Thinking the unthinkable

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America has the greatest health care in the history of the universe, but the system is fraught with problems that are worsening every day. It has become so complex that prospects for significant reform seem bleak. But putting aside political considerations, the solutions might be simpler than we assume.

The main problem is that we have crowded out market forces and reduced consumer choice. What the system needs is a robust dose of capitalism.

No one has done a better job of making that case than Dr. David Gratzer in his book, "The Cure: How Capitalism Can Save American Health Care." The late Milton Friedman endorsed Dr. Gratzer's recommendations in his foreword to the book.

Friedman explained that before World War II, medical care, like other consumer goods and services, was dispensed through a mostly free market. Patients could choose their own doctors and were responsible for paying the fees. Health-care insurance generally didn't cover routine treatment, only catastrophic events.

But when wartime wage and price controls led to a shortage of workers, employers offered benefits, including health care, to make jobs more enticing. Eventually, the government reinforced the practice by exempting this benefit from taxation. In time, our market-driven system became a "top-down" bureaucracy, with "exploding costs" and "widespread dissatisfaction" of patients and providers.

Dr. Gratzer recommends a three-pronged solution centered on market forces. He would make health insurance portable, primarily by eliminating the employer-paid health insurance deduction. He would shore up Medicare, partly by setting aside some of the payroll tax into registered health accounts, to be invested in the market. Finally, he would attempt to "create a market that will catalyze innovation in drugs and medical services."

Dr. Gratzer says that by reintroducing market forces, "American health care will become cheaper, better, and more accessible for everyone. Capitalism is not the cause of America's health-care problem. It is the cure."

How true. But sadly, the market approach is precisely the opposite of what Democrats -- and some Republicans -- favor. Liberals have this regrettable habit of increasing government control over institutions and sectors of the economy, then denying responsibility when their supposedly good intentions only make the problems worse.

We've seen this from the war on poverty and welfare to education. But with blind faith in their failed prescriptions, they always demand heavier doses of the same poisons: government money and control.

One would hope there would be such an adverse reaction to full-blown socialistic policies that supporting them would be political suicide. Indeed, many conservatives believe universal health care is still so unpopular that Hillary Clinton's sponsorship of it in the 1990s could sabotage her presidential ambitions today.