What Our State Could Do

On the topic of health care, the federal government can only do so much. It’s job is to ensure there is free trade among the states, protect our borders and people from military threats, and engage in international diplomacy, hopefully opening up our borders for free trade and immigration.

We face several problems with health care that can be easily solved within our own state. The problems are roughly the following:

• Health care is really, really expensive.
• Health care is really, really hard to provide.

If we simply bring free market forces into play, I believe we can solve both problems, which are really the same.

First, we could protect doctors. By default, if a doctor botches medical care, and the patient dies, they should not be responsible. Medicine is a tricky and inexact science. It’s really more of an art. We really don’t understand the human body. Our bodies are programmed to die anyway. No doctor can preserve someone’s life forever. Eventually, all of us will die, and it will be due to some disease.

The only time a doctor should be held liable is when they failed to provide the level of service they promised. That is, they said they would do one thing, but they really did another.

We should also limit damages, just in case we do have a doctor that committed fraud. As a state, we should set a maximum lifetime reward. That is, cap the value of human life, and make it so that no person should pay more than that in compensation for disability or death. Even if we set this way above any sensible limit, let’s say, 10 million dollars (hardly anyone would ever make that much in their lifetimes), then insurance companies could limit the amount of coverage they provide for doctors, bringing the price of malpractice insurance down.

The next thing we need to do is remove all the barriers to the health care market.

Insurance companies. We should allow insurance companies to write whatever policies they like. Outside of a few basic restrictions, such as you can’t sell yourself into slavery, etc… any kind of contract should be allowed. Insurance companies should be held responsible for making sure people understand what their policy says, of course. If we find out they are misleading people, or if they are aware of gross misinterpretations but do nothing to educate, then we can bring them in for bad business practices.

Hospitals and health clinics. I don’t think we need to have government-run hospitals, nor do they need to be supported by the community. We also shouldn’t limit where people can build new hospitals. Treat it like any other business. Grocery stores have no problem providing groceries to people at a cheap price. Why not allow hospitals to compete in a similar way? If someone makes a profit from their hospital, because they run a tighter ship, then so be it. As long as anyone  can open a hospital next door to challenge their profit margin, I’m fine with it. I personally don’t think people will do much better than the church-run and charitable hospitals. However, if those are so terribly run that others can open a for-profit hospital and make money doing so, so be it.

This means, of course, that we’re going to have many, many more hospitals and health clinics than we do today. This means they will be even more accessible to the poor who have limited transportation. Also, I see different hospitals specializing in different types of care. We are already seeing that, but I foresee it on a much larger scale.

What do we do for those who can’t afford health care? The answer is not to allow anyone to be treated in emergency clinics by threat of law. Someone has to pay, and pretty soon, government has control of the emergency room through their pocketbooks.

The answer is simply to let the market figure it out on their own. Already doctors volunteer their time to help the needy, so why can’t hospitals do the same? Perhaps hospitals can choose to cooperate and pool their charitable resources so that those hospitals in poorer neighborhoods can have access to more funds.

Doctors and other health professionals. I believe we should eliminate all state boards and certification programs. These artificially limit the number of professionals available. Rather, let the professionals arrange their own affairs. If they want to form a trade union, so be it. If each hospital or network wants their own rules, so be it.

Why do I think this? Well, I believe that having a government-run certification program is prone to corruption, and in the end, makes things worse. People can hide behind their certificates, rather than having to convince their clientele that they are qualified.

Let me share an example. Let’s say there’s a branch of medicine, let’s call it, Foobarology. Foobarology is built on shaky science, but the people seem to like it. In the private certification market, Foobarologists will form their own review board and hand out their certificates, and try to demonstrate to people why Foobarology works. People who think Foobarology is a load of crap will be free to say things like, “Look at how Foobarology doesn’t work. These doctors with Foobarology certificates have treated these people with no effect at all.” The public’s opinion shifts, and all of a sudden, a lot of Foobarologists are scrambling to find customers. Eventually, they either switch specialties or find something else.

In the public certification system, the public Foobarology board will demand that a law be written to to incriminate anyone who suggests that Foobarology is not good medicine. At the same time, Foobarologists will tell their clients, “See? I have a government-issued certificate. Even the government thinks Foobarology is correct!”

Bottom line, if the medicine is good, you don’t need the government to tell you. If it is bad, then you don’t need the government to tell you. Let people stand on their own two feet rather than rely on government sanctions.

