Why Socialized Medicine Leads to the Prohibition of Private Medicine
An article in today’s (Feb. 20, 2006) New York Times makes clear that Canada’s much ballyhooed system of socialized medicine, in addition to being plagued by interminable waits for treatment, has prohibited competition from private medicine. But now, as the result of a ruling last June by Canada’s Supreme Court, limited forms of private medical care are apparently in process of being allowed to appear, at least in some provinces. In The Times’ article’s words: “The cracks are still small in Canada's vaunted public health insurance system, but several of its largest provinces are beginning to open the way for private health care eventually to take root around the country.� [See full Times article.]
The Canadian Supreme Court’s decision was the outcome of a lonely and courageous struggle conducted at great personal cost in time and money by a Canadian physician, Dr. Jacques Chaoulli. Dr. Chaoulli went to court with the case of a chemical salesman who had been forced to wait a year for a hip replacement and who at the same time was prohibited from paying for private surgery. As described in an earlier Times article, Dr. Chaoulli argued
that regulations that create long waiting times for surgery contradict the constitutional guarantees for individuals of “life, liberty and the security of the person,’' and that the prohibition against private medical insurance and care is for sick patients an “infringement of the protection against cruel and unusual treatment.''
To most Americans it may come as something of a shock simply to learn that all is not well with health care in Canada. That’s because Canada’s system has continuously been held up as the model for the United States to follow. Sometimes it seems that every ignoramus with a graduate-school diploma is ready to pontificate on how wonderful medical care is north of the border and that to solve our problems with medical care, all we need do is adopt that wonderful, single-payer Canadian system.
I could stop here, with the satisfaction of conveying knowledge that the system of socialized medical care in Canada is in fact so unwell that the door to its replacement with private medical care has been opened. But there is a deeper point I want to make, which will help to establish why socialized medicine is a profoundly evil and immoral system, that should never be implemented anywhere.
And this is the fact that the prohibition of private medical care that has existed in Canada is not some inexplicable accident but, on the contrary, follows logically from the very nature of socialized medicine. The connection is this:
Socialized medicine is advocated as the means of making medical care free or almost free, thereby enabling even the very poorest people to afford all of it that they need. Unfortunately, when medical care is made free, the quantity of it that people attempt to consume becomes virtually limitless. Office visits, diagnostic tests, procedures, hospitalizations, and surgeries all balloon. If nothing further were done, the cost would destroy the government’s budget. Something further is done, and that is that cost controls are imposed. The government simply draws the line on how much it is willing to spend. But so long as nothing limits the office visits, requests for diagnostic tests, etc., etc., waiting lines and waiting lists grow longer and longer.
Then the government seeks to limit the number of office visits, tests, procedures, etc., etc., by more narrowly limiting the circumstances in which they can occur. For example, a given diagnostic test may be allowed only when a precise set of symptoms is present and not otherwise. A hospitalization or surgery may be denied if the patient is over a certain age.
As part of the process of cost control, the government controls and sometimes reduces the compensation it allows to physicians and surgeons. For example, in the present fiscal year, in the United States, the fees paid to physicians by Medicare are scheduled to fall by four percent. (The New York Times, Feb. 4, 2006.)
Now all one need do to understand why socialized medicine leads to the prohibition of private medicine is simply to hold in mind the combination of deteriorating medical treatment and controlled physician incomes under socialized medicine and ask what would happen if an escape from this nightmare exists in the form of private medicine. Obviously, physicians who want to earn a higher income and to have the freedom to treat their patients in accordance with their own medical judgment will flee the socialized system for the private system and leave basically only the dregs of medicine for what will remain of the socialized system. That is what the government’s prohibition of private medical care is designed to prevent.
This was confirmed in arguments before the Canadian Supreme Court. The Times article on the subject reported that
Various medical experts, government representatives and union leaders argued in court that privatization of insurance and services would bring an exodus of medical talent from public to private practices, and make waiting times even longer.
