Preventive care increases costs because people live longer. What we need is to remove taxes on cigarettes and alcohol, and get rid of the safety requirements for cars etc, so people die quicker.
True, preventative care causes people to live longer. However, it also cause people to live more free of mobidity and mortality, which in turn decreases healthcare costs. Decreasing the prevalence of obese and overweight people does not only decrease the number of CABGs, angiograms, organ transplants, and the like, but if the patient is a woman of reproductive age, it also decreases the likelihood her children develop diabetes, become overweight/obese, or develop cancer (among other), all very expensive, chronic diseases with high morbidity and mortality rates.
You also assume that preventative care merely delays the utilization of care. It doesn't. Someone who is obese, never moves, and smokes a pack a day is, to say the least, unlikely to die of natural causes. Preventing someone from becoming this person does not mean that he (because males have higher CVD risk) will simply need the heart transplant, insulin therapy, pulmonary lobectomy, etc. later. It means that he will likely never need such care. People who die of natural causes cost almost nothing.
Even if it were more expensive, morally it is incomprehensible that any nation with access to such care will deny it simply on the grounds of saving money.
Could you be a little more specific about what types of litigation you want to reduce? Would you change the laws so that legitimately injured people can no longer file malpractice lawsuits? What makes you think that so much of the medical malpractice litigation is frivilous and baseless?
From my understanding in New Zealand complaints are handled by the Health and Disabilities Commissioner, a subsidiary of the Ministry of Health. There is a standard, the Code of Consumer Rights, in the legislature, but this means that the standard of enforcement is consistent. It also means that because the damages are not paid by individual physicians, they do not order every single test under the sun for diagnoses are that are statistically unlikely but which could, if missed, would result in a lawsuit.
On a similar note, I think that physicians should be paid by the government for at least part of their work. It means that, at least for the work they do for the public sector, there is no longer any financial incentive to see as many patients as possible and instead to take more time to ensure better care. This means that likely physicians will be poorer than they are currently, but that is almost a non-issue. In New Zealand, doctors are financially well-off. From my understanding, in the United States doctors are rich.
The free market dogma and myth of meritocracy are so deeply entrenched in this nation's populace that our economy and government will need to almost completely collapse before the people will be ready to question their beliefs and restructure the economy, and even then it may not happen. We could just end up as another South American or Latin American-like third world country where a small percentage of the populace is rich with the rest being poor.
I haven't really thought this through and as such it's got many holes in it, but I was wondering the pros and cons of the government being, instead of a democracy, being a true meritocracy.
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