On Healthcare Rationing

The Denver Post

Re: Obama's Grand Strategy, April 26 Charles Krauthammer column.

As a public health nurse for some 25 years, I disagree with Charles Krauthammer’s idea that health care would be rationed under single-payer insurance system. It is already rationed by cost.

Only the wealthy and the federal legislature can afford health care (paid for by taxes). None of the poor and few of the middle class can afford health insurance, so they either do without or use public facilities. To tie health insurance to employment was a mistake and is now a direct cause of business and industry failures.

Most of us are aware of health care rationing. No money, no care. Health care for profit was not a good idea. Basic health care and certainly preventive services are a right, as they prevent the spread of disease and monitor epidemics for the whole population.

Our current non-system has priced itself out of existence and no amount of the same old cries of reducing costs by making providers more competitive is getting more tiresome to the public-at-large.

Beth Hohle, Denver

This letter was published in the May 3 edition.

My Commentary:

Ms. Hohle is relying on Orwellian language distortion to advocate for single-payer tyranny.

Rationing is defined as “to distribute, in times of scarcity”. This implies a central authority with the power “to distribute”–for example, the government under single payer. There is no such thing as “rationing by cost”, since there is no central authority to do the rationing. There are only producers of healthcare trading their work for the earnings of others willing and able to pay for it, by voluntary agreement to mutual advantage…just as in all other economic sectors. What Ms. Hohle objects to is justice…the natural fact that in a moral society, when you want or need something produced by others, you can acquire it only by voluntary means. You pay for it or you depend upon private charity and generosity. Morally, being unable to pay for your healthcare…while unfortunate…gives you no right to seize it forcibly by theft or through political surrogates you elect.

She’s right, though, that “To tie health insurance to employment was a mistake”. The third-party-payer system, imposed by government through tax code distortions, is a major reason why “Our current non-system has priced itself out of existence”. In fact the current crisis, if you want to call it that, is a consequence of the massive buildup of government interventions in the medical industry over the past 75 years or so. Government insurance mandates and the state-imposed trade barriers that prevent a competitive national market are also key reasons for the high cost of private health insurance.

So the claim that “None of the poor and few of the middle class can afford health insurance” doesn’t stand up to the facts. They are paying plenty in healthcare costs…only not their own. The person who can’t afford his own coverage is forced to pay, through his taxes, the healthcare expenditures of: the elderly (Medicare), the poor (Medicaid), other peoples’ children (SCHIP), other uninsured people (“charitable” aid to hospitals to cover “free” emergency room care, including for illegal aliens, under the federal law EMTALA), etc., etc., etc. In addition, there are research grants to universities and colleges. And don’t forget foreign aid healthcare spending, including former President Bush’s $50 billion Aids relief package to Africa. Undoubtedly, there is more.

America currently spends some $7500 per capita per year ($30,000 per family of four and rising) on healthcare. Almost that entire amount represents third parties spending other people’s money. If healthcare is unaffordable, how is it that we can foot that large of a bill? This is a fundamental part of the problem. That money comes from all of us in a myriad of ways, yet leaves us with little control over how it is spent. Leave that money in the hands of the people that earned it through some vehicle like HSAs, end government insurance mandates and the third-party-payer system, phase out existing “public” plans like Medicare, Medicaid, and SCHIP, and let people take personal responsibility for their own healthcare.

I’m always amazed at how flippantly and thoughtlessly people like Ms. Hohle are willing to throw away their freedom and the earnings and freedom of others in exchange for the “free lunch” of a “single-payer” healthcare dictatorship. Ms. Hohle brushes off “the same old cries of reducing costs by making providers more competitive”. But competition based upon the ability of consumers, providers, insurers and patients to act upon their own rational judgement and contract voluntarily with each other is called freedom. Does Ms. Hohle mean to discard “the same old cries” of a nation founded upon the concept of unalienable individual rights?

For more in depth analysis on the causes and solutions to the problems of American healthcare, read the following articles in The Objective Standard;

Moral Health Care vs. “Universal Health Care”

Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America

The current semi-socialized system needs major reform. The only just and moral course to take on healthcare reform is to rid the industry of government interference, and establish a free market. Calls for freedom-crushing, ration-based central government healthcare planning as a cure for what government itself caused to begin with “is getting more tiresome to the public-at-large”, of which I am a charter member.

Comment by Mike Zemack — May 3, 2009 @ 4:15 pm

Other's Commentary:

The private insurance companies are scared of competing with the government. I thought they were all about free markets.

Comment by Dave Clark — May 4, 2009 @ 4:00 pm

My Response to Dave Clark

“The private insurance companies are scared of competing with the government. I thought they were all about free markets.”–Dave Clark

A free market is based upon the recognition of individual rights, in which physical force is banished; i.e., all associations are voluntary.

A “public health insurance option”, as it is deceptively called, is backed by the legal force of government, which can subsidize it through taxes, while setting legal restrictions and conditions on its private “competitors” through its tax and regulatory authority…etc. A private company has no coercive power, and must rely upon the voluntary private market…which the very existence of a government “insurer” distorts and undermines…while all along being subject to the coercive edicts of politicians bent on protecting their “public option”.

To pretend that there can exist “competition” between a government-run “insurer” and a private one is to say there is no difference between an armed mugger and his victims.

Comment by Mike Zemack — May 5, 2009 @ 3:37 pm