And there you have it. Socialized medicine destroys the quality of medical care and dare not allow the competition of private medical care. To prevent that competition, it must prohibit private medical care and establish a legal monopoly on medical care.
[This article is copyright © 2006, by George Reisman. Permission is hereby granted to reproduce and distribute it electronically and in print, other than as part of a book and provided that mention of the author’s web site www.capitalism.net is included. (Email notification is requested.) All other rights reserved.]
Comments (43)
I happen to agree completely with this article, and I have never advocated "making medical care free or almost free" to everyone.
What I have advocated is that health "insurance" should be made available to everyone on equal terms. It is unfair to exclude those with pre-existing conditions from being able to purchase reasonably priced medical insurance simply for the sake of the almighty dollar (profits). Plus I have advocated making the purchase of health care mandatory, much like auto insurance is mandatory in many states.
The problem we have in this country is that health care is free, not almost free, but totally free to many in this society, creating just the environment you describe, and we shift the cost, for that care, to those who purchase health insurance.
Nothing we do, in the form of HSAs, or shifting more costs on to the consumers, will fix the problems with health care in the US until we adopt a policy of universal enrollment, requiring everyone to purchase a minimum level of health insurance.
We need to stop looking at Canada or even the UK for a health care system to copy, there are many other countries around the world, e.g. Switzerland, Germany, Ireland, Japan etc. that have health care systems patterned very closely to that currently practiced in the US, with the sole exception that everyone is required to purchase a basic level of insurance. In all those countries, waiting times are non existent, outcomes are better then the US, and they do it at less than half the cost.
Published: February 20, 2006 9:53 PM
"It is unfair to exclude those with pre-existing conditions from being able to purchase reasonably priced medical insurance simply for the sake of the almighty dollar (profits)."
In this case my friend you no longer have insurance, but a transfer of payments. When you talked of resonably priced, i am assuming you mean below market price, and are advocating the forcing of insurance agenies to transfer payments of the other clients to cover these people. This is welfare plain and simple.
If you want every person to be covered by a minimal amount of insurance, then you are going to need to transfer payments once again to those who can't afford this minimum amount, which will again constitute a welfare system in which people do not have to pay for what they ask for. This will produce the same over-demand as in the socialist system.
Finally you risk wasting people's money by forcing them to purchase something they may not want, which makes people worse off. Under your system my grandmother, who wished to die naturally at home, would have been forced to pay for an insurance program she would never use.
Your solution solves no problem, but just better disguises the cost shifting, and your trashing of the "pursuit of the almightly dollar" seems to hint that you don't really appreciate the knowledge that only prices can give.
I usually don't post hear, but these type of people just get me in a bad mood.
Published: February 20, 2006 10:28 PM
I'd like to add to Ross Williams's excellent comments. Marc says:
Not being allowed to exclude people with pre-existing conditions is like being required to insure someone for fire damage after his house has burned down. Under such a rule, who is going to buy insurance before needing to submit a claim? Oh, that's why Marc says insurance must be mandatory. But then it's not insurance at all; it's a welfare program.
Marc's analogy with auto insurance is also specious. Laws requiring auto insurance are a result of the government owning the roads. (Private road owners might very well require insurance, but these would be mere policies -- conditions of use -- rather than laws.) Apart from the question of the feasibility of private roads, the analogy does not carry over to (what could be) a free market -- health care.
Note that you don't need auto insurance to drive on your own land, or other private land with the owner's consent. Even more obviously, you don't need auto insurance if you choose not to drive. These are proper analogies to health insurance.
Marc's statement that health care is totally free in this country is true enough, but that's caused by government intervention! This is not an argument for more socialism; it is an argument for less socialism.
Published: February 21, 2006 12:44 AM
Canada does have one fully private healthcare system ... with the result that the operation you wait years for your dog waits minutes for, and if your cat doesn't like dogs, he can convalesce in a cat-only hospital.
