Why Conservatives should support Government Healthcare

by Roland Lindsey

David Frum posted an excellent post on the Bush Economic Legacy over at NewMajority.com.  I hope that the Republican leadership reads it.

When you look at the traditional levers of tax policy, interest and inflation rates, there is just not much room to make things any easier on business to create jobs and raise income levels, let alone pay for health care. There are many things we can do to encourage business and wage growth, however. Like fix this odious, job-killing system we have in America called Health Care.

Reforming health insurance alone will not solve the problem of cost. Even if all insurers became non-profits but otherwise performed at the same rate, it would only reduce the cost of health care by 1% of the $2.4 trillion it costs us now.  Want to see the data?  Check an NPR analysis of the data here.  From the article:

To negate this notion, AHIP features a dollar bill with one tiny slice out of it (shown below) on their Web site, illustrating that their members only make 1 cent of every dollar spent on health care.

That may be the case, says Princeton economist Uwe Reinhardt, but “whether it’s fair or not depends on what it is you want to describe,” he says.

“All that statement says is, if you eliminated all our [insurance company] profits, national health spending in America would be 1 percent lower. It has meaning only in that context,” Reinhardt says.

Tort reform is not going to bring our costs significantly down. How do I know this? Look at the size of the medical malpractice insurance industry. Not only is the medical malpractice insurance industry doing very well from a profitability point of view, the cost of medical malpractice is at a 30 year low. In fact, in 2008, the total cost of medical malpractice insurance premiums was $10.7 billion. That is less than one half of one percent of the $2.4 trillion we spend on health care. Total payouts from malpractice insurance in 2008? $4.7 billion.  There is a study here on tort reform by the CBO from 2004.  They did not believe then that it would affect the economics of health care.  There is another study undertaken by Americans for Insurance Reform.  Same deal, it’s just not a significant factor, and honestly should just be taken off of Republican talking points.

Come on, Republicans. We can do much better than this. And the independents, those people who really decide elections… They know whether or not they did better in the last decade or if they did worse. They don’t care what Glenn Beck says, and they don’t care what Keith Olbermann says. They care about their own situation and their own prosperity. And while Republicans do not solve problems for them, they will vote Democrat. It’s the simple truth.

We hear the comparisons to Canada and the UK and Switzerland, and we laugh it off because we say, “Well sure, they may control costs better than we do, but I’d hate to get sick over there!” And then we lay out a lot of reasons why our system is better.

Except the costs of our system are crushing individuals, business, and our economy. And we Republicans are blind to the reality that our “solutions” to the problem are tiny drops in an enormous bucket. Would you prefer the economic growth of the ’80s or the ’90s to the economic growth of the ’00s? We all would agree that would be preferable. Would you be willing to go back to an ’80s standard of Health Care to achieve that?

If the only substantive choice to contain health care costs is to move over to a Single Payer system like Canada (costs 10.6% of GDP), or a Nationalized system like the UK (costs 7.5% of GDP), then we must support the substantive choice. We can cry about losing our liberty and freedom all we want, but do not forget that economic freedom equals real freedom. That personal liberty is not possible without economic liberty. And the trajectory we are on is one that leads to economic slavery.

If I have to choose between continuing economic disaster in this country while the Republicans remain in permanent minority status and waiting 3 months for a doctor visit, I’ll take the waiting list.

Published in: on September 15, 2009 at 10:53 pm  Leave a Comment  
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The American Free Market Healthcare System Is Socialist

by Luna Flesher

Opponents of healthcare reform fear socialism.  And rightly so.  They list a host of problems that other socialist systems have seen.  While some examples are unrealistically exaggerated, their underlying point is well-taken.  Socialism, no matter how well intended, suffers from a number of unintended consequences.

The intention of collectivism is to provide equality, but the frequent result is that everyone is equally deprived.  No one is allowed to have more than anyone else.  Motivations become skewed, producers produce less, consumers consume more. Bureaucracy increases with the intent to stop fraud and abuse, which leads to increased inefficiency.  The least common denominator is prized because it is something everyone can agree on.

The Soviet Union is one of the best examples of this cycle, when it inevitably collapsed under its own weight.

A hat tip to my socialist friends out there. Yes, I know the USSR didn’t practice “true” socialism. But I still make my claim — any collectivist system of more than 100 people will generally suffer from similar symptoms.  When properly balanced, those issues can be stabilized and mitigated somewhat, but they are real problems that need to be recognized for what they are.

Socialized medicine is criticized for the following reasons:

  • Overall costs are rapidly driven up by lack of market forces.
  • Providers, manufactures, and other achievers are not compensated enough.
  • Choice becomes limited.
  • Care is rationed.
  • There are long waits for care.
  • There is a high level of bureaucracy leading to inefficiency, frustration, and corruption.

