Universal Freedom: The Only Hope for Health Care

“Universal Health Care” is the increasing drumbeat of advocates who want Americans to place all responsibility for their health care in the hands of government.

“Universal Health Care” is the increasing drumbeat of advocates who want Americans to place all responsibility for their health care in the hands of government. They say health care needs require us to put aside such considerations as personal choice and individual freedom as outmoded ideology that should be dispensed with. First drop the context of individual rights, private property, and privacy—then the government is liberated to micro-manage every detail of the medical treatment you are allowed to have.

The loss of freedom may be unfortunate in this view, but is necessary because most Americans cannot afford to pay for health care, or even for a significant fraction of the cost. Of course if that were true, the government could not afford health care for everyone regardless of cost either. However those who might be relieved to learn that they are not responsible for the cost of their own health care would soon discover that they have become responsible for the cost of everyone else’s. There is a much higher price than that: a government that pays for all of our health care would inevitably come to think and act as if it owns our bodies. That is a big bill to pay to avoid the difficulty of paying insurance premiums. The talk about a “right” to health care really means that no one should have the right to any health care at all except through the government.

Many of us find paying for health care challenging. Many more have difficulty making it a priority in our spending—often because we think it should be someone else’s responsibility. Some who sincerely make the effort can’t pay for everything they need. Others, especially the young who know they will live forever, choose not to make provision for their health care even if they can afford it. That does not mean we should resort to the government to force others to provide it, or that everyone in the country should be herded into the gray and barren landscape of a compulsory government medical system. The fact that some people are hungry does not mean that everyone should be forced to obtain their food from the government, and be taxed to pay for it. The existence of the homeless should not mean that everyone be forced to find shelter only through the auspices of the Department of Housing and Urban Development.

We are told that because we all need health care so badly, considerations such as individual freedom and especially the rights of medical professionals must be over-ridden, even if all physicians must be drafted into government service as if they were property—so their practices can be micro-managed by the medical police. But it is precisely because our health care is so important to each of us that we need to be especially careful to preserve and protect the rights of physicians and other health care providers.

One rationalization of advocates for Universal Health Care is that insurance companies are wasteful and bloated corporate bureaucracies with high administrative costs, but that government health care like Medicare and Medicaid are models of administrative efficiency. This ignores the cost of the more than 100,000 I.R.S. employees who collect Medicare taxes, as well as the tremendous administrative burden to providers of trying to understand and comply with 130,000 pages of Medicare regulations. Yet those regulations have not been effective in preventing billions of dollars in fraudulent payments, as documented in New York Medicaid by several New York newspapers this year. You can save a lot on overhead if you don’t mind pumping out billions of dollars without oversight. The administrative cost of burning money can be quite low. It is not explained how the efficiency of government works for health care and not for the post office. Markets work better than Socialism. One wonders if any of the current health care collectivists noticed the twentieth century as it was going by.

Universal Freedom is the only proper moral and political foundation for health care policy. “Universal Health Care” must be rejected as a government threat to our liberty. American health care must be based on American values.

Richard E. Ralston, Capitalism Magazine

Free Markets are Good Medicine

Those who prefer government management of medicine have a wider agenda: they hate the idea of a free market in medicine because they hate the idea of free markets in anything.

There is an unstated context behind the health care debate. Those who prefer government management of medicine have a wider agenda: they hate the idea of a free market in medicine because they hate the idea of free markets in anything.

Of course, an actual free market in medicine disappeared long ago. What remains is so heavily regulated by the federal and state governments that it is beyond recognition. The U.S. government directly pays for, and therefore controls, half of medical care today. We are only fighting over the remnants of a bygone era.

All the more reason for a vigorous fight.

The private medical practices and partnerships that remain today are, at their core, small businesses. They struggle to survive under more government-imposed burdens than most businesses. Medicare and Medicaid regulations place an enormous administrative load on even the smallest practices. Add to that similar regulatory regimes in 50 states. And those regulations have established a pattern for private insurance companies. This has imposed a growing and costly burden on private practices. Any physician who cannot manage a complex accounting operation and legal compliance with more than 100,000 pages of regulations cannot remain in practice.

Unfortunately, not all physicians resent this. A few even embrace the idea of a total government takeover of all medical payments. A supposed opinion poll reported a few years ago by a comedian, about young people starting their working careers, explains this. Half said that the greatest threat to achieving their career goals was the government. The other half said that they had no goals but wanted a job working for the government. In the case of physicians, those who want to toss away their own freedom to practice medicine in return for obedience to the new government masters of medicine must not be allowed to take the rest of the profession with them.