Published: February 21, 2006 4:56 AM
The Canadien government's arguement that allowing people to have private insurance will take money away from the government health system sounds a lot like the arguments used by the public schools in the US.
Published: February 21, 2006 8:10 AM
Interesting point, Chris. I was amazed by how a fairly complicated surgery procedure and other forms of care were available for my dog with no waiting period, and at a cost that couldn't be more than a fraction of what the Canadian government steals and spends per patient.
Published: February 21, 2006 9:35 AM
And in case you weren't aware of it, if you have a pre-existing condition, and lose your job, after COBRA runs out, in 14 states (I could be wrong on that exact number), you will not be able to purchase health insurance. In the other approximately 36 states, you are placed into a high risk pool where you are guaranteed insurance at a minimum of 170% above the going rate. This even though you have purchased insurance your entire life. Is that fair?
Well that is exactly the way the system works right now. Everyone who purchases insurance pays a tax, built into the insurance premium, to cover the cost of those who don't purchase insurance, yet need health care.My plan would sismply require everyone to purchase insurance spreading the risk more uniformly (which is why we have insurance), and likely lower the cost for those who purchase insurance, and reduce the welfare state.
The one aspect of health insurance that is different from all other types of insurance, is that everyone will need health insurance some time in their life. Like Larry said, it would be unfair to allow anyone to wait until they need health care before they purchase it.
Published: February 21, 2006 9:47 AM
Marc,
Why does anybody owe subsidized coverage to people with pre-existing conditions? Why is it not "fair" to treat them as insurers currently do?
Published: February 21, 2006 9:59 AM
Australia's health care system has evolved from something like Canada's or the UK's National Health Service to more of a safety net. The Government penalises those earning above a certain level for not purchasing health insurance which provides access to the private hospital system. Of course this is "insurance" in name only since it is one price for all regardless of risk (which is why it needed to be mandated - there was a serious selection problem with the young and the healthy not wanting to subsidise the old and sick).
Notwithstanding these positive differences, the public system is plagued with the classic socialist outcome of rationing by queue. Waiting lists are similar to those in Canada.
One thing I'm curious about. Given that 75% of Canadians live within 100 miles of the US border, why isn't there a flourishing business in setting up private hosiptals targeted at Canadian just inside the border?
Published: February 21, 2006 10:15 AM
"And in case you weren't aware of it, if you have a pre-existing condition, and lose your job, after COBRA runs out, in 14 states (I could be wrong on that exact number), you will not be able to purchase health insurance. In the other approximately 36 states, you are placed into a high risk pool where you are guaranteed insurance at a minimum of 170% above the going rate. This even though you have purchased insurance your entire life. Is that fair?"
I can't speak to the fairness or lack thereof, but one could just as easily attribute this problem to the link we have in the U.S. between health coverage (I would hesitate to call it insurance) and employment. If one were responsible for insurance for himself (or his family), he would have an incentive to buy coverage that would persist even if health problems subsequently developed.
Published: February 21, 2006 10:50 AM
You mean why is not fair to deny coverage to someone once they get sick? Is that what you are really asking?
What is the point of purchasing insurance if, as soon as you need it, the insurance company says they're not going to cover you?
Published: February 21, 2006 11:01 AM
There appears to be some confusion as to the point I was trying to make in my first post, so I was hoping to clarify the statement concerning the denial of insurance to those with pre-existing conditions.
It is unfair to exclude those with pre-existing conditions from being able to continue to purchase health insurance, or purchasing it at the fair market value, assuming they have been purchasing insurance prior to becoming ill.
As I said to Lisa in my last post, what is the point of purchasing insurance, if as soon as you need it, the insurance company can deny you coverage, simply because you become unemployed.
Published: February 21, 2006 11:26 AM
Marc,
Thanks for clearing that up. I think you are correct; an insurance company should not be able to drop someone just because they have become sick. But this is should be covered in the contract. If an insurance company breaks its contract, then the subscriber should be able to take the company to court. If somehow the insurance companies are getting away with this form of fraud, then the solution is to enforce contracts, not make insurance mandatory.
