The following article by David I Knowlton, a former deputy commissioner of health in New Jersey and current president and CEO of the New Jersey Health Care Quality Institute, has been published in the June 24, 2009 Star-Ledger of NJ. This is just another man with another statist plan.
Health reform isn't brain surgery
My Commentary:
Posted by Zemack on 06/24/09 at 8:39PM
The purveyors of government control of medicine, euphemistically called "national health care reform", offer all kinds of angles to plug their wares. In all cases, they start by citing the current problems in American healthcare, and propose some government-imposed solution.
What they never acknowledge is the fact that our current system is a creation of government. Yet they hold the government up to be champions of their own victims.
The premise that "we are all our brothers' keepers" is the governing principle, and is the first major problem. America currently spends some $7500 per capita per year ($30,000 per family of four and rising) on healthcare. Almost 90% of that amount represents people spending other people's money. There are the government programs such as Medicare, Medicaid, and SCHIP. There is the tax distortion-created third-party-payer system. There are the thousands of state and federal dictates imposed on the insurance industry such as community ratings, guaranteed issue, and benefits mandates which are nothing more than wealth redistribution masquerading as insurance. Today's private insurance industry is actually a quasi-private, government created and protected cartel, and is not indicative of a free market. It is a conduit for government edicts, not a dynamic, competitive, entrepreneurial industry free to tailor policy choices to market realities.
Our system is a combination of communism for seniors, the poor, and some peoples' children...and fascism for the rest of us.
Ours is a system in which everyone is forced to pay for everyone else's healthcare, but is not responsible for his own (except for small co-pays and deductibles). What kind of incentives does anyone think that will create? Yet Mr. Knowlton prattles about "urging our leaders to realign incentives in the health care system", and "plenty of models we can look to for guidance". There sure is a model to look toward - a free market, the system based upon the recognition of individual rights. Instead of forcing us to take care of everyone else, while at the same time demanding that everyone else...i.e., the government...take care of us, how about getting government out of healthcare and health insurance and leave us free to make our own decisions and take personal responsibility for our own health? You'd be surprised what kinds of incentives are evident when you reap the rewards of good habits and pay the price for the bad, while having our unalienable rights guaranteed.
But it is not solutions that are the goal. It is power...the power of control by bureaucratic and political elites. The artificial "incentives" and tax-funded "investments" are code words for the coming tyranny.
It gets tiresome to hear the David Knowltons of the world keep promoting government solutions to the problems created by government. Our money is not "there for the taking" by any man with another plan. Our money and property are not his, nor the government's, nor anyone's to dispose of...except those who earned it.
The current "debate" on "reform" is an intellectual and philosophical fraud, leaving Americans with the false perception that our choice is either the status quo or submission to state-run medicine. There is no political sponsorship for the authentic alternative.
Any honest and objective healthcare reform debate must begin with an examination of how we got to this point to begin with. The problems in American healthcare have grown in lock step with the growth of government intervention over the past 75 years. The solution is to discover capitalism. The only just and moral course to take on healthcare reform is to rid healthcare of government interference. End all government insurance mandates, barriers to inter-state competition, 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, as is their unalienable right under American principles. Leave healthcare dollars in the hands of the people that earned it through some vehicle like HSAs, leave providers and insurers free to compete directly for those consumer dollars, and restrict the government to its proper role of protector of the individual rights of all (which includes anti-fraud laws and enforcement of contracts). The natural incentives inherent in a free market provide the proper, moral dynamics for affordable, widely available quality healthcare.
Wednesday, June 24, 2009
Monday, June 22, 2009
One NJ Doctor's Rebellion
From the Star Ledger Reader Forum.
Cash-only health care
As a psychotherapist, I do not accept Medicare or Medicaid. Why? Because they pay a pittance compared to private health insurance. Yet private insurance has been reducing reimbursement rates with no warning or notification to providers. In fact, there has been no increase in reimbursement since 1994. Can you imagine not getting a raise in pay for that long and having your income reduced as well?
If President Obama's health care reform passes, any provider worth his weight will not take insurance at all and take only cash, freeing themselves from the organized crime of insurance all together. This will leave only the worst providers as "In network." Quality care will be left only to the rich, while those trying to save a buck will save little. People need to speak up and demand answers from "for-profit" insurance companies.
Leo Battenhausen, Roselle
My Commentary:
Posted by Zemack on 06/22/09 at 7:26PM
Leo Battenhausen describes how American medicine is slowly being destroyed, but misses a crucial fact and thus blames the wrong culprit... the "for-profit" insurance industry.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. Our current system is not indicative of a free market, but of a mixed economy. Perversely, the insurance company works not for the consumer...i.e., the patient...but for the employer, union, or other third party, to which it is beholden. It has created huge administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of insurance company bureaucrats, and tied people to their jobs.
I have encountered, as a patient, the squeeze between what my doctor wants to prescribe and what the insurer demands. Since I am not the insurer's customer, I have no leverage and no choice. Because of the third-party-payer system, which was created and maintained by tax-code distortions, the doctor-patient relationship is disrupted, leading to the kinds of problems described by Mr. Battenhausen.
What is needed, for the private sector, is an end to the third-party-payer system, all insurance mandates, and all state-imposed restraint-of-trade laws. Government, through its controls and interference, is the source of the seeming power of the "private" insurance company. The proper role for government is an important one; to protect against fraud and breach of contract, and to mediate contractual disputes. Beyond that, the politicians should get out of the insurance business altogether. Health insurance is properly a contractual matter to be decided between the individual and his insurance company, as a matter of unalienable right. Likewise, healthcare services are a matter between the provider and the patient. If the insurer works directly for the patient, then he...the doctor's customer...is responsible for payment, whatever the contractual arrangements he has with his insurer happen to be. A doctor and patient are free to make payment and price arrangements directly, by mutual agreement, as it should be.
The problem is not "for-profit" insurance as such, but government interference, which inverts the normal market incentives. In a free market - which is a system based on individual rights - insurers, providers, customers and patients are free to contract with each other, voluntarily to mutual advantage. Profits are a natural consequence of the free market. They are the result of providing goods and services at prices that are both affordable yet above the cost of production, and accrue to companies best at doing that. The profit motive drives prices lower and quality higher, but only in a free market where companies compete directly for the consumer's business. The whole history of capitalism, when it is allowed to function, is one of growing profits by cutting prices by cutting production costs, thus expanding the market by increasing affordability. More importantly, the right to any profits earned by one's own productive work in any field is a moral, unalienable human right. Profits, properly understood, are noble.
As to government-run "insurance" programs, they should be phased out and abolished. They are corrupting and destroying medicine in this country. By refusing to deal with Medicare and Medicaid Mr. Battenhausen is taking more than a practical step. He is taking a moral stand against his own enslavement. Perhaps if more doctors rebelled in this manor, we would get the only moral solution to the problems plaguing American healthcare - a free market - rather than the ultimate disaster we appear headed for.
Cash-only health care
As a psychotherapist, I do not accept Medicare or Medicaid. Why? Because they pay a pittance compared to private health insurance. Yet private insurance has been reducing reimbursement rates with no warning or notification to providers. In fact, there has been no increase in reimbursement since 1994. Can you imagine not getting a raise in pay for that long and having your income reduced as well?
If President Obama's health care reform passes, any provider worth his weight will not take insurance at all and take only cash, freeing themselves from the organized crime of insurance all together. This will leave only the worst providers as "In network." Quality care will be left only to the rich, while those trying to save a buck will save little. People need to speak up and demand answers from "for-profit" insurance companies.
Leo Battenhausen, Roselle
My Commentary:
Posted by Zemack on 06/22/09 at 7:26PM
Leo Battenhausen describes how American medicine is slowly being destroyed, but misses a crucial fact and thus blames the wrong culprit... the "for-profit" insurance industry.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. Our current system is not indicative of a free market, but of a mixed economy. Perversely, the insurance company works not for the consumer...i.e., the patient...but for the employer, union, or other third party, to which it is beholden. It has created huge administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of insurance company bureaucrats, and tied people to their jobs.
I have encountered, as a patient, the squeeze between what my doctor wants to prescribe and what the insurer demands. Since I am not the insurer's customer, I have no leverage and no choice. Because of the third-party-payer system, which was created and maintained by tax-code distortions, the doctor-patient relationship is disrupted, leading to the kinds of problems described by Mr. Battenhausen.
What is needed, for the private sector, is an end to the third-party-payer system, all insurance mandates, and all state-imposed restraint-of-trade laws. Government, through its controls and interference, is the source of the seeming power of the "private" insurance company. The proper role for government is an important one; to protect against fraud and breach of contract, and to mediate contractual disputes. Beyond that, the politicians should get out of the insurance business altogether. Health insurance is properly a contractual matter to be decided between the individual and his insurance company, as a matter of unalienable right. Likewise, healthcare services are a matter between the provider and the patient. If the insurer works directly for the patient, then he...the doctor's customer...is responsible for payment, whatever the contractual arrangements he has with his insurer happen to be. A doctor and patient are free to make payment and price arrangements directly, by mutual agreement, as it should be.