Most physicians are small businessmen. If they are to survive, it must be as businessmen. That is why those who hate business hate physicians in private practice. Before Obamacare passed into law, an editorial in the New York Times attacked private physicians as “unabashed profiteers” because they (instead of the government) “decide what medical or surgical treatments are needed.”

The threat of the absorption of all medical care into the loving arms of politicians, whom we all trust so much, is made possible by a fundamental economic error and a fundamental moral error.

The economic error is the illusion that the government can create medical care.

The government cannot provide medical care or anything else to anyone that it does not first expropriate. It can seize the practices of physicians and replace their decisions about patients with those of government boards. It can pay medical bills only with money taken from individuals and employers–or by imposing reimbursements that do not cover a physician’s or hospital’s costs.

Ultimately, business activity must finance all medical care.

But the most important error is moral. The right to make medical decisions is destroyed by the deception of a “right” to medical care. That false right requires that medical care not be allowed except by government permission. What the government cannot create, it can only take, regulate or forbid.

The quality and growth of medical care requires that physicians be left free to literally mind their own businesses. I know that, though I am not a physician, because I am an American businessman. Like my fathers before me.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.

In a Crisis, a Compromise Solution is Worse than No Solution

The raging argument on the left between progressives who argue for radical change and centrists who advocate for incrementalism is hardly new.

Nearly a century ago, progressive titan and Wisconsin Gov. Robert La Follette and then-President Franklin D. Roosevelt were often at loggerheads over the same question.

Roosevelt, La Follette complained, was too quick to compromise with reactionaries. FDR insisted that “half a loaf is better than no bread.” While that might seem intuitively obvious, La Follette had a ready reply. “Half a loaf, as a rule, dulls the appetite, and destroys the keenness of interest in attaining the full loaf.” That can be dangerous. The average adult male requires approximately 2,500 calories of nutrition per day. Twelve hundred and fifty is better than zero, but 1,250 is still malnutrition that would eventually kill him.

Even in a long-running crisis, the sustained agitation necessary to pressure the political classes into granting concessions doesn’t usually occur before people’s suffering has become acute. If the powers that be provide partial relief in the form of a half-measure that partly alleviates a problem, angry citizens can be persuaded to put down their pitchforks and go home peaceably. Yet the problem persists.

The Affordable Care Act is a perfect example. Barack Obama became president at the peak of a major economic crisis, the subprime mortgage meltdown of 2007-09. With hundreds of thousands of people losing their jobs every month, the need for government intervention in the health care system was obvious to most Americans. So Obama campaigned on major change that included a public option. Two out of three people, including many Republicans, favored a single-payer system similar to those in many other countries.

Instead, we got the watered-down ACA.

As COVID-19 has made clear, the for-profit American health care system is even more scandalously dysfunctional than it was prior to the passage of Obamacare. The ACA “marketplace” has collapsed; many places only offer one “take it or leave it” insurance plan. Nevertheless, health care is no longer a top political issue. Support for a public option or “Medicare for All” has dropped to about 50%. The Democratic Party chose to nominate someone who promised to veto Medicare for All even if both houses of Congress were to pass it.

Tens of thousands of people are still dying every year because they can’t afford to see a doctor. But in too many people’s minds, health care was partly solved. So they are no longer demanding improvements. Though it might seem counterintuitive, the politics of the health care crisis would be vastly improved had the compromise ACA never been enacted. More people would be suffering. But the absence of an existing, lame plan would add urgency (and supporters) to the fight for a real, i.e. radical, solution.

Half a loaf is killing us.

As President-elect Joe Biden fills his Cabinet with Obama-era centrists and corporatists, many Democrats say they are satisfied with the improvement over President Donald Trump: officials with government experience replacing crazies and cronies, pledges to reverse the outgoing administration’s attacks on the environment, fealty to science. They are falling into La Follette’s “half a loaf” trap. Especially on existential issues like climate change but also regarding the precarious state of the post-lockdown economy, compromise will sate the appetite for meaningful change without actually solving the problems. As with the ACA, voters will be deceived into thinking things are getting better when, in fact, they will still be getting worse, albeit perhaps at a slightly slower rate.

Climate scientists are divided between those who say we might be able to save human civilization if we achieve net zero carbon emissions within a decade (which is the goal of the Green New Deal pushed by progressives) and those who say it’s already too late. A widely reported study predicts that human civilization will collapse by 2050, yet that’s the year Biden is promising to begin net zero carbon emissions. So if we do what Biden wants, we are going to die.