Most socialist healthcare systems in the world today show at least some of these problems, to one degree or another.

Previously, I posted about how our healthcare system is in crisis.  Our free market system is supposed to be immune to these problems.  Yet I’m noticing a strange correlation.  We are already experiencing all of the issues listed above.  How can this be?

Correlation is not causation, but I had already reached this conclusion a number of years ago for different reasons.  I briefly made this claim elsewhere in this blog, when I argued for government intervention, but did not have room to make my case.

My conclusion?  Health insurance is socialist.
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Published in: on August 24, 2009 at 11:15 pm  Comments (2)  
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Health Care in America – Choice?

by Roland Lindsey

“Choice” is a word we hear from talking heads and politicians nearly every time they talk about Health care in America.  President Obama recently declared on talk radio, “Choice, competition, reducing cost, those are the things I want to see accomplished in this health care bill.”  Nancy Pelosi said, “I agree with the president when he said a public option was the best way to keep the insurance companies honest, that it would be the best way to increase competition so that we can lower costs, improve quality of care, retain choice and expand coverage.”

On the other side of the debate, the Republicans have opposed Democrat plans for health care reform, often claiming it would take choice away from the American people.  Representative Paul Ryan claimed the federal bureaucracy would replace “choice and competition.”  Representative Bob Latta claimed “I believe people should have the choice to keep their own insurance, or Health Savings Accounts, if they are satisfied with their coverage and not be subjected to government intrusion into their personal choices.”

Republicans have introduced a plan called “The Patient’s Choice Act of 2009” that would create state insurance exchanges.  The purpose of these exchanges is to make it easy to compare and select plans.  Apparently they have never heard of http://www.ehealthinsurance.com.  The plan would also… give people money to buy health insurance.  And if you are uninsurable through these plans?  They will do what Washington State did and create a “high risk” pool that would be more expensive, but would still provide coverage.

So much concern over preserving “choice” or granting more “choice.”  After consulting my own experience, I pause to wonder, “Why do you keep saying that word?  I do not think it means what you think it means.”  Like 56.5% of Americans, I have always received health insurance as part of my total compensation from my employer.  Odds are good that you receive your insurance this way, so I ask you:  When was the last time you made a choice in your health insurance?
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Published in: on August 21, 2009 at 8:51 pm  Comments (3)  
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Our Healthcare System In Crisis: The Evidence

by Luna Flesher

It’s become clear to me based on the feedback from my previous posts on healthcare that many people in America don’t realize there are any problems with our existing system.

There is plenty of information available about these problems.  I always like to steer people towards personal research, but these links should get you started:

Plus:

And I’m not even talking about universal coverage to pay for those who can’t afford it.  I don’t have to even go there.  Because like it or not, we already pay for the poor’s healthcare through:

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Published in: on August 15, 2009 at 4:52 am  Comments (7)  
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The government is not trying to kill Grandma

by Roland Lindsey

Excellent interview here.

The media has gone crazy with this idea that the government wants to euthanize old and handicapped people, and that these things are in legislation before the Congress.  Yesterday, I posted quotes from Rush Limbaugh repeating the same lies.

Today, I saw an interview with Senator Johnny Isakson (R-GA) about the issue.  From the article:

How did this become a question of euthanasia?

I have no idea. I understand — and you have to check this out — I just had a phone call where someone said Sarah Palin’s web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up.

Read the whole interview and stop listening to the misleading liars who are telling you anything different.

Published in: on August 11, 2009 at 9:24 pm  Comments (4)  
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Health Reform Bill Reading Project: Part 1, The Meta-Summary

by Luna Flesher

I have just finished reading the House version of the America’s Affordable Health Choices Bill of 2009.

I will give a detailed account in this multiple parts.  This post will be the overall summary.  See Part 2 for detailed dissection so you can judge for yourself.

Here are my qualifications, or lack there of:  I am simply an American who does not want to be screwed over by the health care industry or the government.  My political alignment is “pragmatic libertarian”.   I am generally skeptical.  I am intelligent, but I am not a lawyer.  I have zero law training nor any training in the medical or health fields.  In fact, I generally hate the topics of law and health because they bore me.  I only chose this task because 1) I was challenged to it, 2) I happened to have time this weekend, and 3) lots of people are claiming to be experts, but few actually seem to be reading the damn thing.

This is probably the last time in a very long time I will attempt something like this.

The AAHCA was 1018 pages long, approximately 200,000 words.  I did not log my hours, but I’m guessing it took me about 6 hours total, spread out over 3 days.  I spent 2 hours writing this summary blog post, and expect to spend at least another 2 hours compiling my notes for the detailed posts.

