• What we should be focusing on as Republicans finalize a plan
• No overseers and slaves, market approach delivers product
• Make taxpayers decision makers to control costs more so than indentured servants visiting company store
Triggered by an article in today’s The Federalist, we also reviewed related links in the publication we found meritorious and set forth links and some excerpts below.
Practical Ways The Senate Can Adopt A Free-Market Approach To Health Care Provocative title, explained philosophically and in terms of human nature. Derek Monson article.
Only free-market reforms are likely to simultaneously offer Americans improved health, affordable coverage, accessible health care, and fiscal responsibility.
Why Nobody Has A Right To Health Care (excerpts, David Weinberger article)
But just because our rights are secured by government, it does not follow that they must be provided by government. This means that while it is correct to suggest that people have a right to food, it is incorrect to say that the state must provide it. Indeed, flowing from our rights to liberty and life, we have the right to keep the fruits of our labor, through which the marketplace has proved superior in providing access to food, as failed communist states have made clear. This brings us to the heart of what is wrong with declaring health care—ex nihilo—a human right.
If Health Care Is a Right, Doctors Are Slaves
Medical care stems not from human nature but from outside of it. This “positive rights” view allows for government to grant as a “human right” anything that may be desirable. But this leads to the problem of our “rights” competing with and contradicting one another. If I have a right to health care, then resources must be channeled for that purpose. But what if doing so sucks resources away from providing access to, say, food? Which right trumps which?
Some might reply that the solution to this dilemma is to simply legislate food as a human right, too. But that is no solution. For what, then, about housing? A decent wage? Education? Transportation? On what grounds can we reject these as “rights”? The regrettable fact of life is that our desires are infinite, but resources are not. Natural law remains the sole remedy for this predicament.
Importantly, areas of the health industry where Uncle Sam has interfered least, such as cosmetic surgery and eye surgery, have witnessed either stable or declining prices. We would therefore do well to move health policy toward a more, not less, free-market solution.
Why Medical Price Controls Are A Terrible Idea (Phillips Gausewitz, MD article)
Excerpting a few points from lengthy article. The title refers to the substance of so much that is intrinsic to current approaches to gov run medic care as repoints out a fools arena experientially a fools errand Excerpt Phillips Gausewitz, MD article)
. . . Third party payment insulated patients from the cost of coverage as well as the cost of the care they consumed. They didn’t even see their bills as doctors and hospitals billed the insurance companies or the government directly. Employees didn’t realize that their insurance benefit was off set by lower pay and came to believe that their medical care cost very little leading to over utilization. We developed a payment system in which, because patients had no concern about costs, neither did doctors, hospitals, insurers, regulators and politicians. No wonder prices kept rising.
Finally, in a misguided attempt to control costs, Medicare price controls were imposed on hospitals in 1983 and on physician fees in 1992. Insurance companies piggybacked on the government rules, resulting in about 90% of physician fees being covered by government or contractual controls. . . .
There is general agreement amongst economists that if price controls succeed in keeping prices below the normal market level they result in increased demand, shortages, lower quality, and black markets. They are particularly destructive in Medical Care where, in addition to economic problems, they result in needless suffering and death.
The damage from Price Controls began in 1993. Of the inevitable results: shortages, lower quality, increased demand and black markets, the shortage of physicians and resulting decrease in quality are the most important. The conservative estimate of the American Association of Medical Colleges is that there will be a shortage of 91,000 physicians by 2020. Physician responses to having their incomes severely limited while their expenses and the incomes of comparable professionals increase are what would be expected from rational individuals and are harmful to patients.
The most obvious response is to see more patients and decrease the amount of time spent with each patient. Appointments are often scheduled for 10 -15 minutes each, much of which is spent on paperwork. If more time is needed for more than one problem additional appointments are scheduled.
Since they are only paid for procedures that are included in the CPT codes, a physician’s incentive is to cut back on the many valuable services which are not included in the codes such as: more time for a careful history and physical examination resulting in better diagnoses; education of patients and their families about medications and healthy lifestyles; telephone consultations; and, discussions of the patient’s situation with them and their relatives. These not only provide better service but save costs.
The incentive is to seek patients who are able to pay reasonable fees and avoid those who, because of their coverage restrictions (Medicare, Medicaid, HMO) can not. As a result Medicaid patients have difficulty in getting appointments and many physicians refuse to take new Medicare beneficiaries. This emphasizes the fallacy of the delusion, apparently shared even by our President, that medical insurance and medical care are the same thing. They are not, and the fact is that without access to physicians and hospitals insurance is as worthless as a free pass to a full parking lot! . . .
Fortunately there is ample evidence that these benefits will occur based on the experience in places where price controls did not or do not exist. The first is the history of our own country before price controls. Medical bills were paid the same way as any other bill. For those in need, physicians would discount or forego their fees and the quality of care was comparable to that of privately paying patients. Refusal of care for inability to pay, age, or perceived economic value to the community, determined by a government board, was unheard of.
For The Cost Of Obamacare Bills Congress Could Build And Run Free Clinics Everywhere For A Decade
Interesting Scott Ehrlch piece. We put this in the area of “don’t challenge the proponents of government run healthcare with this, it is what they want.” Provocative title intended to challenge the big number costs of recent House proposal but it is a largely static analysis and short sighted in not including more commentary on why the theoretical less cost is still a bad idea. Such a system will devolve in so many ways. The theoretical numbers won’t happen. Control will.
Trumpcare Would Make U.S. Health Care A Little Less Socialist
Coverage is the big problem with U.S. health care. People with coverage have little or no incentive to economize, so costs balloon out of control.
Nathan Smith post also delves into delves into conceptual framework of health care delivery and the psychology of it.