Trump denied climate science, deregulated polluters and pulled the U.S. out of the Paris climate accord. Biden appears to be an improvement. He talks about the urgency of the problem, promises to restore Obama-era regulations and to rejoin the Paris agreement. Pro-environment Democratic voters are breathing a sigh of relief.

But if the goal is to slow the rate of global warming as much as we reasonably can, both Obama’s regulations and the Paris agreement are woefully inadequate. “Marginal cuts by the U.S. don’t have a long-term overall big effect on the climate,” Michael Oppenheimer, professor of geosciences and international affairs at Princeton University, told Scientific American in 2014.

According to National Geographic, a 2017 report by the United Nations Environment Program found that “if action to combat climate change is limited to just current pledges, the Earth will get at least 3 degrees C (5.4 degrees F) warmer by 2100 relative to preindustrial levels. This amount of warming would vastly exceed the Paris Agreement’s goal, which is to limit global warming by the end of the century to 2 degrees C (3.6 degrees F).”

“(3 degrees C increase) would bring mass extinctions and large parts of the planet would be uninhabitable,” the UNEP warned in 2019.

If liberals head back to brunch in a month thinking that the Biden administration will move the needle in the right direction, if they stop being terrified, we are doomed. For, as bizarre as it sounds, Donald Trump provided a valuable service when he scared the living daylights out of us.

Consider a more modern analogy than the loaf of bread: If a two-pill dose of antibiotics is required to cure an illness, taking one instead doesn’t make you half better. It actually makes you worse, because not only do you not get better but you also destroy your immune system’s ability to fight the disease.

This country is teetering on the verge of collapse. We can’t afford to settle for the single-pill solutions of incremental Bidenism.

Ted Rall, UNZ Review

How a Laissez-faire Capitalist Society Deals with a Vaccine

Under real capitalism, there is no government policy at all regarding how people are to conduct themselves in a pandemic. With no barriers to innovation, production, and distribution, the pharmaceutical industry would be rocketing us into an almost disease-free future.

Before we start taking for granted the statist perspective on the vaccine and its delivery, let’s look at how a free, rights-respecting government and society would be behaving right now.

Prices of anything in short supply (where I am it’s Bounty paper towels) rise until supply meets demand. The supermarket shelves remain full. The businesses producing and selling these items reap windfall profits, which draws capital to ramp up production, so that in a few weeks prices fall back to where they were.

The same is true of medical services: in a free society doctors are not licensed; consequently, their supply can be expanded; hospitals are not regulated, so they can handle surges in demand as they wish. No fire marshals, building inspectors, environmental impact assessors can interfere with any temporary build-out a hospital decides to make. In fact, no one would dream of even asking to be informed of any decision a hospital makes regarding how to use its own property on its own land.

Tests and vaccines are developed by pharmaceutical companies, in their labs, and get whatever private voluntary certification they choose to get (probably none—why do Pfizer or Johnson & Johnson need any stamp of outside approval?).

As they develop these new tests and vaccines, they distribute early versions of them to their own network of forward-looking individuals, including doctors, medical staff, and researchers, willing to take a little extra risk to get innovative products sooner.

The new tests and vaccines are sold for “all the market can bear.” That means: high prices to early-adopters; then, as safety and efficacy become established by tracking the experience of the early-adopters, the items are sold at progressively lower prices to wider and wider segments of the general population.

Since a free society’s government never compels anyone to get a doctor’s prescription, there are no such things as pharmacies in the traditional sense. Rather, CVS, Walmart, Walgreens have a pharmaceutical area, perhaps staffed by specially knowledgeable people (who don’t require a government license) to advise you. If you don’t need this kind of service, and just want pills to swallow, you can just grab a bottle off the shelf and go to the cash register. Or you can go on Amazon or other sites and buy them just the way you do books, T-shirts, and canned peas.

The “delivery system” for the new vaccines and tests is the same profit-making firms that already deliver everything in a capitalist society. Think: UPS, Amazon, FedEx—but even better, because they are not regulated.

To get products, new or old, we don’t need four-star generals to be in charge of “logistics.” Even today, under semi-capitalism, the task is handled by purchasing managers, inventory managers, buyers, and vendors—and no shortage ever develops, except where government holds prices below market.