The problem is not "for-profit" insurance as such, but government interference, which inverts the normal market incentives. In a free market - which is a system based on individual rights - insurers, providers, customers and patients are free to contract with each other, voluntarily to mutual advantage. Profits are a natural consequence of the free market. They are the result of providing goods and services at prices that are both affordable yet above the cost of production, and accrue to companies best at doing that. The profit motive drives prices lower and quality higher, but only in a free market where companies compete directly for the consumer's business. The whole history of capitalism, when it is allowed to function, is one of growing profits by cutting prices by cutting production costs, thus expanding the market by increasing affordability. More importantly, the right to any profits earned by one's own productive work in any field is a moral, unalienable human right. Profits, properly understood, are noble.
As to government-run "insurance" programs, they should be phased out and abolished. They are corrupting and destroying medicine in this country. By refusing to deal with Medicare and Medicaid Mr. Battenhausen is taking more than a practical step. He is taking a moral stand against his own enslavement. Perhaps if more doctors rebelled in this manor, we would get the only moral solution to the problems plaguing American healthcare - a free market - rather than the ultimate disaster we appear headed for.
Saturday, June 13, 2009
Ken Gordon on "The Public Option"
The gross dishonesty and/or ignorance about the causes of the current healthcare/health insurance "crisis" is evident in this piece.
Nothing Good Just Happens
The author, Ken Gordon, is the former Majority Leader of the Colorado State Senate.
My Commentary:
Mike Zemack said...
What Mr. Gordon doesn’t say is that our system of health insurance is a creation of the government. The third-party-payer system was imposed by government via tax-code distortions. Perversely, the insurance company works not for the consumer but for the employer, union, or other third party that purchases the policy, even though the consumer’s own earnings pay for it. The thousands of state and federal mandates imposed on the insurers dictate the content of the policies, force consumers to pay for coverages that they may not want, sharply drives up the cost of the policies, and actually creates a system of pre-paid healthcare…not insurance. State restraint-of-trade practices prevent a competitive national insurance market from developing, also driving prices up and choices down.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. It has created huge unnecessary administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of government and insurance company bureaucrats, inverted the normal market incentives that lead to higher quality, lower prices, and wide availability, and tied people to their jobs.
Now Mr. Gordon and his ilk propose to “solve” the problems they themselves caused by creation of the fraud called a “public option”. This is nothing more than a back-door attempt at something Americans have never wanted…totalitarian government control of healthcare. The government holds a legal monopoly on physical force. The “option” is backed by this power of the gun. The politicians can and will do whatever it takes to support their “public option”. It will use tax subsidies to keep premiums “affordable”; arbitrary regulatory powers to hamper its private “competitors”, etc. The government will act as any organized crime syndicate does…use its unique power of physical compulsion to drive private citizens out of business. To say that there can be competition between a government-owned entity and private companies is to see no difference between an armed thug and his victims.
The obvious and only moral solution to the problems in health insurance cited by Mr. Gordon is to liberate the insurance market of all of this government interference, leaving individuals and insurers free to contract directly with each other to mutual advantage…a freedom that is theirs by unalienable right. But solutions are not the goal; power is. Having crippled the industry, making it unable to function, it is now cast as the villain. Every advancing dictatorship needs scapegoats.
The real liars here are the “public option” advocates. The problems in American healthcare have grown in lock step with the growth of government intervention. Any honest and objective healthcare reform debate must begin with an examination of how we got to this point to begin with. Instead, they are now declaring that freedom has failed, consumers are too stupid to understand health insurance, and that dictatorship is the answer.
But today’s problems in medicine represent a failure, not of freedom, but of statist government intervention. The choice we face…for ordinary Americans and providers alike…is between being held in a stranglehold by government central planners, or taking control of our own healthcare in a truly free market.
Nothing Good Just Happens
The author, Ken Gordon, is the former Majority Leader of the Colorado State Senate.
My Commentary:
Mike Zemack said...
What Mr. Gordon doesn’t say is that our system of health insurance is a creation of the government. The third-party-payer system was imposed by government via tax-code distortions. Perversely, the insurance company works not for the consumer but for the employer, union, or other third party that purchases the policy, even though the consumer’s own earnings pay for it. The thousands of state and federal mandates imposed on the insurers dictate the content of the policies, force consumers to pay for coverages that they may not want, sharply drives up the cost of the policies, and actually creates a system of pre-paid healthcare…not insurance. State restraint-of-trade practices prevent a competitive national insurance market from developing, also driving prices up and choices down.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. It has created huge unnecessary administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of government and insurance company bureaucrats, inverted the normal market incentives that lead to higher quality, lower prices, and wide availability, and tied people to their jobs.
Now Mr. Gordon and his ilk propose to “solve” the problems they themselves caused by creation of the fraud called a “public option”. This is nothing more than a back-door attempt at something Americans have never wanted…totalitarian government control of healthcare. The government holds a legal monopoly on physical force. The “option” is backed by this power of the gun. The politicians can and will do whatever it takes to support their “public option”. It will use tax subsidies to keep premiums “affordable”; arbitrary regulatory powers to hamper its private “competitors”, etc. The government will act as any organized crime syndicate does…use its unique power of physical compulsion to drive private citizens out of business. To say that there can be competition between a government-owned entity and private companies is to see no difference between an armed thug and his victims.
The obvious and only moral solution to the problems in health insurance cited by Mr. Gordon is to liberate the insurance market of all of this government interference, leaving individuals and insurers free to contract directly with each other to mutual advantage…a freedom that is theirs by unalienable right. But solutions are not the goal; power is. Having crippled the industry, making it unable to function, it is now cast as the villain. Every advancing dictatorship needs scapegoats.
The real liars here are the “public option” advocates. The problems in American healthcare have grown in lock step with the growth of government intervention. Any honest and objective healthcare reform debate must begin with an examination of how we got to this point to begin with. Instead, they are now declaring that freedom has failed, consumers are too stupid to understand health insurance, and that dictatorship is the answer.
But today’s problems in medicine represent a failure, not of freedom, but of statist government intervention. The choice we face…for ordinary Americans and providers alike…is between being held in a stranglehold by government central planners, or taking control of our own healthcare in a truly free market.
Friday, June 12, 2009
"Health Care Debate"--What about the Third and Moral Option?
The following letter was published in the Star-Ledger Reader Forum.
Health care debate
I am perplexed and discouraged by the fight over health care. It's pretty obvious that what we're doing isn't working so well.
In the big picture, it seems to me, if we want our businesses to be competitive, getting health care off their backs is a necessity.
I still hear people, even those who love their Medicare, complain they don't want the government involved in their health insurance. They don't want a government bureaucrat telling their doctor what's okay to do and what's not okay. Meanwhile, I guess, they don't mind some insurance company bureaucrat making those decisions.
I've heard some people suggest we be allowed to buy our insurance in another state where it's cheaper. Think they'll have any preferred providers in your state?
I believe in a compromise: single payer via taxes with a government plan in the mix and private insurance companies competing. This would get the premium dollars off of industry, would let those who want private insurance get it, would let those who want public insurance get it, and would insure all the uninsured. It would help our industries be more competitive, and your health care wouldn't be connected to your employment.
John Smith, Hamilton
My Commentary:
Posted by Zemack on 06/12/09 at 8:29PM
John Smith cites a couple of problems such as employer-based health insurance and insurance company bureaucrats making healthcare decisions. His solution, though, amounts to "First, do more harm".
All of the problems in American healthcare can be attributed directly to government intervention. The third-party-payer system was imposed by government via tax-code distortions. Perversely, the insurance company works not for the consumer but for the employer, union, or other third party, even though the consumer's earnings pay for it. The thousands of state and federal mandates imposed on the insurers force consumers to pay for coverages that they may not want, sharply drives up the cost of the policies, and actually creates a system of pre-paid healthcare...not insurance. These mandates are really wealth redistribution masquerading as insurance. State restraint-of-trade laws prevent a competitive national insurance market from developing, also driving up prices and choices down. Medicare and Medicaid, which have made government the largest purchaser of healthcare products, have so corrupted the market that the normal forces that lead to higher quality and lower costs have been inverted. This is just part of the story.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. It has created huge administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of government and insurance company bureaucrats, and tied people to their jobs.
Yet Mr. Smith's "compromise" would reward the government with totalitarian control over all aspects of healthcare. When the government pays, the government sets the terms...period. You hand your money over to the state, and in exchange you give up your freedom...a lose-lose proposition. This, in essence, is communism. "Allowing" private companies to "compete" against the government-run "option" is merely socialism through the back door, where "private" companies are merely conduits for government control...i.e., fascism. So, according to Mr. Smith, the choices are either the status quo, or some totalitarian combination of communism and fascism.
