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March 16, 2007

Ronald Bailey tries to steer the ship of state away from the monumental, closing-fast iceberg of universal health care.

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|3.16.07 @ 12:38PM|#

Anything that mandates more individual initiative, private responsibility, and non-state control is okay in my book. The question is whether we are loosening or tightening the vise.

As it is in healthcare, so it is in education.

|3.16.07 @ 12:38PM|#

Free health care for all
It's for the children damn it
Got a spare kidney?

|3.16.07 @ 12:44PM|#

Why haiku today?
Haiku Day in December.
So what's up with that?

|3.16.07 @ 12:44PM|#

It's nice to have Mexico so close so that the doctors will be able to slip over and provide medical service to everyone when the neo-pseudo-Canadian system provides universal misery.

Guy Montag|3.16.07 @ 12:45PM|#

ACK! Does that haiku infection have to attack every thread?

|3.16.07 @ 1:08PM|#

You won't hear about it in any American newspapers, but the Swiss just voted down a proposal for a universal single-payer system that was proposed for their wondrous, chocolate-coated country.

|3.16.07 @ 1:19PM|#

The plan still doesn't address the ridiculous notion that preventative care should be paid for via "insurance", thus involving a completely unnecessary third party in what should be considered a routine business transaction.

|3.16.07 @ 1:29PM|#

In a recent New York Times/CBS poll 64 percent of Americans said the government should guarantee health insurance for all.

Which is more proof that majority opinion is not a valid way to reason or to make decisions.

Today, employers purchase health insurance for 153 million workers and their families. Why is that? Because ridiculous federal tax laws allow employers, but not individuals, to purchase health insurance with pre-tax dollars.

This perverse incentive generates a problem of misallocation of resources, and inflates artificially the price of insurance and health care.

The best way to lower health care prices and services is to take away these ridiculous mandates that distort the market, and strip away the power of the AMA to rule over market decisions. The AMA limits the number of doctors that graduate from medical schools. If more doctors are allowed to graduate and more allowed to migrate to the US, the competition will drive costs down. The AMA, as any other union, does not like competition, but its power over the market stems from government fiat - strip it away, and the market will do the rest. Let other medical associations compete with the AMA.

Also, let these associations issue licences but do not impose them by government violence, as it happens know (heck, even hairdressers must aquire a licence these days!!!). The licence is nothing more that a Letter of Marque that generates an artificial barrier to competition. This also drives prices way beyond what would be the natural market level.

|3.16.07 @ 1:35PM|#

Given the growing clamor for national health care, individual mandates may be the only politically viable way to preserve private health care.

I only RTLSOTFA, but I am almost ready to accept the coming of publicly financed universal health care -- provided it is not mandatory.

So long as those who want universal care are willing to accept the dreaded two-tiered system, then those who understand that you earn money to spend it on things important to you, and that little is more important than your health, will still be able to purchase private health care and insurance to the degree desired.

And those who aren't willing to accept a two-tiered system...? Those who believe "single-payer" means no other payers are permitted...? It is hard to imagine how strong a line must be drawn against that mentality.

The Wine Commonsewer|3.16.07 @ 1:37PM|#

I understand the market distortions in the medical field but a private transaction is still a private transaction. That goes to the idea that removing the deductibility of employer-paid health care is a good thing and will help resolve the problem.

Today, IRS taxes fringe benefits like company cars as additional taxable compensation to the employee so maybe if you want to treat employer-paid health care as additional taxable compensation to the employee as well I suppose I could accept that.

The other problem is that we are so far down the road to universal health care I don't think you can stop the ship. We already have it for seniors, the disabled, and the poor.

|3.16.07 @ 1:38PM|#

It's nice to have Mexico so close so that the doctors will be able to slip over and provide medical service to everyone when the neo-pseudo-Canadian system provides universal misery.

Mexico has very competent doctors and very good (and cheap) hospitals. If you need to go for an operation, I suggest you go to the city of Monterrey, just 160 miles south of Laredo TX. Or to Mexico City. The nice thing about Mexico is that, while it is the government that issues licences, they do NOT limit artificially the number of doctors that graduate as the AMA does in the States. Thus, doctors actually HAVE to compete with better prices to get the most clients.

