expansion passes on election day, we will all get a fresh new example of this sad mess. In the end, the people the program is supposed to help will be the one’s it hurts. I recommend people vote against Initiative Measure 427. The sooner we can get government out of the health care business and make health insurance a first-party purchase again, the sooner we will get the health care we all want.

Many ideas for this writing were found at Prager University at

Please contact my office with any comments, questions or concerns. Email me at: Mail a letter to: Sen. Tom Brewer, Room No. 1202, P.O. Box 94604, Lincoln, NE 68509 or call us at (402) 471-2628. ❖

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