It's imperative, before we sink to that level, that we consider the third option...the only moral one and the one ignored by both major parties. End the system of compelling everyone to pay for everyone else's healthcare. End all government interference in the insurance market, leaving government to its proper role of protecting individual rights such as through anti-fraud laws and contract enforcement and mediation of disputes. Leave consumers and patients free to decide, along with their doctors, what treatments to use along with prices and payment options. Leave everyone free to plan for their own retirement, to accept responsibility for their own decisions, to take responsibility for their own lives...not be forced to pay other people's expenses. Leave everyone free to decide when and in what capacity to help others, based upon each person's own personal values, assessments of the worthiness of the recipient, and affordability.
Leave insurers and providers free to compete directly for the consumer's business. Leave providers, consumers, insurers, doctors, and patients free to act upon their own judgement, and to contract voluntarily with each other to mutual advantage.
Free market capitalism, the original American system based upon the unalienable and equal rights of every individual, is the only moral path to health care reform. The government's proper role is to protect individual rights, which are guarantees to the freedom to take the actions necessary for the advancement of one's own life and happiness. Rights are not an automatic, unconditional claim on the earnings, property, products, services, or skills produced others. The government's job is not to guarantee health insurance or healthcare to all, but to maintain the societal conditions of liberty and non-coercive association required for people to live their lives and solve their own problems.
Eliminating coercive government interference in healthcare and insurance combined with individual rights in medicine will dramatically reduce the cost and lead to greater quality. That is what always happens when consumers are free to spend their own money and producers to compete for their business. Healthcare, though a high value product and need, is essentially no different than any other man-made product. Consumers seeking the best value for their money, and profit-driven producers seeking to expand sales and grow, places incentives on the side of greater and greater availability and affordability. These basic laws of economics would work no different in healthcare than they would in any other market, when people are left free.
The current healthcare "crisis", if you want to call it that, is not a failure of freedom or free markets. Any honest and objective healthcare reform debate must begin with an examination of how we got to this point to begin with. The problems in American healthcare have grown in lock step with the growth of government intervention. The solution is to discover capitalism. The only just and moral course to take on healthcare reform is to rid healthcare of government interference.
Today's problems in medicine represent a failure, not of freedom, but of statist government intervention. The choice we face is not between a government-run healthcare dictatorship and the status quo, as Mr. Smith, would have us believe. The choice we face...for doctors, patients, drug producers, etc...is between being held in a stranglehold by government central planners, or taking control of our own healthcare in a truly free market.
Health care debate
I am perplexed and discouraged by the fight over health care. It's pretty obvious that what we're doing isn't working so well.
In the big picture, it seems to me, if we want our businesses to be competitive, getting health care off their backs is a necessity.
I still hear people, even those who love their Medicare, complain they don't want the government involved in their health insurance. They don't want a government bureaucrat telling their doctor what's okay to do and what's not okay. Meanwhile, I guess, they don't mind some insurance company bureaucrat making those decisions.
I've heard some people suggest we be allowed to buy our insurance in another state where it's cheaper. Think they'll have any preferred providers in your state?
I believe in a compromise: single payer via taxes with a government plan in the mix and private insurance companies competing. This would get the premium dollars off of industry, would let those who want private insurance get it, would let those who want public insurance get it, and would insure all the uninsured. It would help our industries be more competitive, and your health care wouldn't be connected to your employment.
John Smith, Hamilton
My Commentary:
Posted by Zemack on 06/12/09 at 8:29PM
John Smith cites a couple of problems such as employer-based health insurance and insurance company bureaucrats making healthcare decisions. His solution, though, amounts to "First, do more harm".
All of the problems in American healthcare can be attributed directly to government intervention. The third-party-payer system was imposed by government via tax-code distortions. Perversely, the insurance company works not for the consumer but for the employer, union, or other third party, even though the consumer's earnings pay for it. The thousands of state and federal mandates imposed on the insurers force consumers to pay for coverages that they may not want, sharply drives up the cost of the policies, and actually creates a system of pre-paid healthcare...not insurance. These mandates are really wealth redistribution masquerading as insurance. State restraint-of-trade laws prevent a competitive national insurance market from developing, also driving up prices and choices down. Medicare and Medicaid, which have made government the largest purchaser of healthcare products, have so corrupted the market that the normal forces that lead to higher quality and lower costs have been inverted. This is just part of the story.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and budgets of the actual, individual consumers of healthcare. It has created huge administrative costs throughout the system, undermined the doctor-patient relationship, placed undue power in the hands of government and insurance company bureaucrats, and tied people to their jobs.
Yet Mr. Smith's "compromise" would reward the government with totalitarian control over all aspects of healthcare. When the government pays, the government sets the terms...period. You hand your money over to the state, and in exchange you give up your freedom...a lose-lose proposition. This, in essence, is communism. "Allowing" private companies to "compete" against the government-run "option" is merely socialism through the back door, where "private" companies are merely conduits for government control...i.e., fascism. So, according to Mr. Smith, the choices are either the status quo, or some totalitarian combination of communism and fascism.
It's imperative, before we sink to that level, that we consider the third option...the only moral one and the one ignored by both major parties. End the system of compelling everyone to pay for everyone else's healthcare. End all government interference in the insurance market, leaving government to its proper role of protecting individual rights such as through anti-fraud laws and contract enforcement and mediation of disputes. Leave consumers and patients free to decide, along with their doctors, what treatments to use along with prices and payment options. Leave everyone free to plan for their own retirement, to accept responsibility for their own decisions, to take responsibility for their own lives...not be forced to pay other people's expenses. Leave everyone free to decide when and in what capacity to help others, based upon each person's own personal values, assessments of the worthiness of the recipient, and affordability.
Leave insurers and providers free to compete directly for the consumer's business. Leave providers, consumers, insurers, doctors, and patients free to act upon their own judgement, and to contract voluntarily with each other to mutual advantage.
Free market capitalism, the original American system based upon the unalienable and equal rights of every individual, is the only moral path to health care reform. The government's proper role is to protect individual rights, which are guarantees to the freedom to take the actions necessary for the advancement of one's own life and happiness. Rights are not an automatic, unconditional claim on the earnings, property, products, services, or skills produced others. The government's job is not to guarantee health insurance or healthcare to all, but to maintain the societal conditions of liberty and non-coercive association required for people to live their lives and solve their own problems.
Eliminating coercive government interference in healthcare and insurance combined with individual rights in medicine will dramatically reduce the cost and lead to greater quality. That is what always happens when consumers are free to spend their own money and producers to compete for their business. Healthcare, though a high value product and need, is essentially no different than any other man-made product. Consumers seeking the best value for their money, and profit-driven producers seeking to expand sales and grow, places incentives on the side of greater and greater availability and affordability. These basic laws of economics would work no different in healthcare than they would in any other market, when people are left free.
The current healthcare "crisis", if you want to call it that, is not a failure of freedom or free markets. Any honest and objective healthcare reform debate must begin with an examination of how we got to this point to begin with. The problems in American healthcare have grown in lock step with the growth of government intervention. The solution is to discover capitalism. The only just and moral course to take on healthcare reform is to rid healthcare of government interference.
Today's problems in medicine represent a failure, not of freedom, but of statist government intervention. The choice we face is not between a government-run healthcare dictatorship and the status quo, as Mr. Smith, would have us believe. The choice we face...for doctors, patients, drug producers, etc...is between being held in a stranglehold by government central planners, or taking control of our own healthcare in a truly free market.
Tuesday, June 9, 2009
Gillis on the Lessons of Atlas
David Gillis of St. Clair, a Times Herald community columnist, wrote a column comparing the business headlines to Atlas Shrugged, published 52 years ago.
The column is entitled "Rand's novel offers lessons for current economic crisis".
I posted the following brief comments, partly in response to other correspondents;
MikeZemack wrote:
Private business is the face of this crisis, but is NOT indicative of actual capitalism--the separation of economics and state. Private ownership can exist in non-capitalist systems, such as fascism. This crisis occurred in a heavily regulated industry, under a central bank money monopoly. There is the Federal Reserve, FDIC, Fannie and Freddie, mortgage guarantees, the CRA, the network of “affordable housing” policies, mandatory accounting rules, the state-licensed rating agency cartel’s AAA endorsement based upon implicit government guarantees, “to big to fail” bailout policies…etc., etc.
Rand correctly identified the corruptive nature of political interference in private economic decision-making, and the way in which the regulatory apparatus acts as the conduit. The government’s primary role in causing and exacerbating this crisis is impossible to dismiss. Those who blame “deregulation” or “unfettered markets” have no clue what capitalism is, and are not looking at the facts.
The column is entitled "Rand's novel offers lessons for current economic crisis".
I posted the following brief comments, partly in response to other correspondents;
MikeZemack wrote:
Private business is the face of this crisis, but is NOT indicative of actual capitalism--the separation of economics and state. Private ownership can exist in non-capitalist systems, such as fascism. This crisis occurred in a heavily regulated industry, under a central bank money monopoly. There is the Federal Reserve, FDIC, Fannie and Freddie, mortgage guarantees, the CRA, the network of “affordable housing” policies, mandatory accounting rules, the state-licensed rating agency cartel’s AAA endorsement based upon implicit government guarantees, “to big to fail” bailout policies…etc., etc.
