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.

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.

 

 

Why Does Health Care Cost So Much in the US?

One of the complaints people have about health care in the US is the price. It seems even the most trivial thing costs a ton of money.

It’s really easy to blame the free market economy for the costs. However, it’s grossly inaccurate. 50 years ago when medical care was free of government control, people didn’t need insurance because they could easily pay for any treatment they needed. Nowadays, government regulates every aspect of health care. It is hardly a free market. The high prices, in fact, are because health care is not a free market and will not be until Obamacare and a number of other regulations are eliminated.

Let us consider the costs of health care.

First, let’s start with the cost of materials. In order to deliver health care, we need trained personnel. What does it cost to train someone to work in the health care industry? Ask your doctor or nurse how much they spent to get educated. Why does it cost so much money? It’s rather easy: the government is artificially inflating the price of education because they pay for the education of a large number of people. Because people do not pay their own way through school, they are buying something they didn’t pay for. You might say that they are paying because they are taking out loans. This is true, somewhat. The education loan industry is heavily subsidized by the federal government, and heavily regulated. This means that people who take out student loans aren’t even bearing the true cost of their loan even if they do pay it all back.

What about medicine: drugs, machines, procedures, that kind of stuff? These cost billions of dollars to develop. The health care you receive in the US is the most advanced in the world. When you hear about a medical discovery, you automatically assume it is from the US because that is largely true. This is not cheap. However, why are we spending billions and billions on medical research and development if our system is overpriced to begin with? Quite simply, it’s because of two reasons.

One, there is a giant hurdle called the FDA that all medical treatments must overcome before experimentation can even begin in humans. Even treatments for people in life-threatening conditions must wait until the FDA feels good and ready to give a thumbs up to experimentation, regardless of what the researchers or patients have to say on the matter.

Two, medical researchers know that they are not dealing with private individuals but the federal government, particularly with elderly care. That is, they have deep pockets they can exploit.

Let me help you understand. There’s a number of really, really good ideas in my industry that nobody pursues because there is no market for it, or at least, no market that could recoup the costs of research and development. Because of this, investors don’t throw their money into it, and people leave it alone. If the market ever changes to the point where it does make financial sense to pursue the research, then it has to compete with every other really good idea out there. In the end, only the best ideas are financed, and only because they make the most sense financially.

In the medical industry, if you develop a treatment that will get covered by Medicare or Medicaid, you can tap a “market” that is the American taxpayer. No old person is going to balance the cost of treatment with their needs. No price is too high. Also, you have a really high threshold to cross with the FDA certification. These two burdens completely distort the market. If you want to do medical research, it not only has to be financially viable, but it has to also include the cost for arbitrary FDA certification and it has to be more profitable than the medical research for treatments to Medicare/Medicaid patients would be. Any research that does get done is going to be extremely expensive, because cheap treatments are simply not even considered.

Add in to this the cost of doing business in America. You need facilities and other staff beyond the medical experts. With taxes high and our economy otherwise unfree of government control, the cost of simply building a hospital is enormous, way beyond what it would cost if government would let us be. In addition, there are boards across the country that artificially limit the construction of health care facilities to artificially keep prices high. This is no different than the hair salons which control the hair industry by requiring licenses and so drive up the cost of cutting hair and artificially limit the number of hair cutters competing in the market.

Now, let’s talk about the insurance companies. Why do we even have them? A long time ago, businesses had to find a way to reward good employees to keep them from leaving. Because FDR’s socialist policies forbade anyone from giving their workers raises, they had to reward them with goods and services rather than cash. Health care was one of those things. Before this, health insurance didn’t even really exist. Everyone paid out of pocket.

Insurance companies really weren’t that bad, at least not until the government decide to control the costs of their insurance programs (Medicare/Medicaid) by strictly regulating treatments. The insurance companies conformed to the government standards, and now everyone is royally screwed. Our medical treatments are not determined by our doctors, but by boards and bureaucrats we will never even know the name of.

If the insurance industry were free, then people wouldn’t participate unless it was in their own self-interest. As it is, states across the union have made it all but impossible to buy private insurance, and have made it all but impossible to have individuals negotiate health care treatment and costs with their doctors. Thanks to government interference, good luck having a truly free market interaction in anything remotely related to health care, even if you pay out of pocket with real money.

