Morgan Liddick: After all, who will pay for the health care fix?

Eureka! I’ve discovered a solution to the problem of health care. And as solutions go, it’s simplicity itself. No complex calculations, government oversight or schemes to entice participation, or force coverage. It will work for everyone, spawn no new forms and doesn’t require an enormous, extensive and intrusive bureaucracy. It will cover everyone, regardless of age, condition or personal predilections.

The solution? Pass a law mandating a minimum income of $90,000 a year for a family of four. Then people will be able to buy their own insurance.

For those who think I’m not serious, a simple question: Why is my solution so much more infeasible than one which promises “universal access to affordable, high-quality healthcare?” While only inflicting tax increases on “the rich,” mind you.

The answer is, it’s not. Universal health care that is both cheap and first-rate is a proposition absurd on its face. Let’s have a look at a couple of reasons why.

First, the universal part. Both Barak Obama and Hillary Clinton are explicit on this point: no one will be denied coverage due to family or medical history, illness or pre-existing condition. Think about that for a moment. You could drink like a fish, smoke like a chimney and juggle chainsaws for a living; an insurance company would still be forced to issue you a policy.

Not only that; because of the “affordable” part, the premium could not come close to reflecting a sane and sober calculation of the risk the company would be taking on. There are two solutions, and two only, to this situation: first, the company might be mandated to accept the risk, take the hit and pay up. This would lead to the rapid disappearance of private health care, as companies ran out of funds caring for the disproportionate needs of their sot-weed craving clients.

It is far more probable that you, mountain-biking, granola-crunching fresh air freak that you are, would subsidize their care through premiums which were considerably higher than that warranted by a calculation of the health risks you ran. You might consider this a direct tax and transfer payment, because that is exactly what it is.

In the end, that won’t be enough — unless you think that Americans are suddenly and rapidly going to become far healthier than they now are. Me, I’m dubious, especially now that the Hollywood writers’ strike is over. So I anticipate what both Mr. Obama and Mrs. Clinton do: Government subsidies to pay most Americans’ health care bills, an open taxation and transfer payment to individuals.

Another absurdity involves “access,” and particularly access to exotic and expensive, but life-saving, treatments. Heretofore, access to these treatments has been allocated by the classical economic relationship of scarcity and price. Take that away and we still have the scarcity — due to the physical limitations on research, development and the construction of very large and elaborate machines – but how will access be regulated in this case? Both the plans of Mr. Obama and Ms. Clinton are silent on this score, but without price allocation, one has a command economy — and everything that goes with it.

In a command economy, all decisions about who gets what are political. Make no mistake, once Someone Who Is Smarter and Better Than You gets the final word about who will receive gene therapy, tomographic imaging or microwave treatments for bone spurs, things will go South fast. All sorts of criteria will go into making decisions about treatment, and most of them will not involve medical questions.

Think of all the jokes you know about unresponsive HMOs. Now think of that HMO without any possibility of a second opinion — because that would be a waste of resources. Universal? Yes. Accessible? Maybe. High-quality? Hardly.

There’s obviously much more to talk about here: drugs, and why bashing the lowest possible price out of pharmaceutical companies will result in fewer lifesaving discoveries. Malpractice insurance, and why demanding that companies meet arbitrary, politically-contrived standards of coverage and price will result in less insurance — and less medical practice, not more. And above all, why promising to pay for improvements in care through “efficiencies” and “technology” is hogwash. But all that will have to wait for another time.

Meanwhile, consider a couple of facts about two other “universal” health care models: in France, a deepening deficit of billions of dollars threatens to overwhelm the system. In Britain, a review committee for cost effectiveness much like that advocated by Mr. Obama has rejected funding the use of drugs such as Erbitux, for colon cancer, Tarceva, for non-small-cell lung and pancreatic cancer, and Avastin, a drug used to treat bowel cancer. They’re expensive, but they save lives.

In the United States. For now.

<i>Summit County resident Morgan Liddick pens a Tuesday column. E-mail him at mcliddick@hotmail.com. Also, comment on this column at www.summitdaily.com.<;/i>