I am not a speed reader.  My intent was to find the truth of what the bill actually does, so my decisions were in good faith, i.e. if I felt I understood a section, I skimmed over details that were repetitive, reinforcing what I understood, or making minor modifications to existing laws.  There were vast pages of “hereby changing the semicolon to a period in title IV of USC blah blah”.  There were vast pages of tweaks to Medicaid.  These I read enough to make sure there was no overt funny business, but I did not spend many brain cells trying to comprehend these sections.

When I did hit a section which seemed important (of which there were many) I slowed down until I reached comprehension.  At times I did additional internet research to make sure I understood what it meant.  In my followup “detail” posts, I will make a note of anything I felt I didn’t fully understand.

There were complications on my understanding of sections which amended existing laws.  Since I have no understanding of those laws, and did not want to increase my reading time by ten to go read those laws, I made some assumptions.  Overall, I didn’t get the sense that there was any trickery going on.  The intent of the law seemed clear and in good faith, so my assumption is those amendments were in that same letter and spirit.

The intent of the law seems to be to improve quality care for everyone, lower or control costs in the industry, to help those who have no coverage to get covered, and to regulate against abuses that are currently going on in the health industry.

I did not see any attempt to replace the insurance or health care industries with government health care.  I did not see any overt violations of individual rights other than the usual: increases in certain taxes and increases in bureaucratic mass.  No death panels, no government takeovers of health care, no limits in doctor choice, no letting grandma die.

So let’s get started.

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Published in: on August 9, 2009 at 10:25 pm  Comments (5)  
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On Tyranny and Health Care: A Libertarian’s Plea for Government Interference

by Luna Flesher

If liberty is one of my chief values, and tyranny is its opposite, then tyranny is my adversary.

By liberty, I mean individual freedom from oppression by another; the ability to move about, act as I choose, and reap the consequences.  In order to fairly protect liberty, freedom must be limited when it begins to infringe on the freedom of others.  I was raised with the phrase, “Your freedom to swing your fist ends where my nose begins.”

To be clear, I do not mean freedom from want.  Being handed unearned resources may increase choice, but this is not the kind of freedom a government can easily grant without violating the rights of someone else.  Nor do I mean the freedom to escape rightful consequences, both positive and negative.  You may act on your rights, but it is not freedom if you unfairly avoid what’s coming to you.  That usually indicates someone else’s rights are being violated, someone else is being cheated.

Tyranny, the antithesis of liberty, can come from any source.  Most libertarians and conservatives are rightfully wary of the tyranny of government.  Typically only a government has police power, military might, power of imprisonment, and the backing of society.

However, tyranny can come from many other sources — any individual or organization who wishes to impinge upon your rights.  They do this through the use or threat of physical force, breaking of contracts, and gaining consent through misinformation.  They avoid the negative consequences of harmful actions, reaping only rewards through unfair advantage, force, and fraud.

Besides governments, large-scale tyranny can come from corporations, outside governments, unions, organized religion, organized crime, academia, political groups, etc.

On a smaller social level, it can come from independent criminals, bullies, abusive families, cults, small businesses, private security organizations, friends and associates, or random people on the street.

We spend so much time thinking of government as the bad guy.  However we forget that its most legitimate purpose is to protect individual liberties from other powers that would exert force or fraud.  That’s why we have allowed the government military and police power in the first place.

We need to look around and ask what other large-scale tyrannies exist in America today.  A good measuring stick to judge this by is, “Does it initiate force or fraud?”  Since it is the topic du jour, let’s look at the health care industry.  Here are three ways it has initiated both.

1. When you or your employer pays for health insurance, you have a contract with the insurance provider to cover certain costs if you become sick.  Your contract is too probably long to read, too confusing for you to understand, and full of loopholes.  This is a form of fraud or uninformed consent.

Even if your contact in fact covers your expensive illness, as soon as you are diagnosed the insurer is likely to drop your coverage.  You will be stuck with prohibitive bills and likely bankruptcy.

You may think this is a rare occurrence, but it is not.  The leading cause of bankruptcy is due to medical bills of people who were already covered by health insurance.

If it happens even once, it is the government’s job to protect all individuals from fraud.

2. Various factors have driven up costs so that access to health care is barred to anyone except those with insurance or those who are very rich.  It is no longer possible for a middle class person to save a percentage of their income and pay directly for health services.

Insurance has created a non-level playing field.  It is a form of privatized socialism.  Doctor’s charges go up to subsidize insurance discounts.  Hospital bills are increased to cover those without health insurance who show up on the hospital steps.

The least advantaged are the employed middle class without employer-provided insurance, small business owners, and the temporarily unemployed.  The system basically forces you to choose between being insured or not having any health care.  The latter choice leads to bodily harm or even death.

If you decide to buy insurance on your own, the costs are prohibitive.  And if you have a “pre-existing condition” like a past treatment for a yeast infection or acne, you will be denied insurance.

