Friday, March 12, 2010

Who's Really "Coming Between You and Your Doctor?"

In a recent op-ed posted at RealClearPolitics, Froma Harrop complains about the practices of private health insurance companies ( Coming Between You and Your Doctor). She writes:

"The lights must dim around Google's data-storage centers every time someone does a search for "government bureaucrat coming between you and your doctor." Foes of the Democrats' health-reform proposals have been chanting this on the hour for a year..."

After claiming, with some truth, that private insurance company bureaucrats already do the same thing, she asks:

"But why has the idea of letting the government do what private insurers do to save taxpayers money become such a hysterical hot button?"

The difference between government action and private action is the difference between force and voluntary, uncoerced agreement. But with regard to private health insurance in this country, the issue is muddied considerably by government intervention ... i.e., the introduction of force into the market.

We also see yet another example of an ObamaCare proponent taking the status quo as the given, thus avoiding the necessity of any analysis of how the government's policies have created the very problems "reform" is supposedly designed to fix. This tactic is vital to their case, because any honest look at cause and effect would lead to a greatly diminished government role and more freedom as the logical solution.

Here is my commentary:

Posted by: Mike Zemack Mar 12, 07:26 PM


--------------------------------------------------------------------------------

“The powers in Washington have clearly decided to keep most working Americans in the hands of private insurance companies.”

So laments Ms. Harrop. The statement is true, but off by about seventy years. Decades ago, the Federal government established the third-party-payer, or employer-based, system of health insurance. This created an artificial middleman that disconnected the consumer of healthcare from the provider. Then came thousands of state-imposed insurance mandates across the nation– from community rating to guaranteed issue to benefits – that force insurers to tailor their policies to the demands of political pressure groups rather than market realities … i.e., to the desires and pocketbooks of the consumer, who is perversely not the customer. These same insurers are protected from interstate competition via interstate trade barriers imposed by government.

We’ve all heard the story of the fireman who starts fires, so that he can rush to the scene to “save” lives and property. (We had a real live one of those living in my neighborhood, some years ago.) Well, in regard to America’s health insurance system, the government is that fireman.

The health insurance industry that ObamaCare supporters love to demonize is a scapegoat and a straw man, because it is in fact a political creation. The alleged power of the insurance companies is an extension of government power and would not be possible in a free market. Our fireman now proposes to save us from its own creation! Our “private” health insurance industry is a government controlled and protected series of state-based cartels operating in a government-crippled insurance market. Our “private” health insurance system is in the nature of fascism, or back-door socialism, and is not indicative of a free market.

“Those who care to move this conversation to a more grownup level” start by examining the role that government intervention has played in placing the healthcare of Americans “in the hands of private insurance companies.” They will find that it was the government itself.

The argument for “letting the government do what private insurers do” is a red herring. It is a call for totalitarian centralized control of medicine by government bureaucrats unconstrained by the need to earn a profit … i.e., to satisfy their customers. Insurance company bureaucrats empowered by our government-imposed third-party-payer system are bad enough. Government bureaucrats possessing the legalized power of physical force - i.e., a gun - would end the remaining fragments of freedom to make our own healthcare decisions that we still possess.

The Supreme Court legalized abortion in Rowe v. Wade based on the argument that abortion is a health matter that should be decided solely between a woman and her doctor. Fair enough. The solution to the problems of health insurance rests with the same logic. Remove all government restrictions in the national health insurance market. Restrict government instead – to its proper role of enforcing laws against fraud and breech of contract, mediating legitimate contractual disputes between insurers and insured, and enforcing and protecting contracts and contractual freedom … i.e., to protecting everyone’s individual rights.

Health insurance is solely a matter between the individual and his insurer, and their rights to contract freely to mutual advantage should be protected. The natural incentives of the free market – the consumer seeking the best value for his money from profit-seeking providers seeking to expand sales in an environment of real competition – is the only moral way to “control costs” because people must consume in accordance with what they have earned and providers must price their products to their customers’ budgets. A government that “controls costs” ends up controlling people … i.e., ends up as a dictatorship.

In a free market “no one is going to come between patients and their doctors” because no one can come between patients and their insurers … or their healthcare dollars.

Tuesday, March 9, 2010

Who's Really Peddling "Big Lie"?

The Big Lie is on the prowl in the health care debate. But who is guilty of employing it? According to the NJ Star-Ledger, it's the GOP. In its 3/9/10 editorial, entitled Health care reform scare: 'Takeover' claim is GOP's big lie, the Editors had this to say:

"Republican congressional and party leaders are pedaling as fast as they can to distance themselves from the Republican National Committee plan to drum up fear that the Democrats are driving America toward socialism.