One thing that insurance does is it divorces the cost from the treatment. People go to the doctor and expect to get treated, and care nothing about how much it costs. No one ever asks if the treatment is worth it financially. Instead, the insurance companies are left to pick up the tab, and so they end up cutting corners elsewhere or raising premiums or limiting treatments, etc…

It doesn’t help that we have a jackpot system in medical malpractice suits. Rather than try doctors by a jury of their peers, they are tried by ignoramuses who know nothing about medicine and are taught to hate the doctors because they are rich. Is it any wonder that we have lawyers getting rich off of people’s ignorance, and doctors paying a good portion of their paycheck just to keep their practice running?

Our US health care system is broken. There is no doubt about it. The proscription is not to keep doing what we have been doing. Things are getting worse as we do that, not better. We are losing our health care freedoms, not getting free health care in exchange.

A simply, robust plan to fix the health care industry overnight would look something like this:

1. Eliminate the FDA, allowing people to treat themselves with whatever treatments they feel is appropriate. (If individual states feel like they need an FDA, let them do it on their own. Doing it at the federal level makes no sense whatsoever.)
2. Eliminate Medicare and Medicaid. (As a consolation, perhaps write a check to refund people for their investment, or provide vouchers.)
3. Eliminate all tax laws regarding medicine. That is, no tax breaks or special taxes on medicine.
4. Allow insurance companies to put together their own plans, free from government force and coercion. One way to do this is to force states to accept out-of-state and international insurers, without being subject to state laws.
5. Reform the tort system, restoring “trial by jury of peers” to its original meaning. Eliminate damages for practicing medicine in good faith and with the consent of the patient.

These 5 reforms would dramatically change the medical industry into a free-market system. Costs would plummet overnight. There would be a lot of crying and gnashing of the teeth by those people who we have been paying money to treat their sickness. However, I believe the philanthropic nature of the American people would find a solution faster than republicans can choose their presidential nominee. With treatments plummeting in cost, it won’t be hard for the same dollars to insure many, many more people.

Medicare and Money

Many people do not understand what money is or why it is even at the forefront of thought in all economic decisions, even when it comes to whether or not your grandma should get cancer treatment.

Let me help you understand.

First, money is valuable because it is valuable. People are willing to trade their time for it, and because people are willing to trade their time for it, you can buy people’s time with it.

All economic goods, from food to medicine, is all the product of someone’s time combined with their ability and the tools and resources they have available to them. The ability is largely dependent on an individual’s natural talent, but much more so on how they have spent their time to refine that talent. The resources they have available to them are available because someone took their time and ability and applied it to get them there.

All of these factors depend, ultimately, on time.

Since humans live about 70 years and then they die, we all have limited time. If we were ageless or immortal, then we probably wouldn’t care about how long things take to do. If it took 1 second or  1 year or a billion years, it would be the same to us. But we are mortal. Each of us will, eventually, die, and so our time is inherently precious to us.

Money represents our time. It is, in essence, a small part of our life. If you treat money as if it were a fraction of your life, or someone else’s life, then you will start to treat it reverently and carefully. You will find you are much more frugal, choosing more often to do without rather than spend someone’s time to meet your needs.

Now, consider grandma’s cancer. Grandma has cancer. She will, eventually, die, either from the cancer or from something else. She has limited time left. She has spent a great deal of time already doing whatever it was she chose to do with her life. Her bank account may reflect the amount of time she used up for her purposes versus the amount of time she used on behalf of others. She has also accumulated other resources, like her children and her grandchildren, maybe her property, and such. These all represent the investments she made with her time.

The decision was made some time ago to invest people’s time into researching cancer treatment and diagnosis. Doctors, nurses, and hospital staff were trained to run hospitals, built with the time and expertise of countless millions of people, both those who put it together and those who brought resources to the building site as well as those who created those resources. We cannot discount the efforts of the architect and board who made countless thousands of decisions after spending time to deliberate about the best way to build this particular hospital. Land was set aside, land that could’ve been used for growing food or building a grocery store or an office building, or even a road that could’ve saved 2 minutes on everyone’s commute every day of the week.