Under pure capitalism, there is no such question as: “Who is going to get the vaccine first?” If it were asked, the answer would be the same as for “Who is going to get the new C8 model Corvette first?” Whoever shows up with the money. If there’s a rush, the price goes up to where demand matches supply. Then supply is expanded to reap the resulting high-profit rate.

And there is no such question as: “What if a segment of the population is afraid to take the vaccine?” People are thinking, not of collective outcomes, but of individual ones. It would never occur to them to worry about people who don’t take the vaccine, because they know that by choosing to get vaccinated, they themselves will be protected.

Under real capitalism, there is no government policy at all regarding how people are to conduct themselves in a pandemic. Not only are there no lockdowns, no curfews, no group quarantines (on the basis of group statistics), but also no thought of government having any role to play. “Public health” is no more connected in people’s minds to government than is “public entertainment.” Health is understood to be a personal matter—just as entertainment is.

Even where there are “social problems,” free citizens of a free society regard it as widespread individual problems, not as problems justifying government coercion.

Take the rising divorce rate, which is widely regarded as a “social problem.” Even today, no one thinks divorce is something to be combatted by government directives. The prospect of government getting involved in marital problems would fill us with horror. For the citizens of a laissez-faire society, the idea of government dictating people’s behavior in a pandemic would be equally as horrifying.

In practice, the laissez-faire utopia I’m envisioning would be tremendously healthier than the regulatory state we live under in America today. Without the dead hand of the FDA, medical experimentation and data-collection from ordinary citizens (via their smartphones, perhaps) would produce vastly more data for AI to use in discovering what works and what doesn’t. With no barriers to innovation, production, and distribution, the pharmaceutical industry would be rocketing us into an almost disease-free future.

Harry Binswanger, Capitalism Magazine

DON’T DO IT !

I just spoke to a biochemist who’s a friend of mine. She’s strongly urging everyone NOT to get the COVID vaccine. It is extremely dangerous, especially in terms of long-term consequences.

Don’t believe a word the government says. Everything the government has has been stolen, and everything the government says is a lie.

The Artful Dilettante

Medicare: Socialism’s Sacred Cow by Michael J. Hurd + commentary

“Ben [Carson] wants to knock out Medicare,” said Donald Trump. “I heard that over the weekend. He wants to abolish Medicare. Abolishing Medicare, I don’t think you’ll get away with that one. It’s actually a program that’s worked. It’s a program that some people love, actually.” [Newsmax.com 10-27-15]

Actually, Carson does not propose abolishing Medicare. According to DailyCaller.com, he says he would not end Medicare and would use health savings accounts, which would eliminate “the need for people to be dependent on government programs.” Carson wants to “provide people with an alternative” that he describes as “so much better than anything else,” but added he doesn’t plan on ending Medicare completely.

Carson is under fire not for suggesting that we should privatize and phase out Medicare — which we should — but merely for hinting that we might provide an alternative to the coercive, government-run program. He’s under fire not just from Democrats, but from fellow Republicans, particularly Ohio Governor John Kasich and apparent front runner for the nomination, Donald Trump.

Is Trump right? Is Medicare popular and, if so, does that automatically make it morally right and fiscally sustainable?

Can’t a majority be wrong? And if they are, isn’t it the job of a leader — in politics, or anywhere else — to educate that majority as to why they’re wrong, and what the consequences of their errors are? Even if that means losing an election in one case (Republicans already lose anyway, even when they win), might it not become an advantage a few years down the road, when they’re shown to be right?

Medicare is a single-payer, socialized insurance plan for those 65 years and older. Back in 1965, Congress would have passed a single-payer plan for everyone, if they thought they had the votes. Even in 2010, Obama and the Democratic Congress would have passed a single payer plan, if they thought they had the votes. (Obamacare was the next best thing).

What nobody seems willing to examine — not even Ben Carson, who’s at least willing to slightly hint at it — is whether single-payer insurance is ever morally right, for seniors or for anyone?

Medicare is a coercive government monopoly. It’s even more communistic and socialistic than, say, public schools. With public schools, you can opt out. Granted, private schools are more expensive and in shorter supply than they otherwise would be, because government dominates the market with federally funded public schools. But it’s not against the law to send your child to a private school, or even home school, in many cases.

Not so with Medicare. With Medicare, once you turn 65, you’re on Medicare, like it or not. You have no right to purchase an alternative plan in the marketplace (or to have planned on one years before), because there is no marketplace, and it’s against the law. While there are “Medigap” plans (Medicare secondary insurance) available through quasi-private insurance companies, most people do not understand that those plans follow the rules of Medicare and the government, not the market. In other words, if your doctor or health provider does not participate with Medicare, then your secondary “Medigap” insurance will not cover that provider, either. And all the rules, edicts, regulations that apply to Medicare likewise apply to the secondary insurance.