Of course, sleazy journalists like to tell stories about quack Mexican doctors that kill gringos with untested or dangerous therapies. However, in actuallity this happens LESS in Mexico than in the States, since the sleazy doctors face MORE competition there than in the good US of A - they lose customers rather more quickly than in the USA. Also, clients there are not so trusting of doctors as in the States, where the heavy licensing creates a false feeling of security ("the doctor must know best - he has a license!") among Americans.

|3.16.07 @ 1:43PM|#

I understand the market distortions in the medical field but a private transaction is still a private transaction.

It is no longer a private transaction - the FedGov now regulates what te insurance company has to cover, regardless of the needs or convenience of their customers. The FedGov also imposes terribly costly "paperwork" regulations, making a doctor into another government bureaucrat.

That goes to the idea that removing the deductibility of employer-paid health care is a good thing and will help resolve the problem.

It will not, really, at least not dramatically. You still need to free the medical insurance market, and allow more doctors to enter the market and compete. Any cosmetic fix will not be enough to avoid the biggest problems in the future: not enough productive people to support the ailing health care system.

|3.16.07 @ 1:48PM|#

Given the growing clamor for national health care, individual mandates may be the only politically viable way to peserve private health care.

I'm glad this sentiment is starting to gain some traction. Great article.

|3.16.07 @ 2:07PM|#

I think Ron is spot on here. Make it the least bad we can.

If we leave this up to to the voters, demographics tells us what the tradeoff will be. Innovation will be burned to the ground in the name of cheaper and cheaper access. Old people all vote and they don't care about innovation.

If we make that trade, millions will suffer and die needlessly.

Schutz|3.16.07 @ 2:32PM|#

Check your facts--AMA does not control medical school graduates nor licensure. Licenses are granted on a state-by-state basis by a government board of medical examiners. Claims about influence, corruption, impropriety and anti-competitive sentiment are not unjustified, but to blame the AMA is incorrect.

|3.16.07 @ 2:40PM|#

It appears that no one on this thread has had to face a serious, chronic illness. In all the ideas of consumer directed health-care, where do people with diabetes, lupus, cancer, ms, parkinsons, crohns, etc, fit in? No private insurance company would ever take on such a person.
In my case, the medicine making it possible for me to work productively, is over $50,000/year. The need for medical treatment is not a lifestyle choice, it is a choice to actually stay alive.
So what is the answer, other than seriously sick people still requiring government assistance via SSI, medicare or medicaid; or just let them hurry up and die?

|3.16.07 @ 2:49PM|#

Check your facts--AMA does not control medical school graduates nor licensure.

Who controls medical school accreditation? Who makes one of the standards of that accreditation the numbers enrolled in the school?

|3.16.07 @ 3:14PM|#

Guy does not like it
we talk too much in haiku
he can go to hell

|3.16.07 @ 3:28PM|#

Janice:

There should be a welfare program that keeps you alive. That welfare program should not extend to every American.

|3.16.07 @ 3:34PM|#

Check your facts--AMA does not control medical school graduates nor licensure. Licenses are granted on a state-by-state basis by a government board of medical examiners.

- # 1899, AMA creates Committee on National Legislation to represent AMA's interests in US Government.
1904, AMA establishes the Council on Medical Education to raise educational requirements for physicians.
1927, AMA Council on Medical Education and Hospitals publishes first list of hospitals approved for residency training.
# 1976, AMA Section on Medical Schools is created.

State bureaucrats do not think for themselves. They get their guidelines for licensing from the usual cadre of lobbying GUILDS, like in this case, the AMA.

"The American Medical Association, organized in New York in 1848, advanced two seemingly innocent propositions in its early days: that all doctors should have a "suitable education" and that a "uniform elevated standard of requirements for the degree of M.D. should be adopted by all medical schools in the U.S." These were part of the AMA's real program, which was openly discussed at its conventions and in the medical journals: to secure a government-enforced medical monopoly and high incomes for mainstream doctors."