You mentioned that people lose their coverage when they change jobs, but that itself is a result of government interference with the market. Government tax policy has encouraged workers to tether themselves to their employers for provision of health insurance (as D. Saul Weiner pointed out above). The solution again is to get the government out of the market.
Published: February 21, 2006 12:55 PM
For the most part the whole of idea of health insurance is bogus. The whole point of insurance is that you don't want to use it. You don't buy home owner's insurance because you hope your house will burn down, etc.
The reliance on third party payors is one of the main problems with the health care. Why not just pay for services? If you break your arm why not just pay someone to fix it? I know that currently it is probably thousands of dollars to repair a broken arm in the hospital. But why is that? The VAST amount of state interfernce in the health care market is what drives prices to exorbitant levels.
The idea of mandatory health coverage in order to spread the risk equally is the definition of a collective healh care system. Whether you make a payment to some company or pay a tax to the state it is exactly the same thing. The problem is that it is impossible to spread risks equally. Risks are occured by individuals and can only be pooled into effective insurance for certain types of risks that lend themselves to an actuarial analysis. Just because everyone would pay the same does NOT mean everyone's risk is the same. This only amounts to forcing the less risky to subsidize the behavior of higher risk individuals.
Eventually the less risky individuals come to realize this, which in turn then leads to calls for the state to regulate/forbid more and more modes of behavior. And on and on it goes.
P.S. Excellent lecture on the economics of risk and insurance (Hoppe) here
By weakening or completely destroying the will to be well and able to work, social insurance creates illness and inability to work; it produces the habit of complaining... it is an institution which tends to encourage disease, not to say accidents, and to intensify considerably the physical and psychic results of accidents and illnesses. As a social institution it makes a people sick bodily and mentally or at least helps to multiply, lengthen, and intensify disease. -LvM
Published: February 21, 2006 12:57 PM
Marc,
You seem to be conflating two different points. If I have a contract with an insurance company to cover me if I become sick, and they drop me becuase I then become sick, then they would presumably be in breach of contract. But if after I become sick, I wish to purchase new insurance from someone else, there is no reason they should be forced to accept me just because I have been covered in the past. I see no issue of fairness here that demands insurers be made to accept people with pre-existing conditions for new policies.
Published: February 21, 2006 2:10 PM
I don't really believe that social insurance encourages people to act in an unhealthy manner, just as I don't believe that mandating the wearing of seat belts, encourages drivers to drive recklessly.
IMO, risky or healthy behavior has more to do with upbringing and maybe even DNA. Social insurance has little, if any, effect on ones behavior.
And Brian your right, there is no perfect way to spread risk, but it certainly can be done in a fairer and more efficient manner than it is now.
Mandating the purchase of insurance, and pricing it based on age and on community ratings, would be one way. Basing it on whether you are employed, and how big a company you work for is not.
I still maintain that the major increases in the cost of health care is a result of the cost shifting necessary to cover the care of the uninsured, which is mandated by the government.
Just research the health care system in Switzerland. You'll find a health care system that is essentially 100% market based, with virtually no government involvement, except for the governmet has mandated that everyone will have health insurance.
There are no waiting times, health outcomes are better than the US, and they do it at half the cost.
Published: February 21, 2006 2:33 PM
For reference, here you may read about the Swiss system that Marc mentioned in his very first comment.
I certainly find the types of systems you advocate to be preferable to those advocated by most universal healthcare proponents, but I don't think they are likely alternatives for the United States. Indeed, the Swiss system you wrote of suffers from cost inflation and overutilization, problems that will almost certainly be addressed by further governmental cost controls and government enforced rationing.
Insurance against bankrupting events is a necessary thing for prudent people. A true libertarian may not propose government compulsion to get people to purchase it, but if we allowed let conseqences of not purchasing it fall on the nonprudent, perhaps we would have fewer such people. I guess as an impure libertarian, I would be willing to tolerate subsidies to those who could not afford such insurance, but I would require that state intervention not be used to save those who simply refuse to hedge risk.