Rand correctly identified the corruptive nature of political interference in private economic decision-making, and the way in which the regulatory apparatus acts as the conduit. The government’s primary role in causing and exacerbating this crisis is impossible to dismiss. Those who blame “deregulation” or “unfettered markets” have no clue what capitalism is, and are not looking at the facts.
Tuesday, June 2, 2009
New Jersey's Autism Mandate
Some New Jersey Legislators have proposed a bill requiring insurance companies to cover autism treatment. This article appeared in the New Jersey Star-Ledger. Posted below is my response to the initial article followed by a lively and emotional debate between myself and other correspondents who support the bill. Others' comments are in block quotes. The entire comments thread can be read by going to the artcle.
The article:
Speaking up for autism
My initial ommentary:
Posted by Zemack on 06/02/09 at 6:11PM
Senate bill s1940, which I believe is still pending, "Requires health insurers and SHBP to provide certain mental health benefits for eating disorders..." Mr. Roberts' bill will force insurers to cover autism treatment. Put another way, both of these laws would make it illegal for any insurer to sell a policy in New Jersey that does not include coverage for these ailments. This means that the cost of insurance premiums will have to rise, forcing everyone to buy coverage for something that they may not want or be able to afford. If you want a peak at one of the culprits that are driving insurance costs up, this is it.
However heart-wrenching the circumstances of a particular medical condition may be on family and patient, it has to be said. All such mandates are driven by special interests and their political surrogates seeking to use the power of government to stick everyone else with their medical bills. They are really wealth redistribution masquerading as insurance. They are immoral and unjust because they violate the rights of insurers and their customers to contract voluntarily with each other to mutual advantage.
Having said that, I also believe there is a genuine injustice suffered by parents of autistic children. While they struggle to pay the cost of their own children's treatment, they themselves are victims of a myriad of other government mandates, programs, and policies.
For example, they are forced to pay the cost of similar insurance mandates such as New Jersey's soon to be (or already) enacted Senate bill S1940. In addition, that same couple that is struggling to afford treatment for their own autistic child is paying, through their taxes, the healthcare expenditures of: the elderly (Medicare), the poor (Medicaid), other peoples' children (SCHIP), other uninsured people ("charitable" government aid to hospitals to cover "free" emergency room care, including for illegal aliens, imposed under the federal law EMTALA), etc., etc., etc. In addition, there are medical research grants to universities and colleges. And don't forget foreign aid healthcare spending, including President Bush's $50 billion Aids relief package to Africa. Undoubtedly, there is more. Such is the unjust nature of a system where everyone is forced to pay for everyone else's healthcare.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and pocket books of the actual, individual consumers of healthcare. The absurdities are not hard to find. For example, my policy covers a myriad of routine medical procedures such as doctor's visits, eyeglasses, dental fillings, medical exams, etc. (after co-pays and deductibles). Yet I can be stuck with massive bills for something like Autism treatment. And I don't have a choice, since my health insurance is purchased by a third party...spending my own money to boot.
A real insurance policy would cover only the major, unforeseen, catastrophic healthcare expenses above a high deductible, such as those cited in the article. That is the real purpose of insurance. In a free market, most medical care would undoubtedly be paid for directly by the consumer with his own out-of-pocket money. It is unlikely, given the choice, that many people would hand over wads of money to insurance companies year after year for routine care or even for such things as mammograms, colonoscopies, moderate amounts of prescription drugs, etc. What we have today is pre-paid healthcare that creates mountains of administrative expenses, empowers insurance company and government bureaucrats to impose decisions properly belonging to the people, and drives up the cost of healthcare and insurance premiums.
The proper role for government is an important one; to protect against fraud and breech of contract, and to mediate contractual disputes. Beyond that, and rather than compound the problem with more mandates, the politicians should get out of the insurance business altogether. Health insurance is properly a contractual matter to be decided between the individual and his insurance company, as a matter of unalienable right. They should not be at the mercy of every politician and special interest group seeking to impose their will on others.
My Response to jlsmith:
Posted by Zemack on 06/02/09 at 8:52PM
The hugely inflated cost of medical care exists under a system of massive government interference. That should be a strong clue. The third-party-payer system, the thousands of mandates, restraint-of-trade state policies, socialist government programs, all of the controls, taxes, and regulations; all of this inverts the normal market incentives that would lead to higher quality and lower prices. Of the $7500 per capita America spends on healthcare, almost 90% of that represents people spending other people's money.
But even in a free market, some healthcare expenses will be very expensive, and there will be those that will be unable to afford them. That is where insurance comes in, as I stated above, or private charity.
But my main point is, no one has the right to force another. This is something you pointedly ignore. Free people have a right to act on their own judgement...consumers, patients, insurers, providers...so long as they don't violate the rights of others. No one...not politicians, nor special interests, nor you...has the right to use the legalized force of government impose his own judgement on others.
A government either protects individual rights, as stated in the Declaration of Independence, or it is a predator. It's freedom or tyranny. Thanks to those who believe that force is a legitimate means of dealing with one's fellow citizens, we're heading in the direction of tyranny.
Others' Commentary:
My Response to njerseymom3, blarneyboy, and jlsmith:
Posted by Zemack on 06/03/09 at 9:14PM
jlsmith
Your argument seems to be: We're 2/3 of the way to totalitarian socialism, so we may as well accept it and go the rest of the way. Well, how do you think we got to "sixty percent socialized"? We got where we are by the same incremental, predatory, dog-eat-dog process that you despise but that is actually epitomized by Speaker Roberts' bill and S1940. It was made possible by the blind pragmatism of people seeing only the small steps and ignoring the ominous trend. It was made possible by the belief that a little bit of rights-violating of our fellow Americans was OK...then a little bit more and a little more...
I agree with you that autism parents are victims of a system that forces them to pay tens of thousands of dollars toward other peoples' healthcare, while leaving them out in the cold. I made that injustice plain on 6/2/09 @ 6:11pm. Your point that we are where we are, it's not going to change, so give me my due is understandable. But I do not accept that freedom is doomed, America is dead, and we should not fight back. The consequences are too dreadful. What do you think it will be like when the "worth" of not just autism treatment but all medical treatment is at the mercy of not "pretentious, condescending neighbors and school board members", but of unknown government bureaucrats wielding dictatorial powers over all of medicine?
When the American government stepped wholesale outside of its constitutional constraints of being a protector of individual rights, beginning in the 1930s, it unleashed the predatory gangs called special interest pressure groups; each seeking to gain control of the legislative process to extract some economic advantage at the expense of the rest of the country. You want dog-eat-dog? Well, there it is in all of its glory. The armies of lobbyists that swarm around the state capitols and Washington, D.C., is a consequence of government's massive control over all economic activity. They wouldn't exist in a free, rights-respecting society.
I do not single out the autism mandate for opposition. I oppose all mandates. The counter-revolution against America's founding ideals of unalienable individual rights, limited rights-protecting government, and justice that began in the Hoover-FDR era is reaching its climax. We are at a tipping point where not only does a line have to be drawn but statism has to be rolled back. Healthcare is currently the central front. The current system is unsustainable, and the choices are either capitalism and individual rights or totalitarian socialism. I do not believe the latter is inevitable, as you do.
I believe in every individual's right to his own life, to act on his own judgement, to his property and earnings, and to the pursuit of his own welfare and happiness, so long as he respects the same rights of others. This is not "survival of the fittest". This is not "dog-eat-dog". This is not libertarianism (which I certainly do not subscribe to!). This is the original ideal of liberty envisioned by the Founding Fathers. I am trying to sound the alarm here...to get people to look up and see where we are headed and to see that no one will benefit from tyranny except the government.
Maybe I and others like me are whistling past the graveyard. Then again, maybe not.
njerseymom3
"Zemack, you do not have to have medical insurance. It's your choice."
I don't have a choice of which insurance company to choose or the policy options. That is determined by a third party...in this case, my union. Changes are constantly made as to the insurer, the co-pays, and the coverage. I have no choice in any of that. Yet, my money...and that of the other members...pays for it.
"The reality is, almost no one can afford to have something medically go wrong, or even right."
Not true. See my post of 6/2/09 @ 6:11pm. Even uninsured people pay plenty in healthcare expenses, just not their own. If healthcare is unaffordable, then where does the more than $2 trillion come from that America currently spends annually on it? We all pay it in a myriad of ways, but most of it is spent by someone else. If we can't afford healthcare, then we can't afford "universal healthcare" either.
The issue is not the wisdom of treatment for autism. The issue is in the "we can make that happen". Who is "we"? By advocating this new law, you are claiming the right to dispose of the earnings and violate the rights of others. This is immoral, and no one has any right to speak for others. Each of us is responsible for his own expenses, not that of others unless we as individuals choose to be, voluntarily. It is the right and responsibility of each of us to decide when and in what capacity to help others, based upon our own values and affordability. No one has the right to force their views and values on others.
