^{Posted on January 22, 2007}

Letters: Rethinking health care options

Flies in Register’s ointment

Saturday, January 6, 2007
Orange County Register

The Register’s editorial, “A healthy dose of free-market forces”[Jan. 2], makes a case for controlling health care spending by reducing government insurance programs and encouraging lower-cost private coverage options that shift more of the spending responsibility to the individual. Such changes theoretically would reduce the “perverse
incentives” to obtain too much care if the individual had to pay for it directly.

The problem with this theory is that most of us need very little care, and the marginal services that we would decline are only a very small fraction of our nation’s total health care bill.

The real reduction in spending would occur with average-income individuals who develop major medical problems and need care.

This reduction would not be the result of informed health care shopping, but it would occur simply because the individuals could not pay the out-of-pocket expenses that would be required by the stripped-down, lower-cost plans.

This is not simply theory, since it has been well documented repeatedly in the health policy literature.

If we follow the Register’s recommendations, hundreds of thousands will suffer needlessly, and tens of thousands will die.

Don McCanne, M.D.
San Juan Capistrano