Published: February 21, 2006 3:02 PM
Marc,
Why are you entitled to have someone else subsidize your health against their will? Why is your health not solely your responsibility?
Published: February 21, 2006 3:05 PM
Yancey,
I guess as an impure libertarian, I would be willing to tolerate subsidies to those who could not afford such insurance...
Then why don't you help subsidize them? Why do you have to resort to violence? Once you have admitted that one instance of a coerced subsidy is legitimate, you can longer argue against any other types without being completely arbitrary and/or contradicting yourself.
Published: February 21, 2006 3:09 PM
Brian,
I guess I look around me and think the world will never be what I might desire, state-free, with people fully responsible for themselves. What I see is the healthcare system about to undergo even more state control, and helpless to stop it, would want to direct it to the least harmful outcome. I freely admit that I may be a fool on a fool's errand.
Published: February 21, 2006 3:27 PM
However, Brian, you are correct, it makes other arguments against compulsion arbitrary.
Published: February 21, 2006 3:32 PM
Lisa, you are wrong. If I have health insurance through my employer, and get laid off or quit, after COBRA runs out, the insurance company is under no obligation to continue to insure me whether, I am healthy or not.
At least in some 36 states, you are placed in a high risk pool, where you can purchase insurance at costs typically exceeding 170% of the market rate. In the other 14 states, you're just s&^t out of luck.
And Brian I have never said anything about subsidizing my health care. In fact I believe I have said just the opposite. I want everyone to be required to purchase health insurance, so nobody will have to subsidize anyone.
And Yancy, as populations age, demand for health care increases, and without additional trained doctors and more hospitals to supply that demand, so will the cost.
That is the driving force behind health care inflation, not the over utilization of health care services by the insured. By the uninsured, maybe, likely, but not the insured.
As with any business, at some point in time, tough decisions have to be made concerning the cost benefit analysis of continued treatments. Rationing is one solution to that problem.
Published: February 21, 2006 3:53 PM
Marc,
I agree that aging of the population is one driver of the cost, but overutilization is certainly another, even in the Swiss system. The other major driver is the inceasing numbers of new procedures and treatments.
However, I would point out that all goods and services provided by other human beings are rationed already. Healthcare is already rationed, the only question is do people ration most of it for themselves and their families, or does government do the rationing for them. The thing I find most annoying about universal healthcare proponents is their belief that it offers some free lunch approach. And please note that I do not place you in that group.
Published: February 21, 2006 4:21 PM
I want everyone to be required to purchase health insurance, so nobody will have to subsidize anyone.
That makes no sense. If no one is subsidizing anyone then why must everyone be forced to purchase health coverage. If I never go to the doctor and am forced to pay for health "insurance" where does this money go? It pays for someone else to go does it not? But this isn't a coerced subsidy? If not what is?
Published: February 21, 2006 4:50 PM
I am unclear as to why you think I am wrong. As I understand it, when you are an employee of a company, the contract that provides your coverage is between the employer and the insurance company, not you and the company. Once you are no longer an employee, you are no longer part of the contract. COBRA merely forces the company to keep covering you. Where is the fairness problem if an insurer stops covering you because you are no longer an employee of the company whose employees they are contractually obligated to insure?
Published: February 21, 2006 5:38 PM
You're right Lisa, the contract is broken as soon as you leave the company. What if you're laid off because your employer can no longer afford to provide health insurance to everyone. Tough s&*t, right? You have to go without insurance and either spend your life saving getting care, or simply die! I call that the "culture of death" that you often hear is practiced in this country.
Yeah, that sure is fair. If you're not employed you can't buy health insurance at a reasonable (market) price.
Even if you weren't sick you wouldn't be able to buy insurance at the same price as you would if you were employed. You would be charged more.
