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Why does Oklahoma City have an unusually consumer-friendly health care sector that's made it possible for people like Keith Smith to do business? Twenty-five years ago, the state rolled back its Certificate of Need (CON) laws. AsTed Balaker reported for Reason TV back in 2010, CON laws, which are still in effect in 35 states, explain in part why dogs and cats often get better medical treatment than people.
CON laws, which differ slightly state-to-state, generally empower local planning boards to block new medical facilities from opening on the grounds that they're providing new supply that could drive down prices. "The existing hospitals go in front of these government agencies and say, 'we don't need any competitors, we're taking fine care of the people,'" Reason's Ron Bailey told Balaker.
Entrepreneurial vets, on the other hand, face no artificial barriers to entry. Dr. Peter Weinstein, executive director of the Southern California Veterinary Medical Association, opened his doors in about 12 weeks. "In veterinary medicine," says Weinstein, "we could have two practices right next to each other and then it's the consumer deciding to whom they want to go."
"How Medicaid & Obamacare Hurt the Poor—and How to Fix Them," Reason TV, April 25, 2013.
If the U.S. were to move to a market-driven health care system in which most patients paid their own routine medical bills out of pocket, many Americans would still require assistance.
double the rate of the privately insured. The challenges Medicaid recipients face in getting basic care explains why they're more likely than even the uninsured to have late stage cancer at first diagnosis, and they're about twice as likely as the privately insured to die in the hospital after surgery.Medicaid, the safety net program we have, is a disaster. The program often pays doctors so little that it's difficult for recipients to get an appointment, which is why they show up at emergency rooms at nearly
What would a better safety-net program look like? Dr. Alieta and Dr. John Eck, primary-care physicians based in Piscataway, New Jersey, who run a free health care clinic in Somerset, New Jersey, have an idea.
"Obamacare vs. Samaritan Health-Care Ministry: A Case Study," Reason TV, October 1, 2013.
Before there were large government programs like Medicaid, many Americans turned to "mutual aid societies" to help pay their medical bills. In 1910, an estimated one-third of American men belonged to one of these organizations in which members pitched in to help each other during times of need.
"Health care sharing ministries," which are some of the last mutual aid societies still around, highlight what's wrong with our insurance-driven health care system—and the unintended consequences of Obamacare's health care exchanges.
"Would Hayek Have Approved Obamacare," Reason TV, February 14, 2013.
Would the great patron saint of contemporary libertarianism and champion of pricing as a system for conveying knowledge have supported the Affordable Care Act?
In an interview with Reason's Nick Gillespie, George Mason University philosopher Erik Angner talks about his 2012 Politico op-ed in which he argued that Hayek may have liked certain aspects of Obamacare, such as the individual mandate and some sort of redistribution to the poor. At the same time, Angner says that Hayek would have staunchly opposed any policies that hobble the functioning of a price system. The bottome line: It's possible to provide for the poor without beating market incentives out of the entire health-care industry.