I’ve already spoken about malpractice. I think changing malpractice laws will do more than anything else to shift the health care industry in the right direction.

Helping the poor. Because I don’t believe mixing church and state together is a good idea, I don’t think having the government provide assistance to the poor is a wise idea. However, and this is a big “however”, it may make sense to do so in one case and one case only.

Certain individuals are left without parents or caretakers. They are wards of the state, incapable of living independently. These people, obviously, should be cared for by representatives of the state. It only makes sense that they be given enough money to support themselves, including health care, which is managed by their caretaker under the supervision of a judge. That is, unless the churches and charities in the state have enough resources to care for them without the state money, in which case, they just refuse the money and help the person out of the goodness of their heart.

Other people who are independent and yet incapable of supporting themselves, including health care, should not have access to state funds. Why? Because this is taking bread out of the mouths of the laborer to give it to those who did not work for it.

Having the state fund health care artificially drives the prices up. Normally, market forces keep supply and demand in sync, meeting at the ideal price that tells both how much the good is needed and how much of the good is available. If health care suppliers can see these prices and respond naturally, then the greatest effort will be spent on keeping costs low and addressing the most pressing needs in the community. When the state starts writing checks, they skew the market and people begin doing sub-optimal things.

What to do with the poor? The answer is nothing. The people can care for the poor themselves. If the people are prosperous, then they can take that surplus and turn around and make health care even cheaper and more available, and that will do more to help the poor than anything else. Or they can take their profits and buy health care for the poor, what they see is appropriate.

I am sure something like what the Church of Jesus Christ of Latter-day Saints does to help the poor will emerge. Yes, we’ll help you, but we won’t enslave you. We expect you to work your own way out of problems, so we will give you opportunities and training and self-esteem and coaching, so that one day, you can help others too.

It’s obvious that the direction the state is going is simply not working. We really need to try out some new ideas. I am sure there are other great ideas. Let me know about them in the comments.

How to Teach a Little Child How to Ride a Bike in 15 minutes

With five kids, I get to do things people who don’t have five kids don’t. For instance, I get to experiment with different ways to teach a kid how to ride a bike.

This method I am about to share is the easiest.

Remember that little kids do not speak or understand complicated things. Say things in the simplest way possible. Use simple statements. Say things like, “You will not fall. You will not hurt. You will have fun. You will go fast.” Speak slowly. Smile. Nod. Listen. Have fun. Kids grow up, so enjoy every moment you can.

Step 1: Get equipment that fits. The simple rule of thumb is that the kid should be able to easily reach the ground while sitting on the bike, knees slightly bent, heels on the ground. They should be able to have their legs out so that the peddles don’t hit their legs. Get a bike helmet that is comfortable and doesn’t cover their eyes. Don’t get knee pads, gloves, etc… They don’t need it.

Step 2: Take the training wheels off. They are dangerous. When a kid starts having fun on the bike, they will try to turn and the bike will fall over because of the wheels. They learn that fast is dangerous, which is simply backwards for a bike. Tell them that the training wheels will make them hurt. It will make them fall off the bike when they go fast.

Step 3. Have them sit on the bike, feet on the ground, hands on the handlebars. Tell them that the bike will not fall over if their feet are on the ground. Tell them that they must not take their feet off the ground. Show them by gently pushing the bike sideways. Their feet will keep it up.

Step 4. Tell them to “glide”. This means they walk the bike, build up some speed, then have their feet float over the ground. If they lose balance, they use their feet to keep from falling and to stay up straight. Do not hold the bike during this. Let them start with walking, then let them build up some speed. When they glide, cheer for them, tell them “Good job!” give them a high five. Tell them they are learning quickly, and doing well.

Step 5. When they get good at gliding, they will naturally put their feet on the pedals. Tell them they can push the pedals to go faster. If they begin to lose balance, they will stick their feet out to keep from falling. Pretty soon, they are riding their bike! When they pedal two or three times on their own, tell them they have learned to ride a bike! Cheer! High five! Give them a cookie!

The last skills they need to learn are how to stop. Show them how to pedal backwards or how to pull on the brakes. They will figure out how to stop with their feet rather quickly. After that, teach them the rules of the road. In our house, it’s basically: (1) Don’t zoom into intesections; stop, go slow, and then go on the straight parts. Cars cannot see you, and you will get hurt and maybe die if you zoom into intersections. (2) When you see a car, say “Car!” and move to the side of the road.