As your grandma enters that hospital, and as the doctor takes time out of his schedule to see your grandma as opposed to anyone else, then as the doctor makes decisions, in consultation with your grandma, further taking up open spots both in terms of who will get what medicine and who will get what time in which facilities, people’s time is consumed.

This is represented with the hospital bill. All those times are represented with a simple dollar value.

If the treatment is more expensive than what people are willing to pay for it, then the doctor has no choice but to refuse to see your grandma. Why? Because there are other people who are more willing to bid for his time and the hospital’s resources.

This is capitalism 101: You cannot force people to do things. They must voluntarily trade their time and money, or there is no deal. If one side says, “I will only do X if you give me Y”, then you can’t get X without paying them Y. Of course, you can negotiate and haggle, but in the end there must be mutual consent to the terms.

(Note that I am not talking about crony capitalism. I am talking about the same capitalism that the guy who sells hot dogs from his cart practices every day. Crony capitalism is not capitalism at all, but socialism disguised, because it relies on government force to work.)

Let’s reword all of the above in terms of money rather than time.

Grandma has cancer. The doctor says, “I will diagnose and treat you, but it will cost several hundred thousand dollars.” If Grandma doesn’t have several hundred thousand dollars, she cannot get treated.

Medicare has distorted the medical field. It does this in a number of ways, but the simple fact that it covers the cost of Grandma’s cancer treatment means that the cost is never considered, either by grandma or the doctor. This means that the doctor, the medicine companies, the hospitals and staff are free to charge almost as much as they want. If they are unhappy with how much money they make, they petition the government to give them even more money,.

This is unhealthy, obviously. Grandma should be in complete control of her health care. She should only be allowed to spend the resources that are given to her. If you wish Grandma could receive more treatment than she can afford, then feel free to send here a few dollars. At the end of the days, Grandma will have to make a decision: Is it best for me to spend the money I have on the best treatment I can get? Should I settle for a cheaper treatment and save my money for the future (or save it for my children?) Or should I forego treatment altogether, enjoy as many of my final moments knowing that there will be more money for others in the future?

Obamacare was proposed because the socialists know that you need some sort of cost control measure. They want to enforce lower prices by refusing treatment altogether for Medicare recipients. That will work, to a degree. However, it won’t be a proper solution because it doesn’t discourage people from charging as much money as they can. Instead, they just have to campaign really hard to get their treatments approved. This is already happening as we see, because certain drugs that are denied to people are already part of the political debate. Such a thing never happened before.

Capitalism says that you allow the individuals to decide for themselves, based on what they have available to them. This sounds harsh, but it means that people who want to have good treatment in their final years will save their own money, doing their best to maximize their wealth in their final years.

It also means, and this is the key component, that they will seek the best treatment they can get at the cheapest price possible. This will drive doctors, hospitals, and drug companies to invest in providing the best care possible cheaply. You will see, under such a scenario, advertisements encouraging people to use particular hospitals or particular treatments, not because they are necessarily superior to all the others, but because they keep their costs deliberately low while providing better service.

If we can put these economic forces to work, we can dramatically decrease the cost of health care. I wouldn’t be surprised if cancer treatment became as cheap as pineapples and bananas are in the supermarkets. Of course, we today think of these things as cheap commodities, but at one point they were the most expensive produce in the world, worth more than their weight in gold.

Imagine if cancer treatment for grandma cost only $10, without a single penny in subsidies from government. It is possible, and it will happen, because everywhere capitalism is introduced, prices fall, supply increases, quality increases, and demand is met.

 

Paul Ryan Explains his Budget Plan for Medicare

Hat tip Right Scoop

Romney’s Health Care Plan

Romney isn’t terribly inspiring, but as of right now, he’s the likely nominee for president. It behooves us, therefore, to examine his policies. To a lesser degree, we should examine the political impact of his positions.

Romney’s Health Care plan is neatly summarized in five bullet points:

1. Restore to the states the responsibility and resources to care for their poor, uninsured, and chronically ill.
2. Give a tax deduction to those who buy their own health insurance, just like those who buy it through their employers.
3. Streamline the federal regulation of healthcare.
4. Reduce the influence of lawsuits on medical practice and costs.
5. Make healthcare more like a consumer market and less like a government program.

If you held a gun to my head, and demanded that I write out the best thought out plan for the federal government health care, something that could actually pass both houses of congress, assuming that the republicans control the house and only have marginal control over the senate, I would probably come up with the plan Romney did.