Is it fair to make someone pay more for insurance simply because he isn't employed? Is it fair to pay a man a higher salary as a woman doing the same job?
Just how fair is a system, that says you have to be working in order to even obtain health insurance at any price (as is the case in many states), even when you have always had it?
Published: February 21, 2006 6:14 PM
The "unfairness" you cite is largely a product of government intervention, namely the government-created incentives that led to health insurance being tied to employment. In a market free of such intervention, I have no doubt insurance would look very different. But more intervention to correct the supposed unfairness of insurance being tied to employment is not the answer. I'm not really sure it's even unfair for someone to pay more for insurance because they're not employed. Insuring employees of a company may offer advantages for the insurance company that insuring individuals one at a time doesn't offer (As for the other question, if I'm willing to take less pay than you are for doing the same job, there's nothing unfair about it). Companies exist to make profits, and they offer insurance on the terms that best enable them to do that. It's not a public service. Charity health care should be provided by charities, not insurance companies.
Published: February 21, 2006 8:02 PM
The Australian government has quotas on the numbers of doctors who can graduate each year. Somehow, this was meant to alleviate the low numbers of doctors working in the rural areas. Supposedly, there is an overabundance of doctors in the cities. Yet, most clinics with multiple doctors in the city have long waiting times. You need to wait months to see any specialist.
In Queensland they have been using police cars to transfer patients between hospitals as there are not enough ambulances. This is even though they introduced a large tax on all electricity bills for the sole purpose of paying for ambulances. Also, unless you buy ambulance insurance, you have to pay for the ride.
Published: February 21, 2006 8:43 PM
Marc: If the goal of a business was simply to make a profit, all someone would have to do is put their money into Certificates of Deposit or bonds and collect the interest (profit) every month.
You can't make nearly as much profit that way as starting a successful company. Come on, that should be obvious. Look at the founders of Microsoft or Google. Don't you think they did better than they would have if they had invested in CD or bonds?
It is true that profit is a measure of how well that task is accomplished, but it is also a motivation. Otherwise why not have the government hand out medals or Certificates of Appreciation to successful entrepreneurs?
Published: February 21, 2006 10:06 PM
I have to wonder if Marc understands what insurance is.
If he believes that the current manner in which insurance companies do their business is unfair, then don't buy it!
Nobody has a right to 'insurance'. Insurance is merely a method to mitigate the risk of incurring huge medical debts in case of ill health. It is no different than other forms of insurance. Quite frankly, in a free market I doubt many people would even bother. Insurance is a lot more costly than simply saving your own money for a rainy day, and then you can insure against a lot of risks other than bad health.
The current system is a mess due to subsidized and regulated (or 'fair' in Marc's words) insurance, driving up costs and driving down supply! Insurance doesn't change the overall risk one iota. If anything, it just puts a lot of bean-counters on the dole. Unless insurance companies had some way of reducing risks (something effectively illegal in this country--again due to Marc's fairness), they're absolutely useless.
Published: February 21, 2006 10:07 PM
Lisa, I have to take back what I said in my last post. You might be willing to do the same job as a man for less money, but it wouldn't be fair. And while you might still take the job because you had no other alternatives, I'll bet you wouldn't be happy about it.
As for some of the other commments, they're not even worth responding.
Published: February 21, 2006 11:13 PM
I don't really believe that social insurance encourages people to act in an unhealthy manner, just as I don't believe that mandating the wearing of seat belts, encourages drivers to drive recklessly.
IMO, risky or healthy behavior has more to do with upbringing and maybe even DNA. Social insurance has little, if any, effect on ones behavior.
Balderdash. I have health coverage through my work, for which I pay 30 dollars a month plus 10 dollars per doctors visit. In the first year I had the plan I racked up 10,000 dollars in bills from jiu jitsu accidents and motorcycle crashes. Would I engage in dangerous martial arts and fast bikes if I had to pay every dollar when I got hurt? Heck no. If the government provided "free healthcare" dangerous activities would have to be restricted to reduce costs.