"But in fact the GOP has been running that playbook for over a year now, portraying President Obama’s policies as radically left-wing, socialist — in effect, un-American. The most obvious example is the Big Lie about his health insurance reform plan, that it’s 'a government takeover of one-sixth of our nation’s economy.'

"First of all, the fact that health care is consuming one-sixth of our gross domestic product is a big problem and not an argument for letting things be. But no one remotely connected with the Obama administration is suggesting anything like a government takeover of medical care in America. Yet the defenders of the status quo conjure up a dystopian nightmare of 'Obamacare' with Soviet-style hospitals and drone-like doctors and with faceless bureaucrats deciding who gets care and who does not. (How they would be different from insurance company bureaucrats is a mystery.)"


Here is my commentary setting the record straight:

Posted by zemack
March 09, 2010, 10:03PM

The “Big Lie” is an appropriate topic for the Star-Ledger to editorialize on in regard to healthcare. But it’s not the Republicans that are employing it. It is the ObamaCare minions, including the Editors here, who are employing that tactic to its fullest. The real Big Lie is the claim that the only choice we have is between Obama’s “reform” scheme and the status quo. But “the defenders of the status quo” are not entirely accurate either. ObamaCare, the logical consequence of which really will eventually be “Soviet-style hospitals and drone-like doctors and with faceless bureaucrats deciding who gets care and who does not”, is not an outright takeover of healthcare. It is rather another step in the decades-long, slow-motion advance toward an eventual full takeover.

As I’ve been arguing here and elsewhere, the missing ingredients in the entire Left-framed debate is an examination of the role that the government has played in creating the problems healthcare “reform” is supposed to correct, and the third alternative – reinstitution of a free market in healthcare. Despite its strengths made possible by the remaining free market fragments, all of the problems attributed to American healthcare are consequences of prior government policies. The runaway costs and the problem of pre-existing conditions are government creations. Thanks to our government-imposed third-party-payer (employer-based) system, thousands of state-imposed community rating, guaranteed issue and benefits mandates, and legal trade barriers barring interstate competition, our “private” health insurance industry is actually a government controlled and protected series of state-based cartels which is more in the nature of fascism (back-door socialism) rather than any semblance of a market-based system.

The health insurance industry that ObamaCare supporters love to demonize is a scapegoat and a straw man, because it is in fact a political creation. The alleged power of the insurance companies is an extension of government power and would not be possible in a free market.

Of course, making a government takeover of American healthcare inevitable is what ObamaReform is all about, the Editors’ protestations to the contrary notwithstanding. But the Dems have cleverly avoided concrete specifics in their plan, giving cover for the Editors’ outrageously false claim that “no one remotely connected with the Obama administration is suggesting anything like a government takeover of medical care in America”. No. Instead, their plan contains the theoretical blueprint for future totalitarian control of every aspect of healthcare. What does anyone think a 2000 page document is full of? The trick is that the specifics will come later under powers granted to government officials, in the form of an unending tidal wave of coercive rules and regulations.

In an analysis of only a small part of one version of ObamaCare, the House’s HR3962, Professor John David Lewis cites numerous examples of this in his Objective Standard essay, which can be read in full in the Winter 2009/2010 issue. His conclusion:

“[The plan] will reach deeply into federal and state regulations and laws, on a scale that will require years for experts to interpret. It will establish institutions that will be effectively irreversible. It will grant arbitrary powers to bureaucrats, who will have to interpret and enforce its dictates.

“This legislation empowers the executive branch, namely the Secretary of Health and Human Services and a ‘Health Choices Commissioner,’ to write thousands of pages of regulations, and to force Americans to comply with them. For every line in this bill, many pages of regulations will be written.

“The central meaning of both is the repudiation of individual rights. No longer will Americans have the liberty to preserve their own lives in the way they judge best—from now on, they will have to conform to government controls on the most intimate details of their lives.”


The Big Lie is alive and well, and firmly ensconced in the Obama Whitehouse … and in the offices of the Star-Ledger Editorial Board.


And here are some supporting comments from docforfreedom, whom I drew attention to in my last post:

Posted by docforfreedom
March 10, 2010, 3:40PM

Well said, Zemack.

When trying to decide which is worse-- government or insurance company control of health care-- the answer is BOTH. We need freedom to choose for ourselves-- what health care to access directly and which insurance to buy for ourselves. The free market would keep both of these in line if the government weren't so busy meddling. The government ought not be providing any health care.

We can now access websites that can tell us where to obtain services at what price. Radiology groups are beginning to post cash prices. Why do we need a middleman for the majority of services?

