Health care isn’t "free"

Applause to those who continue the good fight of keeping personal responsibility a part of health care:

For Racer’s and Micali’s views to prevail will be an uphill fight. These views will require Americans to take responsibility for their health, to become sophisticated health care shoppers, to choose between health care competitors, and to overcome the notion that health care is a special entitlement, immune to market forces and to which they are universally owed, regardless of cost to the American economy.

Comments

Anonymous
From the article:
“Basically the two argue as follows: single-payer systems abroad result in health monopolies, global budgets, rationing, stifling of innovation and individual freedom, and stagnant national economies with high unemployment.
They maintain the United States, given its current health system, has a strong vibrant economy built on freedom, a free market, and competition. These attributes , they say, are why the U.S. has the discretionary income to spend two times on health care those other nations do.”
Wow. Is it just me or does the article say that we have a strong economy because of our current health system? That’s just crazy talk.
Are we the biggest innovators in medicine because of our current health system? Then why should we want to change anything? Let’s continue to have the insurers keep down reimbursements. Defensive medicine must be an amazing thing to be sparking all this innovation. And so must be those big jury payouts that we hear so much about.
Please for the love of God let’s have an honest debate about universal health care and not this lame rhetoric that gets thrown about.
Dr.O
“honest debate about universal health care”?
Your statement is an oxymoron.
There is no such thing as universal right, at expense of freedoms of others. Your “right” implodes into the face of my economic freedoms: I am not your slave, after all.
“Doctors are not servants of their patients, they are traders like everyone else in a free society and they should bear that title proudly considering the crucial importance of the services they offer. — Ayn Rand”
Redhawk
As someone who suffers from chronic pain, I woud love to take “personal responsibility” for my medical care.
Unfortunately, in this alleged medical free market, I am forced to deal with an abusive, monopolistic kleptocracy where I have to pay out the nose for someone else to tell me what I will and will not do, and if I am unwilling to do what I am told, I don’t get my pain treated. In fact, I don’t get my pain treated even after doing what I’m told, but it often takes thousands of dollars of wasted money and months of torture before I can be certain that’s what the verdict is.
So before we start talking about “rights,” I’d like to know by what right the medical profession gets to enslave and abuse me?
Anonymous
I am sorry you live with chronic pain, but how are you enslaved by the medical profession?
Does the medical profession deny you your free will? Does it require you to provide a service to others at your own expense?
Are you not free to do as you please? Are you not free to seek another health professional who is more caring and compassionate than those you have been disappointed with?
You comment is offensive to those peoples with slavery in their history.
Danielle
I’m so sick of hearing the arguments against universal healthcare turned into a “rights” debate. Wanting universal healthcare does not necessarily mean someone supports the idea of healthcare as a right. They may see economic benefits, they may simply see it as a more humane system. It does not mean healthcare is a right. It is simply a system that is supported by tax dollars, ensuring all citizens have access to basic services. Preventative services are cheaper to provide than emergency room services for those who don’t have access to primary practices.
There is nothing monopolistic about single-payor systems at all. In Canada, patients are able to freely choose their doctors and other caregivers, they are free to supplement the government-sponsored health insurance with health insurance provided through their place of employment. Doctors freely choose where they will work, who they will treat and, what treatment options they will use.
Secondly, if you want to talk about economic freedoms, how does going into debt and having to mortgage one’s house demonstrate an excess of economic freedom?
How does having to follow an insurance company’s policy demonstrate economic freedom?
And by the way, the “right” to property is just as suspect from the “freedoms” point of view as the “right” to healthcare.
Anonymous
Secondly, if you want to talk about economic freedoms, how does going into debt and having to mortgage one’s house demonstrate an excess of economic freedom?
You mean I have a right to a medical education? I wouldn’t have had to mortgage my house and go into debt to go to medical school?!?!?! I wish someone had told me…
Anonymous
All rights flow from the natural right to be left alone. My right to property flows from my right not to be enslaved by others to labor for them. I labor for myself and produce wealth (property) which I then have the right to possess unmolested as for someone else to confiscate is to retroactively enslave me by stealing my labor, my time, my life.