Published: February 21, 2006 11:43 PM
One thing I'm curious about. Given that 75% of Canadians live within 100 miles of the US border, why isn't there a flourishing business in setting up private hosiptals targeted at Canadian just inside the border?
In my experience Canadians do make the trip to the US for treatment, though I am unaware if there is an actual business to take care of travel arrangements for them.
My husband is a doctor and the Mayo Clinic has tired to recruit him, when we went there (this is true of the Cleveland Clinic as well) we met many Canadians and (though this isn't a result of socialized medicine) wealthy Arabs who were there on their own dime.
Published: February 22, 2006 8:41 AM
IMO, risky or healthy behavior has more to do with upbringing and maybe even DNA. Social insurance has little, if any, effect on ones behavior.
This is wrong. Your blanket assertion that the existence of a government subsidy does not alter the behavior of those who receive the subsidy is patently absurd. The fact that you simply assume this to be true may arise from an attempt to rationalize one of your political opinions, not because you are interested in the truth.
As for your other comments, Marc, the crux of your misunderstanding concerns what you keep calling a "fair" price. There are no fair or unfair prices. There are only prices, which exist in a market that is either free or something less than free.
If the market is free, then prices are necessarily "fair." This is a tautology. They are fair by definition.
If the market is less than free, then the prices are distorted. If so, then the prices are a symptom of a problem, not the problem itself. The lack of freedom in the market is the true cause of these "unfair" prices. If you make the market more free, the prices will become more fair.
Health insurance is, at a very deep level, a distored market. It exists as a reaction to wage controls that the government instituted during WWII. A government anti-free-market rule is the cause of the lack of freedom in this market, and therefore the cause of distorted prices.
In a free market, if a price is irrationally high, then a more rational competitor will enter the market and offer the same product or service at a lower price.
If you are so very certain that the insurance industry is charging irrationally high prices for a large class of customers, then you have just found a pot of gold! Instead of using yet another form of governmental brute violence to FORCE the prices to drop, or FORCE companies to sell their products as you prefer, I highly recommend that you immediately get off the computer, go out and start an insurance company, and charge these customers the rational, lower price.
They will beat a path to your door! They will throw money at you! In doing so, you will be offering these people the very best coverage at the best possible price, and all of the irrational insurers who insist on charging their excessive, "unfair" prices will collapse and their employees will come to work for you.
I wish you well in this noble endeavor.
Published: February 22, 2006 9:17 AM
George, I think that well summarizes the critique of fairness.
Now if I could only get the Marcs of the world to get me a fair price on a new car.
Published: February 22, 2006 10:10 AM
You know, I don't need a lesson in economics, but I think most of you need a lesson in reality.
Health insurance companies aren't charging irrationally high prices, and neither are health care providers, and I never said they were.
What I said was that everyone who purchases health insurance or health care is paying a premium for their health care, because in addition to paying for their own care, they have to pay for the care of all those who obtain care, but refuse to pay for it, as mandated by the government.
As long as the government continues to condone the theft of health care, no amount of deregulation, elimination of subsidies or the imposition of so called "personal responsibility" plans is going to change the course of health care in this country.
Just consider what would happen if the government said that everyone is entitled to food, and restaurants and grocery stores have to give you food regardless of your ability to pay. And only those that have the means, i.e. assets that can be siezed to force payment, have to pay for it.
What do you think would happen to the price of food? How many grocery stores and restaurants would have to close before we recognize their is a problem?
That may sound a little far fetched, but like health care, food is something that everyone needs, the only difference with food is price increases can be some what mitigated by growing or raising your own food. But still there are limits to even that.
But just try giving yourself open heart surgery.
Published: February 23, 2006 9:13 AM
Marc,
Perhaps we are talking past one another. Everyone seems to agree the health care market is seriously and fundamentally distorted. What would you say should be done?