Blarneyboy
On what basis is this moral? Let me be unequivocal here. The easiest thing in the world to do is to profess concern for some cause, legitimate or not, then seek a law to force others to pay for your concern with their money and their rights. You get no moral sanction from me. There is no compassion in trampling the rights of others.
Others' Commentary:
My Commentary
Posted by Zemack on 06/18/09 at 6:58PM
jlsmith
I am all for reforming our medical care system, but we are absolutely not going to start by throwing kids with autism off the cliff (not when utter crap like Viagra has been prioritized above our children's needs). We will work to accomplish order and equity in the CURRENT SYSTEM while at the same time IN PARALLEL laying the groundwork for a new system.
There is a certain logic to this statement. In principle, we're closer than you think. I have made it clear that a comprehensive approach to "reforming our medical care system" is vital. But this must be more than lip service. What should the "groundwork for a new system" entail? It begins with understanding certain key points.
So there is no "forcing" here--this is what the insurance company should be doing but hasn't, because it has been able to get away with it.
"Should be doing"...according to whom? Exercising one's fundamental right to produce and trade...i.e., freedom...is not getting "away with it", or of anything. That is a primitive, tribal premise of the individual as a subject of the state, rather than the American concept of an independent being possessing unalienable rights. Freedom is an unalienable right, not a gift from the state or society.
More importantly, the claim that a government action is not force is an utter denial of reality...a statement that belongs on Orwell's doublespeak list, along with; War is Peace, Freedom is Slavery, Ignorance is Strength.
Government, by its very nature, has a legal monopoly on the use of physical force. Every governmental action involves the use of force in some manner. This is proper, but only under certain conditions. This basic fact of the nature of government is what necessitates a constitution; the only purpose of which is the protection of private individuals from government force. Proper constitutional constraints limit the power of government to the protection of individual rights. When government steps outside of those constraints, such as legally compelling some people to provide a certain type of insurance...whether on behalf of a ruler, the "public", a pressure group, a democratic majority, someone's need, or what-have-you...it is no longer acting legitimately, but as a criminal.
I am as much as a fan of free market capitalism as anyone...
No, you're not. You advocate a mixed economy...a deteriorating conglomeration of limited economic freedom corrupted by an ever-expanding mass of government controls, regulations, and interventions...i.e., force. The nature and consequences of a mixed economy is described very well...by you. Just get a big enough gang together -- or "critical mass", in your words - to gain control of the legislative process, and you get to impose on others what you couldn't get through voluntary means. On one level, I can't really blame you and others with autistic children. This game of "cold civil war", of pressure groups fighting to use government's power for the purpose of economic predation, has been going on for a long time. The big loser in the mixed economy is the individual and his rights. Note that as a "ragtag" group of individuals, you have no choice but to pay for viagra coverage. But as a political pressure group, you get to force your will on others, just as the viagra lobby was able to force theirs on you. Multiply this process by the thousands, and you have the "dog-eat-dog", Darwinian consequences of a mixed economy. The big winner in this "cold civil war" is the government, which steadily gains power over our lives no matter which pressure group happens to be "winning" at any particular time. At the end of this road lies dictatorship; that the Speaker Robertses and the Blarneyboys can claim an unearned prestige built on the phony "compassion" paid for with other peoples' money. The only solution is the separation of economics and government, a system called capitalism, which would put an end to this beggar-thy-neighbor domestic con game.
Indeed, our insurance industry "in it's current state is massively corrupt and functioning as an oligopoly", if you want to use that ridiculous term. The term "cartel" would be more accurate. A cartel is only made possible by government force. The fact that the insurers are privately owned does not make our current system "free market capitalism". Private ownership also exists under fascism. One of the dangerous fallacies widely accepted today is to equate "capitalists" with capitalism.
In a free market, individual rights...which are guarantees to freedom of action, not a claim to someone else's life or property...are protected by government. There is no "STANDARDS SET UP BY THE INSURANCE INDUSTRY ITSELF", imposed upon all insurance companies by government fiat. There are no cartels under capitalism. The industry is open to all who wish to enter the market, regardless of any "standards" set up by any group of companies calling itself "the industry". An insurer is free to ignore those standards and offer policies in accordance with its own market judgement...its judgement as to what consumers may want and be willing and able to pay for, and what is economically viable. What "is supposed" to be covered...whether established treatments or new ...is determined, properly, by voluntary contractual agreement between the consumer and the insurer. The government's role is not to dictate, but to mediate any contractual disputes through the objective medium of the civil courts and to prosecute breech of contract. But the terms of the contract are set between consumer and insurer, by mutual consent to mutual advantage. In a free market, no one is forced. That is what the "free" in free market means.
Consumers are free to choose among competing policies offered by competing companies. There is complete freedom of contract, with government protections against fraud or breech. But there is no inherent right of consumers to any particular type of policy or coverage, if no one chooses to offer it. There is no inherent right of insurers to sell any particular policy or coverage , if no one chooses to buy it. The basic principle is justice...every person is responsible for his own life, and may satisfy his needs only by means of voluntary trade and association with those who produce what he needs. When government violates rights by interfering in that contractual relationship, such as with mandates, the product ceases to be insurance. When the government uses its coercive power to dole out economic favors to some groups at the expense of others, it is engaging in fascism; the use of superficially private business as a conduit for the illegitimate exercise of government's monopoly on legal physical force. The legislature is then not "acting on behalf of the public", but on behalf of whatever groups claiming to represent "the public" happen to have their political hacks sitting in that body. The government's only real "public interest" function is to protect individual rights...everyone's rights, equally and at all times...because each and every individual is a part of "the public". If the government violates the rights of one single person, it can no longer claim to be "acting on behalf of the public".
The current problems in our healthcare are "not as a result of 'government interference' as you would allege".
Really? This doesn't jive with your previous statement that "About sixty percent of our healthcare system is already socialized", or with the facts of reality. 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. This is a fundamental part of the problem. Without government interference, we would purchase our own healthcare directly from providers, insurance directly from insurers, and be responsible for our own healthcare retirement planning, etc. Our entire healthcare financing system is a creation of government. Over the past several decades, the problems in healthcare have grown in lockstep with the growth of government interference: In other words, with the growth of force imposed on the private sector.
Your reference to "the past few years" is taken to mean the financial crisis. Good comparison. The financial sector is controlled by a central bank money monopoly. This sector is, arguably, even more controlled than healthcare...and look where we are. In similar fashion to healthcare, the crisis we are now in is entirely the result of a build-up of government interference in the banking, mortgage, and housing markets...i.e., the build-up of force.
In fact, the areas beset with the most problems...such as soaring costs, falling quality, and crazy distortions...are the three sectors most heavily dominated by government--healthcare, finance, and education (with energy closing in on fourth place).
There is much, much more to say regarding the "PARALLEL laying [of] the groundwork for a new system". Understanding the difference between government action and private action...between force and voluntary human association...and how the former corrupts the latter is crucial to finding the right reform path--individual rights in medicine.
As for blarneyboy, The issue is; who decides when and how to help another? That is a decision for each of us to make based upon our own evaluation of the worthiness of the recipient of our charity, our values, and our ability to be able to afford the time and/or resources. No one has the right to impose his idea of "compassion" on others, either at gunpoint or by supporting some government law...essentially the same thing. Those who do are phonies. The idea that "we are all our brothers' keepers" has turned America into a nation of thieves, where anyone with a "good cause" in one hand and the lever of political power in the other can pick his neighbor's pocket. That is a fundamental source of the problems in America's healthcare financing system.
I would say that the best protection that the small minority of helpless people have...the "weaker, or sicker"... is the freedom of those who they must depend on. It's no contradiction that you support both the "appealing libertarian concept" and socialism. One is anti-government, the other totalitarian government. In both cases, there is no protection for individual rights. So you are consistent here. Morality is the missing ingredient in your viewpoint. I oppose your Darwinian disregard for the lives and liberty of the strong and healthy...the very people upon whom the "weaker, or sicker" must depend. If you don't want to "leave the ill on a riverbank to be washed away at high tide", you would embrace capitalism, not socialism or libertarianism. Only a rights-respecting and protecting society is a benevolent and compassionate society.
As for blaming pharmaceutical companies for autism, I'm not that familiar with the issue. But my understanding is that there is little evidence to support your claim. It's a cheap shot (no pun intended). There's a funny thing about freedom, though...you don't have to buy the dangerous products made by the evil profit-seeking pharmaceutical companies...unless, of course, the government forces you to. (Never mind the lobbyists. No private person, group, or company can force you. Only government can, at the behest of some special interest. This is why, once again, I advocate the separation of economics and government.)
