After at least 47 years and $13 trillion in public funding, isn't it time to look in a different direction? by Chuck Angier
(libertarian)
Friday, June 19, 2009
I understand that the federal government wishes to "fix" health care, just like it has "fixed" education, poverty and the economy, just to name a few.I hope instead that Congress and the administration will realize that more of the same is just nuts.
National Health Care Expenditures (NHE) for 2007 totaled $2.2 trillion, 16.23% of GDP, triple the 5.23% of GDP in 1960 and is growing at an average annual rate of 8.7%, more than double the average inflation rate of 4.2%. This represents $7,421 per person as compared to $148 in 1960. Prior to the late 1940's, health care costs were flat and insignificant at less than 4% of personal consumption expenditures. Since then it has quadrupled to 17.71% (2008) and has been our largest (and fastest growing) expenditure since 1992 surpassing even food. Many forecast that health care will consume 20% of our GDP in the near future. It is a primary cause of financial ruin. WHY?
I submit that the blame can be laid squarely on government intrusion. Here's how I got there. (For the sake of argument, we will ignore that pesky little issue of Constitutional authority.)
Since 1960:
Government has spent $13.3 trillion (including $9.3 trillion in Federal funds) on health care. To say that $13.3 trillion over 47 years can distort any market is a gross understatement.
Government share of the NHE has practically doubled from 24.7% to 46.2%, from $37 to $3,429 per person and has grown at an average annual rate of 10.3%, 2 times the inflation rate.
Federal share of the NHE has tripled from 10.4% to 33.7%, from $15 to $2.498 per person and has grown at an average annual rate of 11.8%, nearly 3 times the rate of inflation.
Obviously, $13.3 trillion in adulterated demand for health care is certainly cause enough for our dismal situation but there are other issues, policies and regulations that "pile on" including:
Health care is not a "right". A "right" does not require the skill or resources of another. I think some call it "Life, liberty and the pursuit of happiness". No one has a "right" to health care any more than they have a right to a jet-ski.
Insurance. For some reason no discourse on health care can begin or proceed without insurance as the primary issue. I beg to differ. Insurance has no place in health care. To include it in a discussion of socialized health care is laughable. Insurance is the transfer of risk of loss from one party to another in exchange for a premium and duty of care. The risk of loss is such that one would not inflict it upon themselves. (Insurance fraud). This is why we all purchase auto, home, renters or liability insurance (to name just a few) with little complaint. We purchase and the insurer sells those policies with bothhoping they will never be needed. Tell me again, why do we purchase health insurance?
Employer provided health care. Why is the employer responsible for the health care of the employee?
Why must anyone, against thier will, provide for those who CHOOSE to abuse themselves? Why must anyone, against thier will, provide for optional procedures? With demands like "Employers Paying For Sex Transition Procedures" then, what IS health care and who decides?
H.S.A.'s, Flexible Spending Accounts and other tax incentives only serve to further distort health care demand and reduce tax revenues (Oh My!). If HSA's are so great then why can't everybody have one? Why must they be attached to a high-deductible "insurance" policy? Could it be that the insurer has more to gain than the consumer? (See "Insurance" above). Salting money away that MUST be spent on health care, (especially those with "use it or lose it" terms) not only distorts demand for health care, but also distorts demand for investments.
Prior to the end of World War II health care costs were flat and insignificant at less than 4% of personal expenditures. I understand that during WWII, employers provided health care as a method to side-step wage controls. Since that time, government seems to have done everything it can to further corrupt the industry. After 47 years and $13 trillion, what have we gained? Are we living longer? Yes, but at what cost and quality of life? Are we healthier? If so, this great debate would not be happening. Is 47 years and $13 trillion not enough to justify a return to freedom and common sense?
The views expressed
in this article are those of Chuck Angier only and
do not represent the views of Nolan Chart, LLC or its affiliates.
Chuck Angier is solely responsible for the contents
of this article and is not an employee or otherwise affiliated
with Nolan Chart, LLC in his/her role as a columnist.
I HATE UNIONS!!! They create a state sponsor monopoly of the labor resources of a company or industry. What does me hating the UNIONS has to do with the current health care system? Because the whole A.M.A., regulations, licensing, etc... are all like professional UNIONS that give us the consumers less choices and screws us in the process giving us less freedom. The UNION of doctors controls the supply of doctors through licensing.
If you want to be a doctor, you need to be approved by the boards of other doctors. If you want to open a medical school, you need permission from the state and from the existing schools. etc... So in this over-regulated government-intrusive industry the ones who are already in, are the ones who make decide who is allowed to compete agaisnt them. In a true free market society, competition should not be restricted by the competitor with the aid of the state.
So that is your main issue.
Issue number 2: insurance. They sell you the policy in exchange of them taking the risk. But when they don't want to pay whatever the hell the doctor feels like, you are stuck with the bill. In other insurance cases, unless there is fraud, you are not stuck with a bill for whatever they chose. If your house burns down, as long as you didn't do it on purpose, the insurance pays for everything. So why is the medical insurance people are not held to the same level of accountability than the other insurance industries? You may do fraud and burn your house on purpose, thus commiting a crime...but you would never give yourself cancer on purpose to collect from insurance. So where is the fraud? Once they give you the policy it should be their liability to pay.
Issue number 3: medical billing. As you mentioned, HSA's are not the greatest thing, but it is the closest thing that you can have in which the patient has some accountability on the costs. My HSA keeps rolling over year after year pre-tax so what I don't use, I don't lose. However, since the high deductible is there, my insurance will start paying after I incurred about $5k out of my pre-tax HSA in medical expenses. Therefore it makes me more aware of the prices and as such I ask questions up-front. Unfortunately, since doctors are used to bill whatever the hell they feel like, when I ask their receptionists how much is a procedure or a visit I get a lot of "I don't know" or "What is your insurace?" Why should it matter. I am asking for a price to know whether or not I can afford it. I hate that attitude of giving you the service now and billing you later whatever they feel like. There is no other industry where the price is discussed after the proceduer and then you are liable for whatever the hell they want. Prices in stores are all over the place. Quotes for contractors or machanics are standard. ALL UPFRONT!! It is even illegal for some mechanics to do a job on your car without a quote or your approval first. Whay is it that with doctors is the other way around?
Issue number 4: More regulation against us the patients. Three months ago, I got a vasectomy. So now I want to know if my sperm count zero. I did not want to go to the doctor again or he will charge me another $200 just to say hi. So I went to a lab and asked for a sperm count. They asked me for a prescription!!!!!! WHAT? A prescription for that? That does not make any sense. I should not need a prescription to jack myself off and have somebody look at the microscope. Why should I pay another $200 so that the doctor can give me, a supposed free man, permission to jack me off and get my sperm count tested? The sperm count test was just $30. I am so pissed. I asked the lab: What if I want an STD test? or a PSA? Their reply was, we still need a doctor's prescription. They said that I could go to a clinic for that, but they will still have a doctor at the clinic to bill me for NOTHING!!!! All that state and government instrusion is really bad and makes us all NOT FREE!!!
HEalthcare industry is one of the most horrible ones.
A "right" does not require the skill or resources of another. I think some call it "Life, liberty and the pursuit of happiness". No one has a "right" to health care any more than they have a right to a jet-ski.
I couldn't agree more. Free market model of healthcare has already proven to be the most effective way to provide affordable healthcare. If you want an example, take a look at America in the 1950's. Dr. Paul explained that already in his book The Revolution: A Manifesto.
