Myth #20

Adopting The Health Care Programs Of Other Countries Requires Government.

Chrysler Chairman Lee lacocca, the United Auto Workers and many others have looked longingly at the health care systems of other countries and called for a U.S. government solution. But do the workers at Chrysler really need government in order to adopt the health care programs of other countries? It is not at all clear that they do.

The primary way other developed countries control health care costs is through "global budgets." Hospitals, physicians or area health authorities are told by government how much money they have to spend. The government then leaves decisions about how to ration the funds to the health care bureaucracy. [157]

There is nothing mysterious about this process, and no reason why Chrysler needs government in order to copy it. For example, Chrysler workers or any other large group could form their own HMO, called a national health insurance HMO (NHI HMO). The total amount of money given to NHI HMO each year could be 75 percent or even 50 percent of what Chrysler now spends on employee health care, and the NHI HMO managers could be instructed to ration care to Chrysler workers.

If Chrysler workers wanted to exert more direct control, they could elect the chief executive officer of the NHI HMO in annual balloting, and candidacy could be open to all health care bureaucrats or restricted to those with certain qualifications. The most obvious obstacle Chrysler would face would be U.S. tort law. If NHI HMO physicians rationed medical care the way the British do, there would be many potential malpractice suits. But if Chrysler workers owned their own HMO and if enough legal documents were signed, even this obstacle could be overcome.

In short, Chrysler employees could realize "benefits" of national health insurance through private action, without government intervention, provided that is their sincere objective. On the other hand, if the rhetoric coming from Chrysler is merely a ruse to get taxpayers to pay Chrysler's annual health care bill, federal government coercion would be required.