It is a lie to call entitlements to wealth, goods, and services produced by others rights. This is not an extension of being left alone, and infringes on other peoples right to be left alone.
Rights are something that other people can deny you, but which in the absence of active efforts by others to deny them, you just have naturally. So you have a right to free air, but not food. You have a right to seek to earn or create food. You have a right to be free to seek wealth but not a right to wealth.
So a “right to healthcare” is doublespeak that promotes reduction of freedom and confiscation of property, an infringement of rights. You have right to seek to trade your labor for, or beg for healthcare unimpeeded by others.
BTW, the US has no healthcare system. There are a variety of “systems” among which a lot of individuals move seeking to pursue their interests and values.
Redhawk. I wish you could go the corner store and buy any and all drugs you want–it would save me a lot of grief. I would then only have to deal with people who valued me for my knowledge and skills and not only for my prescription pad.
But because a thorough appreciation of the value and price of freedom disappeared from the American electorate generations ago, we have politicians trying to restrict our liberties for our own individual good. The solution to the problems created thereby is not to do more of the same.
We in the profession would, if the busybodies among us had the chance, create a form of medical tyranny with a health oriented nanny-state outlawing any and all unhealthy behavior and requiring everyone to get health insurance. As I see it, people should be free to live however unhealthily they chose, buy insurance or not as they chose, and seek treatment or not as they chose.
Doctors should be free like all other free citizens to set the terms and conditions under which they sell (or give away if they chose) their services, but with no guarantee that anyone will take them up on those terms.
danielle
Anon 4:24 – no, you certainly do not have a right to medical education, but you have a right to the opportunity to it. I don’t know how you inferred that I thought it should be a right. (Although I suspect you don’t really think I do, you’re just being “smart” and avoiding the question).
anon 8:05 – are you confusing my argument as being in support of healthcare as a right? Did you just totally skip over the first part of it?
As for the “right” to property (although I personally think it is one of the main tenets of civilized and succesful societies), it is not a fundamental right like the right to life and liberty.
Property rights infringe all the time on others’ right to be left alone. The very fact that we own property and accumulate wealth, form a society based completely on this social convention, and then limit the freedoms of those who don’t own the same or as much property or wealth, shows that this so-called right interferes with everyones’ right to be left alone. The very system that grants us property rights also makes it impossible for us to not participate in this system if we don’t want to.
Now, obviously a society without property rights would quickly sink into anarchy, so I’m in favour of them. In fact, I take good advantage of my property “right”. I simply don’t believe it is a right like life or liberty is. It’s a necessary system that the government administrates to create a liveable society. Sometimes these kinds of things are simply necessary, and it’s up to every individual society to determine what other services and systems they want the government to provide. It doesn’t mean it’s a “right”.
Anonymous
Of course property rights, as all other rights are not absolute, but they are absolutely critical. Property is required to support life, and it’s creation is the primary thing that people, at liberty, will voluntarily spend most of their time doing. Taking their property takes the time that they devoted to creating that wealth.
No right is absolute, and our society is based on the theory that we have voluntarily surrendered some of them to the governments (some to the state and fewer specific rights to the federal) for mutual protection and common welfare–to in fact secure the more essential liberties.
We may in fact decide to empower the government to confiscate yet a greater part of our property to fund health services for all citizens, and that is fine, as long as we don’t otherwise infringe liberties in the bargin. Just like with funding of universally available education, people are free to provide or purchase educational services privately, if they so choose. They can keep those private schools free of governmental interference if they so choose. The same should and must be true of health care. A fundamental right, with which the government has not been impowered to interfere, is the right to obtain health services with complete privacy.
Letting the government into your medical care, is letting your neighbors nose into your medical care–since in a democracy, that is all the government is.
Anonymous