Published: February 23, 2006 11:29 AM
Marc,
Then why not get rid of the mandate for care when you have no ability to pay? You are advocating a position (coerced payments for healthcare) that is anathema to libertarians, and then you act surprised that they don't agree with you.
Published: February 23, 2006 12:12 PM
I think I did say in my previous post,
In other words, health care has to be made compulsory, or the government has to stop mandating that care be given to everyone regardless of their ability to pay.
We can all talk about how it is coersion by the government, to force people to buy insurance, but the government forces us to do lots of things that we may or may not want to do. Plus many people believe that morally denying coverage to anyone is wrong, so that policy will likely never change.
At the very least we need to make sure everyone pays a share of the cost for health care by what ever means, i.e. sales taxes, payroll taxes whatever, coupled with co-pay and other means to insure personally responsibility.
Published: February 23, 2006 12:20 PM
Yancy, I think I answered your question in my last post, but I'll answer it again.
I would love to eliminate the mandate to provide care for those who don't have the ability to pay, but I am a realist also, and recognize the fact, that policy will never change.
Therefore I am advocating the only other possible solution.
Published: February 23, 2006 12:25 PM
"Plus many people believe that morally denying coverage to anyone is wrong, so that policy will likely never change."
What the hell does "many" mean? If anyone objects to it then MORALLY one should not have to pay for servicing others. What about those that can't afford it precisely because money has been stolen from them to provide for the 'more needy'?
Published: February 23, 2006 1:08 PM
Fine! They can object all they want, but that policy isn't going to change.
If you have health insurance, and/or receive or have received health care, plus have assets that can be siezed for non payment, then you are paying for the care of others whether you like it or not.
Then they go on medicade, and get to steal from everyone else.
That is why the best and easiest solution is to mandate the purchase of health insurance by everyone. That is the only way to stop the theft of your health care dollars, because, like I said before, and no matter how much you object,
"the policy of mandating health care be provided to everyone is not going to change".
Why do you think every other industrialized country in the world mandates universal health care coverage and that everyone pay for it?
Published: February 23, 2006 1:55 PM
"Fine! They can object all they want, but that policy isn't going to change."
That's like the Soviets figuring out how desocialized farming would work. It's all about having the right ideas.
"If you have health insurance, and/or receive or have received health care, plus have assets that can be siezed for non payment, then you are paying for the care of others whether you like it or not."
You are not one for seeing the bigger picture. I entered voluntarily into a contract. That is the difference. The point of insurance is to pool risk together in a price minimizing way. That is why you will not find office workers and football players insured against injury in one pool. Universal health care is essentially the opposite - a program were you put everyone in as big a pool as possible. It creates a systematic transfer program from the healthy to the sick. It also creates a situation where people will become more reckless in their behavior, because they can externalize the cost of this behavior onto the rest of the society. Real insurance is non-systematic, it can not be easily figured out who the beneficiaries will be ahead of time. The free market price mechanism helps people reduce risk, the socialized mechanism creates it.
"Then they go on medicade, and get to steal from everyone else."
Perhaps you are not familiar with the concept of lower-middle class. You see this class still gets robbed, but it still does not qualify to get medicaid. This is actually a small group of something like 80+ million people in the US. That is not to mention the moral dilemma associated with such an exercise.
"That is why the best and easiest solution is to mandate the purchase of health insurance by everyone. That is the only way to stop the theft of your health care dollars, because, like I said before, and no matter how much you object,"
Dude, stop pretending that there is such a thing as a free lunch. The more you subsidize it the more expensive it will become. Universal medicine is the MOST expensive LACK of medicine you can get.
"Why do you think every other industrialized country in the world mandates universal health care coverage and that everyone pay for it?"
Stupidity and 'Capture' (i.e. doctors love it when others can pay high prices for their patients, it reduces the need for them to charge lower prices to attract poorer people). BTW, making appeals to authority won't get you very far on this forum.
Published: February 23, 2006 7:29 PM