It boils down to this:  If you choose to run your own business or freelance, or if you choose a small employer which does not provide health care, or if you are involuntarily laid off, you risk bodily harm.  Contrary to popular belief, “hard work” is not a factor for successful health in this system.

3. In most states, employees cannot choose their insurance provider.  They cannot choose their coverage.  In this sense, they are forced into a contract made between their employer and insurance company.  This limits consumer choice when it comes to doctors, level of care, customer service, price, level of bureaucracy, and reputation.  If my insurance drops my doctor from the network, I must find a new doctor.  If my insurance company raises rates or lowers coverage, I can’t walk away.  I’m trapped.

Conclusion

There are numerous valid sources that show how insurance companies extort, defraud, cheat, and oppress.  The evidence is overwhelming.  There are examples of corruption at every level of the health care industry.  The industry as a whole is the very socialist dictatorship we so fear.

The government seems to be the only entity powerful enough to reinstate the balance and protect the people.  This is the proper role of government.  Health care reform should be embraced by everyone who cares about individual liberty.

This is one time when it is proper to plea for government interference.

Published in: on August 7, 2009 at 10:47 pm  Comments (11)  
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Health Care – Conservative solutions that don’t sound crazy

I have to say that most conservative arguments seem unconvincing and weak to me on health care.  The arguments about “We don’t want government making decisions for us!” is easily countered by “A bureaucrat in an insurance company is better?”  The argument saying “The government breaks everything it touches!” falls down when you consider the high efficiency of Social Security and Medicare (I know they are not sustainable, but neither is a health care industry that increased in cost 87% in the last 10 years.  Social Security and Medicare are more sustainable than that.)  Arguments about choosing doctors fall flat when Canada’s single payer system allows you to choose any doctor, anywhere, and they have a much higher percentage of private practice doctors than Americans.  Arguments about how happy people are with their health insurance fall flat when you realize most of those happy with their insurance have never dealt with a financially crippling illness, which almost always leads to bankruptcy.

So what’s a conservative to do?

There are some much better arguments that I don’t see prominent conservatives making.

Single payer systems are completely unrealistic when you consider they would instantly eliminate $100 billion+ in market capitalization due to the health care insurance companies no longer able to sell a product.  Are we cool with eliminating $100 billion from our economy right now?  Along with all the jobs?  Didn’t we just bail out a company worth $55 billion in 2000?  (GM, I’m looking at you.)  It’s crazy talk to consider this as an option.  And even if you do replace a 15% insurance company cost with a 4% government administration cost, you are only saving 11% of the cost by choosing single payer.

Any solution that attempts to alleviate the pain of health care’s costs needs to focus on…. Health care costs!  Right now, the insurance companies have had no incentive whatsoever to rein in costs.  They always get their 15% no matter what the care actually costs.  Consumers have no real clue what the procedures cost, so what would they have to complain about?

I had a routine physical a few weeks ago, and was shocked to see that my insurer paid $500 for the work.  In that time, I spent 5 minutes with a doctor, and 7 minutes with a nurse!  And that was it!  $500?  I could get a very high priced lawyer for the same cost and he would spend the entire 60 minutes chatting with me about anything I wanted to chat about.

We have seen that the current system has no mechanism for making providers justify their costs, and I believe that is the true problem.  If a provider had to explain why it cost them $500 to spend 12 minutes with me, and it was easy for me to compare what providers cost, and what their patient outcomes were, I would generally choose the best care for the lowest cost.  Transparency helps solve lots of problems, and transparency can definitely work here.  Today, the workings of health care are far too arcane and esoteric.  When we see a provider gouging people on the provider costs & outcomes website, let the market punish them!  Imagine the fun of browsing this site.  “Hey honey, look at this doctor!  Half of his patients die!”

I believe that there is value to making sure that everyone has access to care.  I believe most Americans believe that as well.  I believe in mandated health insurance just as I believe in mandated car insurance.  And I believe that when people cannot afford to pay for health care, we all suffer.  The government seems to be good at loaning people money these days, so let the government loan health care money to those who can’t afford it.  Many will never repay the loan, but some will.  Some will gladly repay it as their fortunes increase.

And finally, make this problem a states problem.  It costs far more to operate a practice in Manhattan than it does in Seattle, Washington, or Butte, Montana for that matter.  The federal government can mandate that the states must come up with a solution that makes sense for them.  The federal government can mandate insurance purchase.  The federal government can mandate that the providers provide complete transparency as to costs and outcomes.  The federal government can loan the poor money to pay their premiums.

Some states can choose to become a single payer system, allowing more doctors to practice more profitably because they don’t have to hire huge administrative staffs to manage claims.  Some states can choose to continue to manage multiple insurance providers.  Some states can keep things as they are.  And we, the people, will vote with our feet.  As always.

Published in: on June 9, 2009 at 6:39 pm  Comments (1)  
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