What should be investigated, but isn't, is the role of religion in the increasing incidence of autism. In the early years, a child has a desperate need and strong desire to understand the world around him, which means to learn to use his cognitive tools of logic that enable him to cope with that world. But if a small child is brow-beaten with the notions that he must blindly obey the arbitrary commands of an incomprehensible supernatural being or rot in hell; that his life is pre-determined by "God's plan"; that he is evil by nature; that humility is a virtue and self-esteem is a vice; that the quest for knowledge is sinful; that his mind is impotent before the "awesome" power of statues gazing down on him in a cathedral designed to make him feel small and inconsequential - would it be surprising if that child escaped into his own autistic world? No, most Christian parents are not holy rollers who literally practice that dogma. That would be cruel. But the rise in autism parallels the resurgence of religion in American culture over the last couple of decades.
NOTES on the CAUSES of AUTISM:
The Extremely Male Brain
" In 1998 British gastroenterologist Andrew Wakefield published a study in the Lancet linking autism to the vaccine for measles, mumps and rubella. The paper was based on only 12 subjects, and the theory has been debunked in much larger studies. Wakefield is being investigated by Britain's General Medical Council for, among other things, misrepresenting his subjects' medical records. But the vaccine theory lives on among parents who refuse to vaccinate their children, with public health consequences for the rest of the population."
The article:
Speaking up for autism
My initial ommentary:
Posted by Zemack on 06/02/09 at 6:11PM
Senate bill s1940, which I believe is still pending, "Requires health insurers and SHBP to provide certain mental health benefits for eating disorders..." Mr. Roberts' bill will force insurers to cover autism treatment. Put another way, both of these laws would make it illegal for any insurer to sell a policy in New Jersey that does not include coverage for these ailments. This means that the cost of insurance premiums will have to rise, forcing everyone to buy coverage for something that they may not want or be able to afford. If you want a peak at one of the culprits that are driving insurance costs up, this is it.
However heart-wrenching the circumstances of a particular medical condition may be on family and patient, it has to be said. All such mandates are driven by special interests and their political surrogates seeking to use the power of government to stick everyone else with their medical bills. They are really wealth redistribution masquerading as insurance. They are immoral and unjust because they violate the rights of insurers and their customers to contract voluntarily with each other to mutual advantage.
Having said that, I also believe there is a genuine injustice suffered by parents of autistic children. While they struggle to pay the cost of their own children's treatment, they themselves are victims of a myriad of other government mandates, programs, and policies.
For example, they are forced to pay the cost of similar insurance mandates such as New Jersey's soon to be (or already) enacted Senate bill S1940. In addition, that same couple that is struggling to afford treatment for their own autistic child is paying, through their taxes, the healthcare expenditures of: the elderly (Medicare), the poor (Medicaid), other peoples' children (SCHIP), other uninsured people ("charitable" government aid to hospitals to cover "free" emergency room care, including for illegal aliens, imposed under the federal law EMTALA), etc., etc., etc. In addition, there are medical research grants to universities and colleges. And don't forget foreign aid healthcare spending, including President Bush's $50 billion Aids relief package to Africa. Undoubtedly, there is more. Such is the unjust nature of a system where everyone is forced to pay for everyone else's healthcare.
Our system of health insurance is an absurd, government-created Rube Goldberg concoction, administered by quasi-private companies forbidden to tailor policies to market demand; i.e., the choices and pocket books of the actual, individual consumers of healthcare. The absurdities are not hard to find. For example, my policy covers a myriad of routine medical procedures such as doctor's visits, eyeglasses, dental fillings, medical exams, etc. (after co-pays and deductibles). Yet I can be stuck with massive bills for something like Autism treatment. And I don't have a choice, since my health insurance is purchased by a third party...spending my own money to boot.
A real insurance policy would cover only the major, unforeseen, catastrophic healthcare expenses above a high deductible, such as those cited in the article. That is the real purpose of insurance. In a free market, most medical care would undoubtedly be paid for directly by the consumer with his own out-of-pocket money. It is unlikely, given the choice, that many people would hand over wads of money to insurance companies year after year for routine care or even for such things as mammograms, colonoscopies, moderate amounts of prescription drugs, etc. What we have today is pre-paid healthcare that creates mountains of administrative expenses, empowers insurance company and government bureaucrats to impose decisions properly belonging to the people, and drives up the cost of healthcare and insurance premiums.
The proper role for government is an important one; to protect against fraud and breech of contract, and to mediate contractual disputes. Beyond that, and rather than compound the problem with more mandates, the politicians should get out of the insurance business altogether. Health insurance is properly a contractual matter to be decided between the individual and his insurance company, as a matter of unalienable right. They should not be at the mercy of every politician and special interest group seeking to impose their will on others.
jlsmith June 02, 2009 at 7:56PM
Wow, we must have some victims of the public education system here. Zemack and Givmeliberty, do you know what insurance is? Seems you don't. It is a vehicle for spreading risk. Any medical insurance policy, to be meaningful, should address all medical issues requiring significant expenditures. Do you know anything about autism? Guess not. Because as the #1 children's major health condition (a biologically based medical condition more common than childhood cancer, diabetes and AIDs combined), it fits cleanly into the category of "major, unforeseen catastrophic healthcare expenses". Do you understand the magnitude of expenses associated with major conditions that are always covered by medical insurance, like cancer, diabetes, heart conditions, rheumatoid arthritis, trauma care, etc.? Obviously not, as autism treatment is absolutely not more expensive than these conditions. Have you priced out a stay in an intensive care unit lately? Do you know what we pay for end-of-life expenses for people on life support? Have you looked at the costs of the newer biotechnology agents used against cancer that often extend life by only a few months? It doesn't take long to amass a bill for hundreds of thousands of dollars or even more for a major medical condition these days. Please do your homework before making inaccurate statements and engaginig in poorly reasoned analyses.
My Response to jlsmith:
Posted by Zemack on 06/02/09 at 8:52PM
The hugely inflated cost of medical care exists under a system of massive government interference. That should be a strong clue. The third-party-payer system, the thousands of mandates, restraint-of-trade state policies, socialist government programs, all of the controls, taxes, and regulations; all of this inverts the normal market incentives that would lead to higher quality and lower prices. Of the $7500 per capita America spends on healthcare, almost 90% of that represents people spending other people's money.
But even in a free market, some healthcare expenses will be very expensive, and there will be those that will be unable to afford them. That is where insurance comes in, as I stated above, or private charity.
But my main point is, no one has the right to force another. This is something you pointedly ignore. Free people have a right to act on their own judgement...consumers, patients, insurers, providers...so long as they don't violate the rights of others. No one...not politicians, nor special interests, nor you...has the right to use the legalized force of government impose his own judgement on others.
A government either protects individual rights, as stated in the Declaration of Independence, or it is a predator. It's freedom or tyranny. Thanks to those who believe that force is a legitimate means of dealing with one's fellow citizens, we're heading in the direction of tyranny.
Others' Commentary:
njerseymom3 June 02, 2009 at 10:19PM.
Zemack, you do not have to have medical insurance. It's your choice. The reality is, almost no one can afford to have something medically go wrong, or even right. Just don't have a baby, not even a healthy one. Don't have an accidental fall and whatever you do, don't develop any chronic illness because you will be begging for charity care or living on the street. Yes, the cost of services is over the top, but the point of this article was the societal costs and long term benefits of providing intervention early on to help produce productive adults who are not a drain on the system. That is the ultimate goal of every parent who has a child with these brain based ailments and we will do everything that we can to make that happen
blarneyboy June 02, 2009 at 10:44PM
Funding for these families is a moral necessity. Jersey, with the highest rate of autism in the land, and highest concentration of drug companies in the world, needs to find the link between the two that appears to be causing this developmental disaster. If we don't, "the fix" is in, so look to see which drug companies, and their individual big wigs, are giving the most contributions to the skethier politicians slithering around the state.
jlsmith June 03, 2009 at 11:21AM
Zemack-
We don't live in your utopian libertarian reality. "Mandates" are already in place on a mass scale. About sixty percent of our healthcare system is already socialized (the Medicare and Medicaid systems are funded by tax dollars), and that is never going to change. Ever. Because most illness occurs in the elderly, and it is politically impossible to pull the rug out from our elderly who on limited incomes and will never be able to afford the care they need. So I understand your philosophical leanings, but they really aren't relevant.
We parents in the autism community are sick to death of having our children "nickled and dimed" with pretentious, condescending neighbors and school board members deciding if our children are "worth" the expense of treating their condition, (and medical insurance companies slamming the door in our faces and providing nothing. These EXACT SAME PEOPLE of course are spending my money every day on their health problems. They have cancer, they have diabetes, they have lupus, they have heart problems, they get trauma care for a car accident. Their parents have alzheimers or congestive heart failure or need kidney dialysis. Their children have asthma, life threatening allergies, or were born needing the services of a neonatal intensive care unit. And I do not EVER say to them, you know, I know your dad has alzheimers and I feel great compassion for him and for you, but as a taxpayer and payor into the into the insurance premium pool, by gosh, I have to tell you that your dad is costing me a lot of money, and I just don't think the we as a society can afford to take care of him. I recently had lunch with a woman who was going through chemo, and has been hospitalized 8 times this year, including undergoing 3 surgeries (imagine the expense). She got onto the subject of how her school district is being financially ruined by the special needs students, knowing full well my child has autism. It took every bit of restraint I possessed to not say to her "I'd love to run the numbers on how much the public has spent on my child versus how much the public has just spent on your care." This woman, just like many others in society who resent our children, are total and complete hypocrites, and their arguments about cost (and "mandates") with respect to autism are utterly invalid, when cost and mandates are not on the table for other conditions.