First, putting states in charge of issues outside of the Federal constitution is a great idea all around. The federal government should not be a national government. Let the states decide how to collect, allocate, and manage welfare dollars.

Second, the tax deduction for health care plans will open up the free market on a national level. When you can choose between the plans your employer offers, or some other plans, then the market immediately expands. Different insurance companies will come up with different plans to cater to different needs.

“Streamlining” the federal regulations is awfully vague. What I hope it means is that he will reduce the overall impact of federal regulations, keeping those bits which honestly improve the market environment, and eliminating those which are just red tape.

Finally, by turning health care into a consumer market rather than a government program, we put the free market to work for us. We allow innovation, ownership, and other key concepts to enter the health care market, and allow people to decide how they want to allocate their assets.

The biggest complaint against Romney (among republican primary voters and pundits) appears to be his support of “RomneyCare”, Massachusetts’ health care plan that was enacted while he was governor. It appears like the Obama Administration is attempting a “death hug”, embracing Romney as a fellow traveler to reduce his popularity among Obama’s opponents. His position on putting states in charge, and merely creating an open, free market at the national level is directly in line with his positions on health care as the governor of Massachusetts.

I think those who think Romney would try to bring a national health plan ala RomneyCare if he became president should reconsider their expectation. It is entirely reasonable to support the socialization of health care on the state level, but embrace an open market on the federal level. If you look at our nation’s history, socialization experiments were routinely attempted at the state level. It wasn’t until prohibition that people tried enforcing national standards outside of the parameters of the constitution. To bring someone like Romney in, who supports some degree of socialized medicine at the state level, only to explain that national socialization is against our interests, would help people understand the true strength of our federal system of government.

As for myself, I don’t believe the government should be involved in health care anywhere near the level it is today, not on the state, national, or even community level. I believe we should allow people to freely contribute what they like to charitable institutions, including hospitals and other medical establishments. I believe we would have a surplus of medical care for the poor and sick if we did.

Another False Dilemma and Medicare

A more complicated scenario that is still a False Dichotomy is that if we privatize elderly care in the US, then the elderly will not be able to afford it, and so they will prematurely die. If we simply keep Medicare, then they will get the care they need near the end of their lives.

This sentiment shows a much higher level of thought than the simple, “If government does not provide health care, then they will not have it” false dichotomy. However, it boils down to the same problems.

I’ll list the factors that will go into determining whether the elderly can afford health care if we get rid of Medicare. Here are the most obvious ones:

1. Medicare pays the bills, and since it has deep pockets, the cost of elder care skyrockets.
2. Medicare regulates the industry, preventing doctors from choosing the best course of action and forcing them to prescribe unnecessary medicines and treatments.
3. The elderly may receive care from charitable organizations, in addition to their children and grandchildren.
4. Those who are planning for their retirement will have to plan for the true cost of their medical care, rather than relying on government subsidies.

Now, let me iterate a few things that, in addition to the above, are critical.

First, the elderly receive treatment that is far and away better than the treatment available even last year. Why? Because there is a tremendous profit motive to invent and provide these things. These treatments otherwise would not exist. When you consider the moral dilemma, “Shall we provide this person a life-saving treatment?” the morality of the issue changes depending on whether the treatment is available. It is the profit motive that creates the treatments in the first place, and allows us to even consider the question. Without the profit motive, there is no moral question at all.

Second, while today we provide treatment for the elderly, no such treatment will be available in a few years. This is the hard, cold facts. there is no tax high enough, there is no source of wealth large enough, there is no class of doctors that we can enslave and force to provide health care to the elderly. We cannot print the money, for if we do we will not afford any more health care than we otherwise could. We cannot borrow the money, because that amount of wealth simply does not exist. In this matter, no scenario wherein the elderly of the future receives medical care provided by the Federal Government exists. Let me reiterate: There is no way the elderly of the future can receive medical care courtesy of the Federal Government. At some point, the entire scheme will collapse, and we will no longer have any means to provide medical care because there is no means whereby the Federal Government can persuade people to provide it.

