Although commonly referred to as “health care reform,” the legislation working its way through Congress is nothing more than a package of tax increases. Taxation is really the only true power a legislature can exercise, although particular forms of taxation often masquerade under different names.Taxation itself supports two basic functions: Warfare and professionalism. The former needs no explanation here. The latter, professionalism, is sometimes referred to as “monopolization” or “regulation,” but I think professionalism is a more useful description, especially when discussing taxation related to health care.
As I explained in a LewRockwell.com article last week, I derived the definition of “professionalism” from a short essay by the baseball historian and analyst Bill James:
After World War II newspapermen were caught by the fever of professionalism which was then gripping the nation. Cops became police officers, nurses became health care practitioners, garbage men became sanitation workers. Newspapermen were no longer content to be newspapermen; by the late 1960s they had become journalists.
At the same time, baseball players were getting unionized, and emerging as professional athletes. Now, I don’t know where you stand on “professionalism,” but I think professionalism ranks with socialism, psychology, and twice-baked potatoes as the worst ideas of the twentieth century. Cops become police officers, but the crime rate soared. Professionalism in law enforcement has brought us the O.J. Simpson case in lieu of justice. Professionalism in education has given us teachers who know how to administer sophisticated evaluative interests, but simply don’t have time to deal with the kids who can’t read.
We would all be better off if the principle of civilian control of the military was extended to civilian control of the judicial system, civilian control of the schools, civilian control of the police force, and civilian control of the medical profession.
Ah, the doctors. The inevitable defense of professionalism is, “Would you rather be operated on by an amateur surgeon, or a professional?” But the costs of professionalism in medicine has given us medical miracles for the affluent, but hospitals that will charge you $35 for aspirin, insurance companies that won’t pay for an overnight hospital stay after an appendectomy, and no access to health care for 45 million people. My father was a small-town school janitor, but when we got sick a doctor came to the house. Doctors are too professional for that now. We work for them.
I don’t concur with all of James’ quantitative assessments, but I think his basic “civilian control of the medical profession” argument is sound. Professionalism represents a separation of the consumer market from the professional market. The consumer market values serving customers. The professional market values its social (or political) position.
The costs imposed by the professionalization of the health care market far outweigh the benefits to consumers. That is the problem with the health care system; it is not the problem that the politicians are addressing (even though many tacitly acknowledge it is the problem). Instead, the politicians propose new taxes to prop up the professional market while publicly scapegoating the insurance companies as the real culprits.
Mind you, the insurance companies are not innocent bystanders. But they are one of the few institutions that has managed to offset some of professionalization’s harmful effects. The newly proposed tax increases will eliminate those meager benefits while offering nothing for consumers in return.
Breaking down the wall that separates the consumer and professional markets means reducing – and ultimately eliminating – taxation in all forms. This includes obvious items like licensing and FDA restrictions on drugs; but it also means abandoning ideas favored by conservatives and some libertarians, such as limits on malpractice damages and state-directed “health savings accounts.” Any tax on consumers for the benefit of professionals must be eliminated in order for true health care “reform” to occur.
{ 1 comment }
I disagree. Twice-baked potatoes are delicious.
The rest of the article is sound.
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