What Our State Could Do

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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.

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