No school of scientific medicine can function in the US without the approval and blessing of the AMA. The AMA LIMITS the number of PLACES that a school might offer to new students, thus limiting the number of doctors that graduate. This is why the doctor to population ratio has changed little since the 1920's (!!!). Instead, the ratio in such countries as Mexico has increased steadily since the 1950's.

|3.16.07 @ 3:35PM|#

Sorry, the quote above comes from Llewellyn Rockwell Jr, http://www.lewrockwell.com/rockwell/medical.html

|3.16.07 @ 3:44PM|#

In all the ideas of consumer directed health-care, where do people with diabetes, lupus, cancer, ms, parkinsons, crohns, etc, fit in?

The same way they fit where private medicine is cheap thanks to competition. My mother in law has high cholesterol, diabetes and high pressure. Her monthly income is only 500 dollars, yet she is able to see a doctor every two months and buy the compete list of medicines. Medicine is cheap in Mexico, you can buy almost any without a prescription (thus avoiding the stupendously expensive "amber bottle"), and generics are DIRT CHEAP.

No private insurance company would ever take on such a person.

You are right, because medicine in the US is SOCIALIZED - blame the FedGov and the AMA, but do NOT blame the free market, if that is what you are aiming at.

In my case, the medicine making it possible for me to work productively, is over $50,000/year. The need for medical treatment is not a lifestyle choice, it is a choice to actually stay alive.

Go to Mexico. You will probably only spend $5,000 a year, if at all. There are expensive doctors over there, to be sure, but the normal, run-of-the-mill specialists cost around 40 to 50 bucks, WITHOUT insurance. Try that in the States...

So what is the answer, other than seriously sick people still requiring government assistance via SSI, medicare or medicaid; or just let them hurry up and die?

Let them have choices. The government has been great at convincing these poor people that they need the FedGov, making them its slaves. Unfortunatelly, people fall with extreme (and worrisome) easiness to these Ad Misericordiam reasonings, the "How awfull! We must do something!" kind of arguments.

|3.16.07 @ 4:00PM|#

In all the ideas of consumer directed health-care, where do people with diabetes, lupus, cancer, ms, parkinsons, crohns, etc, fit in? No private insurance company would ever take on such a person.

I'm sorry that you have to live with poor health. Not I, but a number of my friends and family members do as well.

Of course, no private insurance company will take someone that is already sick (without a rider excluding that particular illness, which is often prevented by state laws!). They do pay for the treatment of such people when they have insurance before they get sick. My question is: Why don't these people have insurance before they get sick?

When I was in college, almost none of the students I knew (including me) had health insurance unless it was provided by their parents (or their parents' employers). Why? It wasn't because they couldn't afford it. It was because they chose to buy booze, hip clothing, weed, concert tickets, etc. If their health matters less to them than these things, why should I or anyone care about their health?

One (non-libertarian) idea would be to require health insurance for every child before they are born, say by the sixth month of gestation or something. Then all Americans would have health insurance on the day of their birth.

|3.16.07 @ 4:41PM|#

> My question is: Why don't these people have
> insurance before they get sick?

Some people's jobs do not include health insurance, and they are unable to get a better job. And they cannot afford health insurance on their limited incomes. Do these people deserve to die?

|3.16.07 @ 4:50PM|#

Too many people in the US don't have health insurance, and the private insurance market has been abusing the system for far too long. Unable to get insurance due to "prior condition." Unable to get insurance because "no insurance history." You finally get insurance, pay through the nose, and then what? They look for excuses to dump you as soon as you fall sick. Or they've spent too much $$ on you. Or unilaterally reneg on the contract after you've gone through the operation, saying "oh, that must have been a prior condition." Look at the profits posted by the health insurance companies and the salaries of their CEOs at the same time you get your coverage unilaterally yanked and you'll see why people are pissed.

You abuse, you lose. Getting your medical insurance paid out should not require having to hire a lawyer. That's why there's been the great shout-out for national health insurance.

Libertarians didn't work on reining in the excesses of the health insurance companies, now you'll have to deal with national health insurance. This is how regulations get made: a sector doesn't police itself, there are a lot of hurt people, then the government steps in.

If you want things to not occur that way, then get businesses to clean up their problems beforehand. Don't keep wringing your hands about "oh, if we only let the free market have a run!" To the average American, the free market HAS had its chance. And failed. Miserably.

|3.16.07 @ 4:59PM|#

I just hope grumpy and his grumpy friends are going to feel at least somewhat guilty for destroying the only significant engine for medical progress on this planet.

