Monday, November 3, 2008

WSJ on AZ "Freedom of Choice in Health Care"

The November 1, 2008 issue of the Wall Street Journal makes some interesting observations about the proposed Arizona ballot initiative:
Who could be against an initiative that protects the right of patients to choose and pay for a doctor or a health plan? The answer is proponents of a health-care system run by the government. For them, enshrining into law protections for private health plans is anathema. Believe it or not, the Phoenix Chamber of Commerce also opposes the initiative. Its big health-insurance members want to protect their interests as contractors to the state's Medicaid plan.

Democratic Governor Janet Napolitano argues that Proposition 101 would limit future health-care reform options. Eric Novack, a physician and the chairman of Proposition 101, responds, "The only option that our initiative rules out is a mandatory single-payer system." Single-payer health-care systems, as in Canada, make it illegal in most cases for people to go outside the government's system and contract for their own medical services. Arizona's proposition forbids those kinds of restrictions.

...Proposition 101 goes to the heart of the national health-care debate. Universal coverage plans, regulated by government, nearly always try to restrain costs by restricting the choices individual can make. This assumes a uniformity in the real-world of patients or the practice of medicine that simply doesn't exist, especially amid rapid developments in medical science. Who should decide -- the patient or a government treatment schedule -- whether a cancer sufferer should be able to try an experimental therapy or under what circumstances a senior citizen gets a hip replacement?

Allowing patients to choose their own medical treatment, get third or fourth opinions, or seek out experimental medicines saves lives. Randy Kendrick, an early supporter of the initiative, says her ability to look around for treatments among doctors after a serious leg injury saved her from what her original physicians said would be a life confined in a wheelchair. Courageous patients and innovative medical clinicians find each other constantly this way. The patient-clinician interface is one reason the U.S. remains a locus of medical progress. Ensuring this progress continues depends on maximizing patient choices. A publicly bureaucratized system will slow it.
That is indeed the fundamental issue: Is your life your own, or are you allowed to seek your own self-interest only by permission of the state? Arizonans will get to decide.