We need to get out of our survival of the fittest, dog eat dog mentality and aspire to a higher moral ground. We need to respond to illness with help, not resentment, and one irrational excuse after another as to why we won't pay.
My Response to njerseymom3, blarneyboy, and jlsmith:
Posted by Zemack on 06/03/09 at 9:14PM
jlsmith
Your argument seems to be: We're 2/3 of the way to totalitarian socialism, so we may as well accept it and go the rest of the way. Well, how do you think we got to "sixty percent socialized"? We got where we are by the same incremental, predatory, dog-eat-dog process that you despise but that is actually epitomized by Speaker Roberts' bill and S1940. It was made possible by the blind pragmatism of people seeing only the small steps and ignoring the ominous trend. It was made possible by the belief that a little bit of rights-violating of our fellow Americans was OK...then a little bit more and a little more...
I agree with you that autism parents are victims of a system that forces them to pay tens of thousands of dollars toward other peoples' healthcare, while leaving them out in the cold. I made that injustice plain on 6/2/09 @ 6:11pm. Your point that we are where we are, it's not going to change, so give me my due is understandable. But I do not accept that freedom is doomed, America is dead, and we should not fight back. The consequences are too dreadful. What do you think it will be like when the "worth" of not just autism treatment but all medical treatment is at the mercy of not "pretentious, condescending neighbors and school board members", but of unknown government bureaucrats wielding dictatorial powers over all of medicine?
When the American government stepped wholesale outside of its constitutional constraints of being a protector of individual rights, beginning in the 1930s, it unleashed the predatory gangs called special interest pressure groups; each seeking to gain control of the legislative process to extract some economic advantage at the expense of the rest of the country. You want dog-eat-dog? Well, there it is in all of its glory. The armies of lobbyists that swarm around the state capitols and Washington, D.C., is a consequence of government's massive control over all economic activity. They wouldn't exist in a free, rights-respecting society.
I do not single out the autism mandate for opposition. I oppose all mandates. The counter-revolution against America's founding ideals of unalienable individual rights, limited rights-protecting government, and justice that began in the Hoover-FDR era is reaching its climax. We are at a tipping point where not only does a line have to be drawn but statism has to be rolled back. Healthcare is currently the central front. The current system is unsustainable, and the choices are either capitalism and individual rights or totalitarian socialism. I do not believe the latter is inevitable, as you do.
I believe in every individual's right to his own life, to act on his own judgement, to his property and earnings, and to the pursuit of his own welfare and happiness, so long as he respects the same rights of others. This is not "survival of the fittest". This is not "dog-eat-dog". This is not libertarianism (which I certainly do not subscribe to!). This is the original ideal of liberty envisioned by the Founding Fathers. I am trying to sound the alarm here...to get people to look up and see where we are headed and to see that no one will benefit from tyranny except the government.
Maybe I and others like me are whistling past the graveyard. Then again, maybe not.
njerseymom3
"Zemack, you do not have to have medical insurance. It's your choice."
I don't have a choice of which insurance company to choose or the policy options. That is determined by a third party...in this case, my union. Changes are constantly made as to the insurer, the co-pays, and the coverage. I have no choice in any of that. Yet, my money...and that of the other members...pays for it.
"The reality is, almost no one can afford to have something medically go wrong, or even right."
Not true. See my post of 6/2/09 @ 6:11pm. Even uninsured people pay plenty in healthcare expenses, just not their own. If healthcare is unaffordable, then where does the more than $2 trillion come from that America currently spends annually on it? We all pay it in a myriad of ways, but most of it is spent by someone else. If we can't afford healthcare, then we can't afford "universal healthcare" either.
The issue is not the wisdom of treatment for autism. The issue is in the "we can make that happen". Who is "we"? By advocating this new law, you are claiming the right to dispose of the earnings and violate the rights of others. This is immoral, and no one has any right to speak for others. Each of us is responsible for his own expenses, not that of others unless we as individuals choose to be, voluntarily. It is the right and responsibility of each of us to decide when and in what capacity to help others, based upon our own values and affordability. No one has the right to force their views and values on others.
Blarneyboy
On what basis is this moral? Let me be unequivocal here. The easiest thing in the world to do is to profess concern for some cause, legitimate or not, then seek a law to force others to pay for your concern with their money and their rights. You get no moral sanction from me. There is no compassion in trampling the rights of others.
Others' Commentary:
blarneyboy June 03, 2009 at 11:34PM
What do you propose, Zemack? Leave the ill on a riverbank to be washed away at high tide? There's a lot appealing about the libertarian concept, but not its Darwinian disregard for those who are weaker, or sicker.
jlsmith June 04, 2009 at 12:43PM
Zemack-
Where to begin? Another primer on medical insurance. When you buy comprehensive medical insurance, it is supposed to cover payment for scientifically validated treatments that are generally accepted as efficacious in the medical community for the full array of medical conditions that exist. As new treatments become available, they are added to the schedule of covered expenses through various processes. Insurance companies often fight the addition of new treatments, particularly treatments that are expensive. They will argue that treatments are "investigatory" or "experimental" long after the evidence is in that they are commonly used and proven safe and effective. Some treatment providers are more effective than others at obtaining coverage for their products and services. For example, the pharmaceutical industry is extremely adept at getting their products covered by insurance companies, and indeed their markets depend on it. The same is generally true for surgical and interventional procedures performed by physicians, although that can be a little more challenging. However, in some situations, the insurance companies are able to successfully keep expensive treatments off their formularies, and that is where mandates come in. A patient base will basically come in and fight the insurance companies, lose, get frustrated, and then fight back in the legal and legislative arenas. You have to understand that in these situations the insurance industry is being sanctioned FOR WHAT THEY SHOULD BE DOING ALREADY IF THEY WERE INTELLECTUALLY HONEST.
In the instant case, therapy for autism should have been covered by insurance IN ACCORDANCE WITH THE STANDARDS SET UP BY THE INSURANCE INDUSTRY ITSELF starting decades ago, when the treatments were first developed and validated. The only reason they got away with not providing coverage is because 1/ the incidence of autism has only recently exploded and the patient base lacked critical mass to effectively fight for this coverage until now, 2/ there were no monied and politically astute pharma or AMA reimbursement professionals working on behalf of providers and patients to obtain reimbursement--just a bunch of ragtag parent groups and non-organized behaviorists crying into the wilderness; and 3/ parents could often get at least a little help (though almost always inadequate) through their school districts, which have a parallel obligation to provide behavioral therapies under IDEA.
From a legal perspective, mandates are effectively an adverse regulatory ruling against the industry--where the legislature, acting on behalf of the public, enforces the industry's own standards on itself. So there is no "forcing" here--this is what the insurance company should be doing but hasn't, because it has been able to get away with it.
I am as much as a fan of free market capitalism as anyone, but the insurance industry in it's current state is massively corrupt and functioning as an oligopoly, with no meaningful competition (and not as a result of "government interference" as you would allege and as is spewed by their pr departments). If you haven't learned that in the past few years, you've been simply asleep.
I am all for reforming our medical care system, but we are absolutely not going to start by throwing kids with autism off the cliff (not when utter crap like Viagra has been prioritized above our children's needs). We will work to accomplish order and equity in the CURRENT SYSTEM while at the same time IN PARALLEL laying the groundwork for a new system. 1 in 94 kids in New Jersey has autism (1 in 60 boys) . They cannot wait.
blarneyboy June 04, 2009 at 2:50PM
Well said, Jlsmith. Give babies dozens of shots and the immune system could react by causing autism, requiring the drug companies to create MORE shots to treat the autism caused by the original overload of shots= PROFIT.
There's so much drug lobby money in the political system, we may never get to the truth...as children suffer. 1 in 94!
My Commentary
Posted by Zemack on 06/18/09 at 6:58PM
jlsmith
I am all for reforming our medical care system, but we are absolutely not going to start by throwing kids with autism off the cliff (not when utter crap like Viagra has been prioritized above our children's needs). We will work to accomplish order and equity in the CURRENT SYSTEM while at the same time IN PARALLEL laying the groundwork for a new system.
There is a certain logic to this statement. In principle, we're closer than you think. I have made it clear that a comprehensive approach to "reforming our medical care system" is vital. But this must be more than lip service. What should the "groundwork for a new system" entail? It begins with understanding certain key points.
So there is no "forcing" here--this is what the insurance company should be doing but hasn't, because it has been able to get away with it.