D.A. Ridgely|3.16.07 @ 5:14PM|#

Some people's jobs do not include health insurance, and they are unable to get a better job. And they cannot afford health insurance on their limited incomes. Do these people deserve to die?

No more than anyone else does, but that isn't the question. Do they deserve to live at other people's expense, especially if such financial support from others is involuntary?

However my answer to that question may differ from Petra's or Janice's, the fact is that Americans increasingly view health care as an entitlement, so Mr. Bailey's proposed alternatives are likely to be short-term at best.

Ironically, probably the group of Americans who have the best health care alternatives are federal employees and retirees who can opt in and out of any number of health care plans every year and may not in general be refused coverage from any of the participating plans because of pre-existing conditions. Only the most cursory knowledge of Pubic Choice theory is needed to understand why this is the case and why, as a result, many in the federal bureaucracy are just a tad resistant to the notion of a universal health care system that would, in effect, screw them as badly as the rest of the population.

|3.16.07 @ 5:39PM|#

Some people's jobs do not include health insurance, and they are unable to get a better job. And they cannot afford health insurance on their limited incomes.

Bullshit. Try again.

|3.16.07 @ 5:41PM|#

I say "bullshit" because every poor person I've ever known (and I grew up in a welfare community) spent money on shit they didn't need, just wanted.

|3.16.07 @ 5:43PM|#

Also, if you are so poor that you cannot afford health insurance, you're poor enough to get aid. No one in America actually goes without health care if they make an effort to get it.

|3.16.07 @ 5:45PM|#

DA Ridgely wrote
"pubic choice" ha ha pubic
in spirit twelve years old

|3.16.07 @ 5:59PM|#

I would be curious to see the results of a study to determine how many of the 2 billion uninsured (or whatever the figure's supposed to be) have cable television subscriptions.

|3.16.07 @ 6:06PM|#

Yeah, yeah, have heard all that before. "greatest machine for innovation on the planet." Not if the US keeps endulging the IDers and the rest of the lunatic anti-intellectual dimwits which our culture so helpfully supports. The US inherited an economy from WWII its culture was not in equilibrium with, build on the brainpower of intellectuals fleeing Europe and springing into growth by the fact that at the end of WWII we were the largest country that hadn't been bombed to pieces or used as a battlefield. But I digress.

I am simply commenting from the viewpoint of a cynical bastard with far too much of a knowledge of history. Governments exist everywhere. When they exist, they get pulled in to "fix things" the surrounding society gets its pants in a tizzy about. This ALWAYS happens. If you want to claim it doesn't, you are ignoring all of human history. If certain groups can police themselves and keep the bru-ha-ha down to the point that the complaints to the authorities never reach critical mass, then well, you can claim "the free market" has won. I myself look upon it as self-regulation before the Czar gets into a snit about the peasant rebellions.

Libertarians come off as a bunch of young sprigs with no knowledge of history, no knowledge of human nature, and even less knowledge of how the world really works.

Petra|3.16.07 @ 6:11PM|#

D.A. Ridgely wrote:
> No more than anyone else does, but that isn't
> the question. Do they deserve to live at other > people's expense, especially if such financial > support from others is involuntary?

Yes, because someday should you find yourself in their situation, you will want the same financial help they are getting.

|3.16.07 @ 6:13PM|#

The Real Bill wrote:
> Also, if you are so poor that you cannot afford > health insurance, you're poor enough to get
> aid.

This is simply wrong. People making ~$20-30K/yr are just getting by paying their expenses, cannot afford $400/mth for health insurance, and do not qualify for aid. It's the people in these middle income ranges who are really the ones at risk.

|3.16.07 @ 6:58PM|#

This is simply wrong. People making ~$20-30K/yr are just getting by paying their expenses, cannot afford $400/mth for health insurance, and do not qualify for aid. It's the people in these middle income ranges who are really the ones at risk.

Indeed but again, this has more to do with market distorsions due to government intervention and detrimental action than with a lack of government action.

I wholeheartedly agree with you that people in the middle income range are the most vulnerable when it comes to health-care costs. However, all of us must keep in mind that the solution cannot be more intervention by the government, making Ad Misericordiam arguments to prove a case. As libertarians we must insist on a totally free health care system, one that is without the shackles of that great guild, the AMA, and the "good intentions" of state bureaucrats.