We take our cars to our local auto repairman hoping that he can fix it. If there is something more complicated, he sends us to a specialist. Of course, with health care, the bills can run up very high, but THEN we need insurance-- NOT for the routine. Why involve a costly middleman when face to face cash payments would save everyone a lot?

Tuesday, March 2, 2010

John Farmer's Booby Trap Exposed

The New Jersey Star-Ledger's John Farmer has made the case that Employer-based health care is a thing of the past.

This, I agree with. But there, we part ways. In classic liberal fashion, Mr. Farmer engages in a bout of breathtaking evasion, ignoring the fact that the insurance system we have now is a government creation. Instead, he simply accepts the status quo as an example of a failure of private insurance, because "the private insurance bigwigs' ... chief incentive is to increase profits in their own and their shareholders’ interest."

Of course, those profits are made possible by offering products that are in their customers' interest, a practice that is essentially forbidden under the very system he laments. Rather than remove those government restrictions and leave insurers free to pursue profits by satisfying their customers, he would rather place your healthcare fate in the hands of the government "whose leaders face the wrath of the voters if they get it wrong." In other words, your healthcare fortunes will be at the mercy of the latest ballot box mob, instead of your own judgement!

The Left is desperate to hang on to the statist controls thay have achieved thus far, and to use them as a springboard for further controls on the way to totalitarian socialized medicine.

I've left a detailed response at the Star-Ledger's website, which is published below. But I'd like also to draw attention to the remarks of docforfreedom, who has several comments posted for this article. He seems mostly right in his comments and a strong defender of the individual.

Here is my full commentary:

We’ve all heard the story of the fireman who starts fires, so that he can be the first on the scene to “save” lives and property. (We had a real live one of those living in my neighborhood, some years ago.) Well, in regard to American health care, the government is that fireman. All of the problems that ObamaCare allegedly addresses are government created. And like that fireman, the politicians - Democrats and many Republicans alike – now rush to fix the problems they created with massive new government interference into healthcare. The health insurance market is at the top of the list of government-created problems.

Today’s health insurance industry is a government created monstrosity. The “power” of the insurance companies derives directly from government interference into the market. Thanks to the tax and regulation-imposed employer-based, or third-party-payer, system, the insurance company works not for the consumer of healthcare, but for some third party. In other words, the consumer is not the customer. But that’s not the only problem. Thousands of state-imposed insurance mandates across the nation– from community rating to guaranteed issue to benefits – force insurers to tailor their policies to the demands of political pressure groups rather than market realities, and force coverages on consumers that they may not want or can afford. These mandates are nothing more than wealth redistribution masquerading as “insurance”. The insurance companies are then protected from competition through interstate trade barriers - imposed by government.

The health insurance industry that ObamaCare supporters love to demonize is a scapegoat and a straw man, because it is in fact a political creation. Our fireman proposes to save us from its own creation! Our “private” health insurance industry is a government controlled and protected series of state-based cartels operating in a government-crippled insurance market. Our employer-based system that Mr. Farmer laments is in the nature of fascism, or back-door socialism, in which the private ownership is more of a mirage than a reality.

The only practical and moral solution is a free market in health insurance. Our current system is as far from a free market as one can imagine short of overt socialized medicine.

A free market is one based on the recognition of individual rights, which means the sanction of freedom of action. This freedom includes the rights of patients, insurers, their customers, doctors, medical products producers, and other healthcare professionals to freely contract with each other through voluntary trade to mutual advantage. The government’s role in a free market is limited but vital – to protect the rights of all concerned, including enforcement of contracts and prosecution of fraud and breech of contract. Otherwise, people should be free of governmental coercion, which is what the “free” in free market means.

Mr. Farmer is right that the employer-based - i.e., third-party-payer - system of health insurance is unraveling. It was inevitable, and a bad idea to begin with. But he misses the obvious: Our deteriorating employer-based health insurance system is a failure of statism, not freedom. Instead, he simply lauds supporters of totalitarian healthcare, - excuse me, ObamaCare in all of its guises – as “those who know something” and writes off opponents as ignorant. But this is only a evasion, and sets the stage for his monumental booby trap – that our only choice is between socialism and fascism:

“Who can we best trust to oversee health insurance? The federal government, with its spotty record for efficiency but whose leaders face the wrath of the voters if they get it wrong? Or the private insurance bigwigs whose chief incentive is to increase profits in their own and their shareholders’ interest?”

The individual citizen who is free to “oversee” his own healthcare and health insurance needs doesn’t even warrant token consideration! Interesting, eh?

Mr. Farmer is dead wrong. The choice is not between government-run healthcare (socialized medicine) and the status quo (quasi government-run healthcare). The choice is between government-run medicine (in all of its incarnations) and a free market.