Medicare is a monopoly. It’s a coercive, one-size-fits-all single-payer system. If Republicans running for President will not acknowledge this, then I don’t know who will. It’s a fact, all the same.

Is Medicare popular? Well, of course it is. People have no other choice. But “popularity” implies a willingness to choose one option over all others. If there are fifty restaurants in a town, one or two restaurants might draw 60 or even 75 percent of the diners. We’d call those restaurants the most popular, with good reason. Medicare is, according to the law of the land, the only option for seniors in health insurance. By what stretch do you call that popular, or say that people “love” it?

It’s reasonable to assume that most people on Medicare would not want the plug pulled on it overnight. I don’t know of anyone who’s proposing that. The only rational and just way to handle the problem is to phase Medicare out. Put young people on notice there will be no Medicare program for them, because there most certainly will not be anyway, given the fiscal unsustainability that its morally wrong and coercive approach creates. Unless the U.S. economy can find a way to sustain debts and deficits too high for economists or computers to calculate, or tax rates so high that the economy will grind to a complete halt, Medicare (like Social Security) cannot go on forever.

Debate should be open to how best, or in what way, start privatizing Medicare and all of health care in America. Until or unless we get to that point, no discussion of the subject makes any moral or economic sense. Even flailing about Obamacare does not address the core issue. If you want to privatize health care in America, you’ve got to take on Medicare.

Medicare’s fiscal unsustainability (freely acknowledged by the government, including Obama’s own Treasury Department) is not the worst thing about it. The worst thing about it is that it’s forced. It prevents people from freely acting as they otherwise would. Why are proponents of Medicare, Donald Trump included, so afraid of a free market, or even an alternative market as Ben Carson suggests we might need? If Medicare is as beloved and as great as they assume, nobody will ever opt out of it. Of course, even if we established health savings accounts for seniors as Carson proposes, it’s still not a fair competition, because government would still have the upper hand with its federally funded (albeit bankrupt) programs. Yet nobody can tolerate even this much competition with the government in health care, not even the vast majority of Republicans. It’s pathetic.

Donald Trump is supposed to be such a smart businessman, and so willing to speak his mind. Both of these things may be true. But his comment that Medicare is popular and beloved by seniors is laughable. If the government passed a law that people may buy only one kind of car — same size, color and model for everyone — would you call that brand and style of car popular? Even though that’s the only one they’re permitted to buy or own?

That’s exactly what Donald Trump and other Republicans are saying.

Without any meaningful or principled opposition to Medicare, Republicans are dead in the water on health care. We might as well have the Democrats in charge. These are their programs, and if socialism is morally justified in health care, then socialism is morally justified potentially anywhere. If Republicans really opposed socialism in principle, they’d be willing to take on or at least question the sacred cow of Medicare.—Michael J. Hurd, drhurd.com

Medicare: The Mother of All Generational Larceny by The Artful Dilettante

Medicare is the Big Enchilada, the mother of all generational larceny. Like most federal entitlement programs, Medicare is financed through long-term debt. In other words, the cost of every hip replacement, knee replacement, open-heart surgery, kidney replacement, indeed most eldercare, will be borne by our children and grandchildren, the young and unborn. Talk about taxation without representation. We older Americans love to talk about how much we love and spoil our progeny. We brag about their report cards and athletic prowess, and shower them with money and gifts well beyond anything they’ve done to deserve it. Yet we have no guilt, no mercy, and give not a second thought to them when it comes to passing along the costs of our old age onto them. Because of us, they will inherent a debt they will struggle and suffer their whole lives to pay. Our legacy is nothing less than making them slaves to debt. We all want to live to be 100 as long as someone else is footing the bill, bearing the consequences. Try asking an elderly person, “Who paid for your hip replacement?” and they’ll likely respond, “It was free,” or “The government paid for it.” Their response should accurately be, “My neighbor paid for it, and they didn’t even ask for his permission.” Or, “My newborn grandchild will be paying for it her whole life, and I don’t even care,” or how about, “My kids are paying for it. It’s part of their inheritance.” So don’t go around shouting from the rooftops how much you love and spoil your grandchildren. As long as you are mortgaging their future, you’re just blowing smoke. And making a lot of Wall Street bankers very happy.