We must insist that we as consumers are intelligent enough to make health care decisions, and that the doctors are suppliers, and not RESOURCE ALLOCATORS, as they have been until now - placing restrictions on pharmaceuticals, for example. Again, in many other countries, almost all drugs are over the counter. Yet here, the AMA and the government must consider that the average American is a retarded simpleton that cannot buy and take medicine without overdosing. Or how else can you explain prescription-drug laws? Pharmacist licenses? Even for a pair of lousy spectacles you need a prescription!!!

And you wonder why health-care is expensive? "Monopoly by government fiat" comes to mind as an answer.

Lynne|3.16.07 @ 8:33PM|#

Yes, because someday should you find yourself in their situation, you will want the same financial help they are getting.

Petra,

Are you saying that we all will want the government to pay for our health care in that situation, or we'll otherwise all want the money and not care about where it comes from? I don't think that's true (though I admit that people do sometimes ditch beliefs that have stopped being to their advantage). I personally share D.A. Ridgely's objection to the funding of the welfare state, and if I were put in that situation tomorrow, I wouldn't truly want other people forced to fund my care. I'm sure others here are the same way. Believing that the taxation that funds the welfare state is wrong means that it's just as problematic to demand other people pay for your care as it is for them to demand you pay for theirs. Yes, if I had an expensive medical condition and no money, I'd want more cash. But I wouldn't want to get it by, effectively, forcing unwilling people to work for me.

eugene|3.16.07 @ 8:54PM|#

There's always folks like Real Bill to come crawling out of the woodwork who attempt to spoil the efforts of the earnest libertarians. To summarize :

Earnest Libertarian: "The free market provides the best way for the poor to receive health care; we just need to make sure the government doesn't hinder the market's natural mechanisms"

Skeptic (like Grumpy Realist): "Well what about these cases where poor people are chronically sick, getting screwed by insurance companies?"

EL: "Well you see, that's because the government doesn't allow-"

Real Bill: "IT'S THEIR OWN DAMN FAULT! STUPID LAZY POOR PEOPLE!"

EL: "(ugh..shut up Bill!)...uh..as I was saying.."

|3.17.07 @ 12:30AM|#

Also not to throw the cat among the pigeons too much or anything, but isn't anything like insurance a rather un-libertarian idea anyway? You're getting support off the payments of other people, right?

(I'm honestly not trying to be snarky about this. I forget what thread it was, but some commentator made a statement that seemed to indicate pure libertarians were against the concept of insurance.)

And if libertarians are ok with the concept of insurance, how is this reconciled with the fact that the greater the pool, more stable the system since the fluctuations (which are what kill you) get evened out? The more stable the system, the less you have to charge to have a large reserve to cover fluctuations. Hence, it seems to me that larger insurance companies would be able to offer lower premiums than smaller companies.

...see where I'm going? What this seems to lead to is the conclusion that a system that would cover as many as people as possible would be the cheapest.

|3.17.07 @ 1:09AM|#

"Skeptic (like Grumpy Realist): "Well what about these cases where poor people are chronically sick, getting screwed by insurance companies?"

Earnest Libertarian:
Sorry - I am in the habit of not replying to loaded questions.

|3.17.07 @ 1:13AM|#

"Also not to throw the cat among the pigeons too much or anything, but isn't anything like insurance a rather un-libertarian idea anyway? You're getting support off the payments of other people, right?"

GR, insurance makes sense whe you are trying to hedge your bets on events that are somewhat likely, but have NOT happened yet, meaning that they are unforseeable. Health insurance should be the same, protecting you in the case of really catastrophic health problems. Instead, health insurance is seen as a form of payment, a Ponzi scheme where people that are NOT sick pay for those that are. THis is not the insurance companies' fault, but government's. It is the government that mandates the coverage, it is the one that regulates the industry.

|3.17.07 @ 1:25AM|#

grumpy realist:

Libertarians didn't work on reining in the excesses of the health insurance companies, now you'll have to deal with national health insurance.

That's not a realistic view of what's wrong with health care in this country. Competition in health care delivery is mitigated by government regulations. Many of these regulations come at the behest of various medical providers wishing to limit their competition.