We are already seeing the effects today. So-called “death panels” already exist, determining which elderly get which treatment. Doctors are refusing to work for Medicare, because Medicare does not provide enough payment to compensate them. And Medicare cannot afford any more care, nor can they raise taxes because there is not enough wealth in the United States to provide even a hope of balancing the Medicare fiscal problems.

At best, we can hope for a “soft landing”, a phasing out of Medicare over the next few years, and probably limited coverage for a small minority of the elderly. Maybe some smart accountants can juggle the budget around and provide more or less soft landing, but ultimately, Medicare cannot exist.

Those who do not accept this fact are delusional, or they know something I do not. When you have a liability worth hundreds of trillions, you are talking about money that can simply never be created, not for thousands of years.

Paul Ryan’s budget is addressing this fact. His budget is the first of many that will gradually phase out Medicare, or replace it with something at least marginally sustainable. But even Paul Ryan’s budget is a promise that cannot be kept. Eventually, costs will rise, revenues will fall, and we will be back to where we are today.

The best solution is the hardest solution, the solution the people will most likely never tolerate. That is the constitutional solution, which is that Medicare is eliminated immediately. If we took such a drastic step, not only would the economy improve, but for reasons I listed above, the cost of treating the elderly will fall dramatically. The money saved by regular, working people can be used to charitably donate to people’s grandparents, churches and communities to support the elderly in the later years. If such money cannot be raised, then the economic means to provide treatment to the elderly does not exist, and so we no longer have a moral issue of “Shall we provide this treatment to this person?” Instead, we only have the choice of not providing it because the means to provide it do not exist.

Yes, that means that people will die, but those are people that would die anyway under the same circumstances because the means to treat them do not exist, even if the knowledge does.

End Medicare Now

One of the biggest complaints the left is forming about the Ryan Budget, that just passed the house in a quick, decisive vote, is that it defunds Medicare.

They play off of an obvious logical fallacy. They pretend that either seniors have their health care funded by the Federal Government, or they will be left out in the streets to die. If you’re having a hard time seeing the logical fallacy here, I’ll name it for you: False Dilemma. The bottom line is that every senior citizen, and soon to retire senior citizen, has more options than dying or accepting Federal aid.

Those among the senior age can turn to their families, their churches, the many public charities, and even the local communities for help. If Medicare did not exist, they would still receive medical treatment.

In fact, the very existence of Medicare is what is driving up the cost of medical care in the first place. Because doctors and pharmaceutical companies know that they don’t have to ask the senior citizens for a dime, they can charge as much as they want for their services. In many cases, they are required to provide services that they know are not necessary. Eliminating the bureaucracy of Medicare would likely improve the service our senior citizens receive, but also reduce the price as there will now be a price pressure and a strong incentive to provide superior health care for a reduced price.

Secondly, the cut in Medicare accepts the reality that already exists. Medicare is already cut whether the Ryan Budget cuts it or not. The simple reason is because there will never be money to pay for it, and there is nothing we can do about it.

If the Federal Government passed a budget that completely eliminated the Medicare fund, and all attached regulations and regulatory bodies, and stopped collecting medicare taxes (and they are tax, not a deposit!), we as a country would be much better off than the position we are in. The fact of the matter is we are trying to live a lie. The longer we try to perpetuate the lie, the more damage will be done when we realize the truth. Yes, many people’s lives would be disrupted, and likely a lot of people may die. (Who knows whether they would have died under Medicare? Regardless, the Medicare cuts will receive the blame in popular media.) But the longer we lie to ourselves and to our senior citizens, the more damage will be done with Medicare finally collapses and no one gets any medical care.

Emotions over Reality

The “reality based community” is up in arms that Gov. Jan Brewer of Arizona is cutting some enrollees and benefits of the state-run Medicaid program in the interests of saving money. At stake is taxpayer money and people’s lives. One of the most popular comments on the left is that Gov. Brewer is implemented the very death panels that Gov. Palin warned us about, ignoring, of course, the fact that Gov. Palin said that when government is put in charge of distributing wealth, inevitable they will have to make decisions about who gets what, making the government the final arbiter in who lives and who dies. It doesnt matter who’s in charge, there will always be the problems of scarcity, and having government decide who gets what means government will be blamed when people die.