Let me offer a somewhat simplified solution, and the only one in my opinion with a chance of working. I believe the mechanism of healthcare funding will change.
Instead of being provided as an employment benefit, it will be funded by taxation of all, preferably in the form of a national sales tax. Any other mechanism will leave the unemployed without contribution to the plan.
The federal, not state, government will fund the plan. It will provide the basics only; and only provide care and medications proven to be cost and therapeutically effective. Each patient will be limited to a certain number or dollar amount for medications without an appeal. This will prevent wanton prescibing by physicians, encourage generic substitution, and discourage overconsumption by patients. Those DTC ads, in fact almost all pharmaceutical marketing, will become extinct.
Expensive end-of-life care financed by the federal government will be curtailed. Death will be accepted as an inevitable part of the human life cycle. The emphasis will change to comfort and compassion; quality rather than morebund longevity.
Elective surgeries and procedures funded by the government will have associated waits and/or approvals that must be obtained. This will at minimum limit the speed with which unnecessary services are provided. Many knees and backs will be found to have improved themselves miraculously while waiting for a surgical date.
This is not to suggest that patient choice or availability of medications and services will be limited. Quite the contrary. But they will have to finance the extra themselves, either out-of-pocket or by supplementary private insurance. Doctors and private hospitals will be able to set their own prices. Patients will be aware of prices and quality measures, and able to comparison shop. Better doctors and facilities will be able to command better reimbursement in total. They will collect the government allowed amount plus the amount paid by patient and/or private insurance. Insurance companies will no longer have the power to coercively determine total reimbursement. The nature of private contracts will be between patients and their insurance company, not doctor and insurance company. Ultimately prices will be set by the market.
There it is, in simplified form. Why don’t we do this like Linux. Now that there is a basic framework, take it from there and make it happen. If you don’t someone else will, and nobody will be happy.
Anonymous
That would work great–with some other species. Humans are, by nature self-interested, willfull, and devious in pursueing their interests. They are also mostly pretty short-sighted most of the time.
I think providing just cost-effective and proven care is fine–as long as the service I want (or provide) is on the list. If it isn’t, I will band together with like-minded citizens and work to make it so.
“Death will be accepted.” Yeah, sure, I will accept your death–but I am going to fight for every minute and demand, manipulate, even lie–whatever it takes to get the medical I think I need to make that happen. When practicing, faced with a dying patient begging for a treatment that doesn’t meet criteria, I will just falsify the record (as often happens now).
“Associated waits”. Yeah right. I am sure our congressmen are going to ingore the flurry of irate letters from constituents in pain over that one.
“Quality measures”. I’ll have to make sure that I get on that committee to skew the choice of measures in my favor and against my competetors. I will have to tighten my prescreening to even more effectively deny care to those whom I anticipate will have poor outcomes. You know the old observation, just take out healthy appendices, you will have few complications.
“Pharmaceutical marketing will become extinct.” No American businessman is going to stop marketing his product. If usage is controled by government agency–well, there is the old bribe.
What you are proposing is a classice two tiered system–with a heavy dose of pollyannish optimism on a level of commanding the tide not to come in.
I agree with two tiers–but few politicians have the guts to speak for it out loud. The very idea that we have a crises is based on the rejection of two-tiered systems–that everyone ought to have access to the same.
Once we accept two-tiers, the question that becomes obvious is “Why not just, using your sales tax, locally fund charity clinics and hospitals?” Each local public health authority can prioritize the services to match the revenue, as each local community or state decides how much this is worth to them. No one has to enroll–they just show up. It also presents fewer levels of red tape and more opportunities to receive volunteer labor.
And it avoids the assault on the tenth amendment to the constitution that any national health plan will result in. (Not that the tenth is much respected now anyway other than in the breach). I see no advantages in any case of making this a federal plan. The taxes come from the same people and most states already collect sales taxes.
Anonymous
Anonymous : 4:49 PM:
You are being part of the problem rather the solution. This is not a local issue and requires a comprehensive national plan.

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