The health insurance industry is also less competitive than it should be due to government regulations. Again, often at the behest of insurance companies seeking to limit their competition.

Libertarians are advocating exactly what is needed to make health care a better deal for consumers.

|3.17.07 @ 1:40AM|#

grumpy realist:

This is how regulations get made: a sector doesn't police itself, there are a lot of hurt people, then the government steps in.

That is not typical of the dynamic that plays out at all. For an underatanding of how govwernment regulations tend to come about, see the analysys of the Progressive era; The Triumph of Conservatism by Gabriel Kolko (BTW, in the title, Kolko meant "conservatism" as big business, not a political philosophy), in which he makes a strong case that the dominant trend in the last three decades of the nineteenth century and the first two of the twentieth was not towards increasing centralization but rather was "toward growing competition. Competition was unacceptable to many key business and financial leaders, and the merger movement was to a large extent a reflection of voluntary, unsuccessful business efforts to bring the irresistible trends (of more players in the market place) under control."

As new competitors sprang up, and as economic power was diffused throughout an expanding nation, it became apparent to many important businessmen that only the national government could "control and stabilize" the economy. Ironically, it was not the existence of monopoly which caused the federal government to intervene in the economy, but the lack of it.

|3.17.07 @ 1:54AM|#

grumpy realist:

Libertarians come off as a bunch of young sprigs with no knowledge of history, no knowledge of human nature, and even less knowledge of how the world really works.

I can't recall ever reading a libertarian who has come anywhere near as close to that description as yourself, judging from the lack of understanding that you've displayed on this thread.

|3.17.07 @ 2:08AM|#

grumpy realist:

isn't anything like insurance a rather un-libertarian idea anyway? You're getting support off the payments of other people, right?

You really need to drop the "realist" part of your screen name. You don't even have a basic understanding of libertarianism! But that doesn't stop you from strongly objecting yo it Libertarians oppose the initiation of force. There's obviously nothing coercive about the insurance business, as long as government stays out of it,

|3.17.07 @ 6:40AM|#

"IT'S THEIR OWN DAMN FAULT! STUPID LAZY POOR PEOPLE!"

These are not my words; they are yours. Obviously, you are too mentally incompetent to argue with what I actually said, so you just make shit up. Moron.

|3.17.07 @ 10:38AM|#

Lynne wrote:
> Yes, if I had an expensive medical condition
> and no money, I'd want more cash. But I
> wouldn't want to get it by, effectively,
> forcing unwilling people to work for me.

Then how would you get "more cash?"

Really, how?

|3.17.07 @ 12:08PM|#

I just hope JasonL feels guilty every time a kid loses a mother because her cancer wasn't detected until she ended up in the emergency room.

Thomas Paine\'s Goiter|3.17.07 @ 12:34PM|#

Healthcare costs are set by the government. A Dr. friend of mine charges $xx for a CT for Medicare and Medicaid because that's what Medicare and Medicaid will pay for that procedure. The scale goes up from there to privately insured people and higher yet for the uninsured.

The government is setting all of the price points in the medical market AND eliminating competition at the same time.

Break the government stranglehold on medical care and licensing (make it an independant process) and price will go into a freefall.

Lynne|3.17.07 @ 2:15PM|#

Then how would you get "more cash?"

Really, how?

Charity? Friends? Family? Regardless, I wouldn't find it ethically acceptable to force other people to pay for it. Simply wanting cash doesn't mean I'd want to use taxation to get it, in the same way that wanting anything else doesn't mean I'd want to do anything to get it, regardless of who got hurt or was coerced.

|3.17.07 @ 3:46PM|#

Lynne wrote:
>> Then how would you get "more cash?"

> Charity? Friends? Family?

Sure. Show me the charity one can turn to when one has substantial medical bills -- or even routine medical bills.

And few people have wealthy friends or family who can pay tens or hundreds of thousands of dollars for medical expenses.

Face it: You don't have any idea where such money is to come from. You're grasping at straws.

Once you'd been through enough pain and suffering, when fear has seeped deep within you, and when you are facing the end of your very life, you'd quickly reconsider your libertarian principles and discover the blessings of government-financed health care.

