Additionally, health status or level of health is not the same as access to health care. In fact, access to treatment does not necessarily lead to health, as the condition has in most instances has already occurred. In fact, federal “reform” often hurts the public health system. Both public health and health care experts have criticized Medicare and Medicaid, enacted by Congress in 1965, for changing the focus of health care practitioners from prevention to treatment. Infectious disease mortality rates rose 22 percent in the 1980s (even after discounting for AIDS deaths), despite rising public and private spending on health insurance and medical care. In 1988, the Institute of Medicine warned of a deteriorating public health system. Inadequate vaccine supplies, such as the recent shortages of the measles-mumps-rubella vaccine or influenza vaccines, are at least in part the result of federal attempts to control the production and distribution of the vaccines.

Requiring all Americans purchase health insurance, which ObamaCare requires, and is likely unconstitutional, would not address the underlying socio-economic issues at the root of most public health problems. Income, social capital, employment status, and other factors have a stronger impact on population health than access to health care. The less educated smoke in higher amounts, have worse diets, have higher rates of obesity, higher rates of diabetes, exercise less, are more exposed to violence, low weight and pre-term infants, etc. People with more education and higher incomes are better able to avoid health risks. Poor children have higher levels of blood lead precisely because they live in older dwellings more likely to contain lead-based paint.

Proponents of government control contend that “rationing” is inevitable. Either the government will do it. Or someone else, particularly insurance companies, will do it. But there’s a big difference between government deciding how to distribute limited goods and services for others and individuals deciding how to balance competing goods and services for themselves.

Today employers have too much control over individual insurance plans. The answer is not to transfer that control to politicians, but to return it to patients. People need a medical system that allows them to make basic health care decisions, especially what kind of insurance to buy and what kind of coverage to choose.