Our text and an article I recently read both point to the fact that one of the problems with going to a national health system is that U.S. citizens like to be able to make choices. I had to think about this. My first question was, is having a choice worth having the most expensive healthcare in the world and a system that doesn’t meet the needs of the people? As I thought about it more though, I began to wonder if we really do have a choice in matters that we feel are important. What about our political system? Supposedly we get to choose who will represent us and represent out country to the world. Now, I don’t know about you but I don’t consider the option of choosing the lesser of two evils as being much of a choice. Not to mention the fact that there is some question as to whether we actually chose the current president. Choosing a president reminds me of parents giving their children a choice as to what to wear to school. Do you want to wear the blue polyester pants or the green ones? I want to wear shorts and a tank top. That’s not one of the choices. How about using choice as a tool for competition? Let’s say that oil companies could offer gas for sale at $1.50 a gallon and still make a profit but chose instead to sell it at $3.00 a gallon. Choice and competition should mean that a company could offer gas to consumers at $1.75 and take the entire market. It doesn’t work that way though does it? Instead, a major company raises the prices and everyone else follows suit to get in on the profits. Americans aren’t going to go without gas so there is no need to compete. Americans aren’t going to go without healthcare either so where does that leave us? We pay more and more for less and less while those that can’t afford it go without. Is there any chance that this is going to change when money is the key factor in determining healthcare? Should competition and choice still be part of the system? Certainly! There is no denying the benefits that are received when there are true choices and a sense of true competition. For this reason, a system more like Canada’s rather than Britain’s where the government runs the health insurance and pays doctors fees-for-services would probably work better in the U.S. Doctors would still need to attract patients to their practice. Those that gave better care, better follow up, more services such as responding to emailed questions from patients, would have a larger practice. This form of competition, of trying to get doctors to see more patients and offer better care, would be a pleasant change for Americans. One problem with this system that is seen in Canada and China is that doctors tend to congregate where the people are. To make the most money, you have to have the most patients, which means your practice needs to be where the most people are. In an effort to offset this, incentives could be offered to doctors who had practices in rural areas. The effectiveness of national healthcare would be measured in several ways but two of the measures would have to be the percentage of people receiving basic care and the cost of that coverage. Is having a choice worth having the most expensive healthcare in the world and a system that doesn’t meet the needs of the people? Not unless it’s the best healthcare in the world. The United States is a long way away from that. Do Americans get to choose when it comes to important matters? Nope. We have a dozen choices for hamburgers and can go so far as to not eat a hamburger. We can’t go without healthcare and we don’t have much to choose from. People in positions of power choose for us. Blue polyester or green, that’s the choice. It follows that Americans should not be shunning a national system based on a lack of choice.