When they get older, show them the stop signs, tell them to stay off the sidewalk if they go fast, tell them to stay on the right side of the road, and teach them the hand signals.

Three of my five kids learned this way. The last two learned in 5 minutes flat.

The last one that learned (6 years old) was really upset when we took off the training wheels. He showed us how the bike falls if it doesn’t have training wheels, and he said, “I will get hurt! It will be bad!” We had to show him all the other kids riding their bikes, and show him that they do not have training wheels and they do not fall. It took him a while to understand, but when he did, he wanted to learn.

Tomorrow, I am going to try and teach the 5 year old. I think he understands that the training wheels do not help.

It helps if you have a very, very gentle slope on a street. This will help them build up some speed, but not so much they realize what is happening.

Finally, training wheels are like government assistance. It seems like a really, really good idea, until you learn you never needed them in the first place, and are better off without them.

Repeal and Replace

Conservatives get really worried when they hear the phrase “repeal and replace”. I don’t think it’s such a bad phrase, especially if I agree with what we intend to replace Obamacare with.

Here are some simple ideas that will dramatically reduce the cost of health care, while simultaneously increasing availability to everyone.

The goals are rather simple:

• Opening Up The Market. Bring buyers and sellers into a common marketplace, where prices will be forced down by natural market forces.
• Weening the people off of the government. Rather than have the government decide how to spend people’s money, let the people decide what is best for them.
• Ending unfunded entitlement programs that will bankrupt us. This is rather simple: offer cash or vouchers in exchange for people surrendering their entitlement.
• Empowering states to experiment with various ways of caring for the poor and sick in their own state, rather than a one-size-fits-all approach that helps no one.
• Driving the cost down to provide medical services.
• Ensuring the people who can afford health care do not “freeride” on other people’s money and resources.

These are some specific policy proposals that would help achieve those goals.

• Allow people to purchase health insurance across state or national lines. States cannot preclude health care packages from entering their states simply because someone lives there.
• Eliminate the tax benefit of employer-provided health insurance. Lower taxes to compensate. Now employees buy health insurance from the market, not their employer.
• Relax the regulations on foods and drugs. Maintain clear labeling standards, however, including requirements to clearly publish at the point of sale what the side effects are, and what studies should be done but have not yet been done.
• Issue lifetime vouchers to those who would receive Medicare benefits. Better yet, allow people to “cash out” of Medicare. Allow those who still want it to continue to participate, but make it in people’s interests to take the cash payout.
• Rather than regulate where medical dollars can be spent, or how much things cost, write a check to each state to be used as they see fit. If that’s providing health benefits to the poor and needy, so be it. Let each state figure out what they think is the best way to distribute those funds.
• Tort reform: make it more difficult to prove negligence (ie, requiring malice), and limit the amount of money paid out. Medicine is an inherently risky business, and we cannot ask doctors, hospitals, and medical manufacturers to shoulder the entire burden. It should be understood that despite the best efforts of the best doctors and best technology, you are still going to die one day. (Individual states will have to reform their own tort systems. The federal government cannot mandate this.)
• Hospital reform. No longer require hospitals to treat every patient who enters the hospital. No longer reimburse hospitals for so doing. If states want such a law, let them write it and pay for it with their own money.
• Lower taxes overall. By allowing people to keep more of their own money, they will have more to take care of themselves, their families, and their community’s health needs.

I don’t think the American people would disagree with all of these reforms. They would certainly agree to the goals, and I am very sure that these reforms would move us in the right direction.

 

 

Chief Justice Roberts, Round 2

If we give the most highly educated minds in our country months to debate issues, then I can hardly be expected to get the right answer after years. Allow me to change my opinion. I will probably change it again soon.

My current thought on the Roberts decision on Obamacare is that he should not have re-written the law. The law, if it is incorrect or unconstitutional, should simply be stricken. Tell congress what they did wrong, but don’t pull out a correction pen and publish your own version.

This means that Roberts was wrong to do what he did.

I think this is a good model for legislation. Either the law stands, or it doesn’t. If it doesn’t, the justices do not have power to pass their own laws to replace them. Let the people decide what path they want to take to resolve the laws and the constitution. It could be they like the law as is, and want to change the constitution through an amendment. Or, they like the constitution and want to change the law. Or perhaps, they want to get rid of the law altogether. That’s not up to the judge to decide.