Lynne|3.17.07 @ 4:46PM|#

Petra,

I don't believe that everyone would abandon their principles in such a situation. People are different, and some of them will stick by their beliefs in dire circumstances. People have, in fact: see, for instance, Christian Scientists, or (in a different area) soldiers who believe in their cause. It seems presumptuous of you to assume that we'll all react the same way.

And even if I personally would abandon my beliefs in the face of adversity, I think that ought to be my risk to take. (I already take plenty of them: every time I get into a car, for instance, I'm at risk of dying or becoming horribly injured.) Should adult Christian Scientists be forced into medical care at the first sign of potentially fatal illness, lest it progress to the point where it's not treatable and they come to regret relying (at least initially) on religious treatments?

(For the record, I'd have little problem if the government wanted to run a truly opt-out health program -- where you can agree to not pay for it in return for never being able to utilize it. This would probably keep in all but the most committed. It would also probably never happen.)

Robert|3.18.07 @ 1:18PM|#

I too have been led to believe insurance would cover X, only to have payment denied after the fact. I even know a lawyer who's had that happen to him. Neither of us are going to pay, of course.

Suppose we grant, in medical insurance or any other field, that if the private sector doesn't clean up its act, the clamor for gov't intervention will be irresistable. What then does it leave for the activist, the liberty concerned, to do about it to prevent the latter step? What control do we have over the private sector?

|3.18.07 @ 2:23PM|#

"What control do we have over the private sector?"

As of now, very little. In a market economy, you vote with your wallet. Only way would be to generate networks of healthcare by cash payment, where the client accepts not to deduct the costs for tax purposes. Those networks would be able to work below the AMA-Government radar, at least for a while, until libertarian lawyers can defend their cases on the Supreme Court. In other words - it will be difficult.

|3.18.07 @ 2:40PM|#

"Sure. Show me the charity one can turn to when one has substantial medical bills -- or even routine medical bills. "

Petra, it will be difficult to find such charities when much of the money is being given by the government. However, there are some charities out there:

http://www.drinet.com/charity.asp

It does not mean they will be able to cover everything, but you must consider that the system is so disrupted by government regulations and price controls, that is difficult for even charities to cover all expenses. THis is not an indictment on charities, Petra, but on who is doing the regulations and controling. Arguing that because some people cannot pay, we need to steal from others to pay for them (i.e. a totally socialized healthcare system), is still fallacious.

|3.18.07 @ 5:19PM|#

Break the government stranglehold on medical care and licensing (make it an independant process) and price will go into a freefall.

And how likely is that? With the current lobbying by the medical monopoly and the insurance groups?

The medical/insurance groups used government to establish and entrench their monopolies in the market. Rolling those back is not a feasible option whereas universal healthcare is. It's just like the arguments for gay marriage. The libertarian position is to get the government out of marriage, but that ain't gonna happen. So we attempt to balance it out by expanding the contract. Same scenario with healthcare. The medical establishment is locking people out due to anti-competitive behavior, so we equalize the other part of the option.

If the medical community didn't want government stepping in, they shouldn't have started their anti-competitive practices in the first place. If they aren't gonna back out of it, it's time to throw some weight behind government to start regulating them some more - just in a way that don't like.

|3.18.07 @ 9:00PM|#

joe:

Even at face value, my sin would hurt fewer people. A lot fewer. Destroying innovation is the worst utilitarian decision that can be made because of the value of a cure or significant new treatment over the course of time.

If it means everybody can't have everything right now, though it will all be cheaper as time goes on, you are damned right I'm comfortable.

Too, you don't feel the slightest bit of anxiety around what a nationalized system would look like when the innovative subsidy currently paid by US consumers evaporates? You are optimistic that, as advocates suggest, that ALL of that money is wasted now?

|3.19.07 @ 7:29AM|#

Just FYI, Ron. I haven't read the article completely yet, but you don't have the plan types right for Commonwealth Care. I work at one of the MCOs (Boston Medical Center HealthNet Plan) and believe me, I KNOW that there are only four types of plans, not seven, for people and families making less than 300% of the FPL. It is only a minor quibble, and not a mean-spirited one as you're among my favorites here, but it is something you should fix in the article.

Now off to read the rest of it. ;)