The idea that somehow someone somewhere is entitled to free medical care is laughable. Yet we live in a world where if we say, “If they can’t afford the medicine or procedure, maybe they shouldn’t have it” we’re treated as if we’re some kind of monster. Those wagging their fingers don’t even consider the costs of medical care, namely, the human sacrifice that goes into every treatment delivered, every dose of medicine, and every surgical procedure.

I’m sorry to inform the world, but the very fact of the matter is, if you can’t afford it, you can’t afford it, no matter how much you want it. There is no magical credit card in the skies where you can buy something that doesn’t exist, and government can’t make things exist by changing laws and regulations.

If we intend to deliver free medical care to anyone, it is going to come out of some sacrifice of someone else. Someone somewhere is going to end up paying for the medical treatment that the patient receives. The question should always be, “Who should decide who has to sacrifice what?”, never “Does so-and-so deserve X?” And the answer is always, “the person who has to make the sacrifice.” We can provide incentives to people to sacrifice. This is what every employer does every day of the week. And every student studies hard because there is a huge carrot at the end of the road. “If I can obtain this degree, and set myself up for a career in X, then I can retire and enjoy the good things in life without worrying about where my next meal comes from.”

If you approach this from the basic human rights perspective, then you have to violate two parts of a right. A right, first of all, is something that you have because you are human, not because someone gives it to you. And a right always demands some sort of duty on the part of others to recognize that right. If the duty amounts to slavery, as is the case with the so-called “right to free medical care”, then it is no right at all, any more than the white race had a right to enslave the black race. In advocating free medical care, you are advocating that an entire class of people, be it the taxpayers, the doctors, or the nurses, be enslaved to the will of everyone else. Even if everyone is just enslaved a little bit, it is still slavery and still wrong.

When it comes to medical care, the only rights we have are the rights to our property, and the rights to barter and exchange with anyone we want for any service we wish. Outside of this, we have no right to have that which we do not create or barter for.

Suggestions for Improving Health Care in America

President Obama said that if we have any suggestions on how to improve health care, he’d like to hear it.

My suggestions are simple.

1. Eliminate Medicare/Medicaid and all government spending on health care, including spending on any federal employee’s health care.

2. Eliminate all the programs and regulations that have to do with health care, including abolishing the FDA. This means no more free trips to the hospital thanks to federal laws. Let the states decide.

3. Make a federal law that allows people to buy health insurance from out-of-state companies, thus circumventing all the stupid regulations at the state level. (This is what the commerce clause was really about—allowing free trade between the states.)

4. Eliminate all taxes and tax breaks that have to do with health care and insurance.

The above 4 reforms would have the following effects:

1. People would have to find health care from private sources, without subsidies from the government. Real market forces (supply & demand) will ensure that health care goes only to those who really need it the most and have the means to compensate those who create it in the first place. The profit motive will drive prices down by providing better care for everyone. The more people who participate in the market, the more likely health care is to become a commodity like rice and wheat. At that point, doctors and hospitals will be compelled to provide the best health care possible for the lowest price possible.

2. If there are no social safety nets when it comes to health care, then people will have to rely on other people instead of elected politicians and bureaucrats for charity, the way Jesus commanded us to do it. I trust that the benevolent people of our country will provide better health care for the poor than what they receive today, especially if health care costs are driven as low as possible and when the average American keeps more of his paycheck for himself.

3. The cost of developing new medical procedures and drugs will be cut to a tiny fraction of what it is today. In place of the FDA, private organizations will evaluate medical treatments and drugs. Those who sell out will be exposed; those who maintain the highest integrity will become internationally recognized. In all things, individuals, patients and doctors, will be able to evaluate each case and decide whether or not experimental treatment is appropriate.

4. The government will shrink dramatically in size. Medicare consumes the largest part of our federal budget, and the federal regulations imposes harsh spending requirements on the states. Having this cost evaporate leaves surpluses at both the federal and state level, surpluses which will be used to pay off the debt and to lower tax revenues. This means the American people will have more economic freedoms than they do today, which translates to more civil freedoms because they can afford it.

The risk of eliminating the health care plan of an entire segment of our population is, of course, enormous, However, the cost of providing that health care, on top of the accompanying laws and regulations, is much, much greater. Either we embrace freedom or we embrace statism, which is no different in substance than socialism, communism, nazism, and all the other evil -isms from the history of the world.

I choose freedom.