"Should be doing"...according to whom? Exercising one's fundamental right to produce and trade...i.e., freedom...is not getting "away with it", or of anything. That is a primitive, tribal premise of the individual as a subject of the state, rather than the American concept of an independent being possessing unalienable rights. Freedom is an unalienable right, not a gift from the state or society.
More importantly, the claim that a government action is not force is an utter denial of reality...a statement that belongs on Orwell's doublespeak list, along with; War is Peace, Freedom is Slavery, Ignorance is Strength.
Government, by its very nature, has a legal monopoly on the use of physical force. Every governmental action involves the use of force in some manner. This is proper, but only under certain conditions. This basic fact of the nature of government is what necessitates a constitution; the only purpose of which is the protection of private individuals from government force. Proper constitutional constraints limit the power of government to the protection of individual rights. When government steps outside of those constraints, such as legally compelling some people to provide a certain type of insurance...whether on behalf of a ruler, the "public", a pressure group, a democratic majority, someone's need, or what-have-you...it is no longer acting legitimately, but as a criminal.
I am as much as a fan of free market capitalism as anyone...
No, you're not. You advocate a mixed economy...a deteriorating conglomeration of limited economic freedom corrupted by an ever-expanding mass of government controls, regulations, and interventions...i.e., force. The nature and consequences of a mixed economy is described very well...by you. Just get a big enough gang together -- or "critical mass", in your words - to gain control of the legislative process, and you get to impose on others what you couldn't get through voluntary means. On one level, I can't really blame you and others with autistic children. This game of "cold civil war", of pressure groups fighting to use government's power for the purpose of economic predation, has been going on for a long time. The big loser in the mixed economy is the individual and his rights. Note that as a "ragtag" group of individuals, you have no choice but to pay for viagra coverage. But as a political pressure group, you get to force your will on others, just as the viagra lobby was able to force theirs on you. Multiply this process by the thousands, and you have the "dog-eat-dog", Darwinian consequences of a mixed economy. The big winner in this "cold civil war" is the government, which steadily gains power over our lives no matter which pressure group happens to be "winning" at any particular time. At the end of this road lies dictatorship; that the Speaker Robertses and the Blarneyboys can claim an unearned prestige built on the phony "compassion" paid for with other peoples' money. The only solution is the separation of economics and government, a system called capitalism, which would put an end to this beggar-thy-neighbor domestic con game.
Indeed, our insurance industry "in it's current state is massively corrupt and functioning as an oligopoly", if you want to use that ridiculous term. The term "cartel" would be more accurate. A cartel is only made possible by government force. The fact that the insurers are privately owned does not make our current system "free market capitalism". Private ownership also exists under fascism. One of the dangerous fallacies widely accepted today is to equate "capitalists" with capitalism.
In a free market, individual rights...which are guarantees to freedom of action, not a claim to someone else's life or property...are protected by government. There is no "STANDARDS SET UP BY THE INSURANCE INDUSTRY ITSELF", imposed upon all insurance companies by government fiat. There are no cartels under capitalism. The industry is open to all who wish to enter the market, regardless of any "standards" set up by any group of companies calling itself "the industry". An insurer is free to ignore those standards and offer policies in accordance with its own market judgement...its judgement as to what consumers may want and be willing and able to pay for, and what is economically viable. What "is supposed" to be covered...whether established treatments or new ...is determined, properly, by voluntary contractual agreement between the consumer and the insurer. The government's role is not to dictate, but to mediate any contractual disputes through the objective medium of the civil courts and to prosecute breech of contract. But the terms of the contract are set between consumer and insurer, by mutual consent to mutual advantage. In a free market, no one is forced. That is what the "free" in free market means.
Consumers are free to choose among competing policies offered by competing companies. There is complete freedom of contract, with government protections against fraud or breech. But there is no inherent right of consumers to any particular type of policy or coverage, if no one chooses to offer it. There is no inherent right of insurers to sell any particular policy or coverage , if no one chooses to buy it. The basic principle is justice...every person is responsible for his own life, and may satisfy his needs only by means of voluntary trade and association with those who produce what he needs. When government violates rights by interfering in that contractual relationship, such as with mandates, the product ceases to be insurance. When the government uses its coercive power to dole out economic favors to some groups at the expense of others, it is engaging in fascism; the use of superficially private business as a conduit for the illegitimate exercise of government's monopoly on legal physical force. The legislature is then not "acting on behalf of the public", but on behalf of whatever groups claiming to represent "the public" happen to have their political hacks sitting in that body. The government's only real "public interest" function is to protect individual rights...everyone's rights, equally and at all times...because each and every individual is a part of "the public". If the government violates the rights of one single person, it can no longer claim to be "acting on behalf of the public".
The current problems in our healthcare are "not as a result of 'government interference' as you would allege".
Really? This doesn't jive with your previous statement that "About sixty percent of our healthcare system is already socialized", or with the facts of reality. 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. This is a fundamental part of the problem. Without government interference, we would purchase our own healthcare directly from providers, insurance directly from insurers, and be responsible for our own healthcare retirement planning, etc. Our entire healthcare financing system is a creation of government. Over the past several decades, the problems in healthcare have grown in lockstep with the growth of government interference: In other words, with the growth of force imposed on the private sector.
Your reference to "the past few years" is taken to mean the financial crisis. Good comparison. The financial sector is controlled by a central bank money monopoly. This sector is, arguably, even more controlled than healthcare...and look where we are. In similar fashion to healthcare, the crisis we are now in is entirely the result of a build-up of government interference in the banking, mortgage, and housing markets...i.e., the build-up of force.
In fact, the areas beset with the most problems...such as soaring costs, falling quality, and crazy distortions...are the three sectors most heavily dominated by government--healthcare, finance, and education (with energy closing in on fourth place).
There is much, much more to say regarding the "PARALLEL laying [of] the groundwork for a new system". Understanding the difference between government action and private action...between force and voluntary human association...and how the former corrupts the latter is crucial to finding the right reform path--individual rights in medicine.
As for blarneyboy, The issue is; who decides when and how to help another? That is a decision for each of us to make based upon our own evaluation of the worthiness of the recipient of our charity, our values, and our ability to be able to afford the time and/or resources. No one has the right to impose his idea of "compassion" on others, either at gunpoint or by supporting some government law...essentially the same thing. Those who do are phonies. The idea that "we are all our brothers' keepers" has turned America into a nation of thieves, where anyone with a "good cause" in one hand and the lever of political power in the other can pick his neighbor's pocket. That is a fundamental source of the problems in America's healthcare financing system.
I would say that the best protection that the small minority of helpless people have...the "weaker, or sicker"... is the freedom of those who they must depend on. It's no contradiction that you support both the "appealing libertarian concept" and socialism. One is anti-government, the other totalitarian government. In both cases, there is no protection for individual rights. So you are consistent here. Morality is the missing ingredient in your viewpoint. I oppose your Darwinian disregard for the lives and liberty of the strong and healthy...the very people upon whom the "weaker, or sicker" must depend. If you don't want to "leave the ill on a riverbank to be washed away at high tide", you would embrace capitalism, not socialism or libertarianism. Only a rights-respecting and protecting society is a benevolent and compassionate society.
As for blaming pharmaceutical companies for autism, I'm not that familiar with the issue. But my understanding is that there is little evidence to support your claim. It's a cheap shot (no pun intended). There's a funny thing about freedom, though...you don't have to buy the dangerous products made by the evil profit-seeking pharmaceutical companies...unless, of course, the government forces you to. (Never mind the lobbyists. No private person, group, or company can force you. Only government can, at the behest of some special interest. This is why, once again, I advocate the separation of economics and government.)
What should be investigated, but isn't, is the role of religion in the increasing incidence of autism. In the early years, a child has a desperate need and strong desire to understand the world around him, which means to learn to use his cognitive tools of logic that enable him to cope with that world. But if a small child is brow-beaten with the notions that he must blindly obey the arbitrary commands of an incomprehensible supernatural being or rot in hell; that his life is pre-determined by "God's plan"; that he is evil by nature; that humility is a virtue and self-esteem is a vice; that the quest for knowledge is sinful; that his mind is impotent before the "awesome" power of statues gazing down on him in a cathedral designed to make him feel small and inconsequential - would it be surprising if that child escaped into his own autistic world? No, most Christian parents are not holy rollers who literally practice that dogma. That would be cruel. But the rise in autism parallels the resurgence of religion in American culture over the last couple of decades.
NOTES on the CAUSES of AUTISM:
The Extremely Male Brain
" In 1998 British gastroenterologist Andrew Wakefield published a study in the Lancet linking autism to the vaccine for measles, mumps and rubella. The paper was based on only 12 subjects, and the theory has been debunked in much larger studies. Wakefield is being investigated by Britain's General Medical Council for, among other things, misrepresenting his subjects' medical records. But the vaccine theory lives on among parents who refuse to vaccinate their children, with public health consequences for the rest of the population."
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