Editorial
Authoritarianism Is Bad for Your Health
The administration's terrible healthcare reform bill is now law, but the debate over how – and whether – the federal government should be involved in providing healthcare services is not over. It is not too late for America to correct its course and stop the march toward a government run, "single payer" healthcare system.
Polls show that a large majority of Americans don't want Obamacare. Congress should seize the opportunity to repeal the very worst aspect of this new legislation, namely the mandate that forces every American either to purchase health insurance or face an IRS penalty. This mandate represents nothing more than an unconstitutional, historically unprecedented gift to the insurance industry. I introduced the "End the Mandate Act" (HR 4995) expressly to prevent the administration from ever putting this provision into effect.
Instead of mandating the same failed entitlement healthcare schemes that are bankrupting Europe, Congress should fundamentally re-examine the case for free-market healthcare. Our current model, based on employer-provided health insurance, did not arise based on market preferences. On the contrary, it makes no sense to couple health insurance with employment. But federal wage and price controls instituted during World War II left employers with no alternative to attract workers in a tight labor market other than offering extra benefits such as health insurance and pensions. Over time these nonwage benefits became the norm, especially since employers could deduct the cost of health insurance premiums from their income taxes while individuals could not. The perverse consequence is that employees lose both their paychecks and their health insurance when they lose their job.
As reliance on third-party health insurance grew, patients became detached from the true costs of their doctor visits. In the 1970s the Nixon administration, along with the late Senator Edward Kennedy, championed the cause of health maintenance organizations (HMOs). Congress accepted the faulty premise that HMOs would reduce costs through centralized management of patients, when in fact the opposite was true: more bureaucracy would only lead to higher costs, less accountability, and worse patient care.
In recent years Congress has only intensified the problem with more laws and more regulations, especially with the disastrous Medicare prescription drug benefit. The drug benefit was another example of naked patronage to a politically-connected industry, and it exponentially worsened the federal government's balance sheet. Obamacare will be the last nail in the coffin of our bankrupt entitlement system.
More laws are not the answer. Instead, we need to allow a market system to operate that reflects consumer choices while rationally pricing services. In a market system patients likely would pay cash for basic services, while maintaining relatively high-deductible catastrophic insurance for serious illnesses and accidents. The cost of most routine medical care would drop if the patient paid the bill on the spot, especially if doctors no longer needed to employ large staffs solely to deal with insurance and billing.
Let me repeat: we need a system in America where patients pay cash for basic services, and carry insurance only for serious illnesses and accidents. "Health maintenance" is the responsibility of each of us individually. We cannot continue to collectivize the costs of healthcare and expect things to get better.
Authoritarianism is bad for your health. Congress should end the Obamacare mandate and allow market-based medicine to flourish.
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Posted by Lila Rajiva on 06/22/10 09:24 PM
@ DB
There is an organic, group effort " which is part of the spontaneous order..which operates through human emotions, of solidarity, pity, shame, honor, religious or ethical duty..
And there is legally mandated, coerced group effort, which operates through the law and police.
The trouble with the latter is not that it is inherently immoral, but that it is provably ineffective for most forms of group action.
We should reserve the word "collective" (with its Soviet connotation) for this latter.
So there is no irony is acting as a group to oppose collectivism.
Libertarian individualism is not opposed to the group. It's opposed to the collective as inimical to the individual AND the group.
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Posted by Leonardo Pisano on 06/16/10 03:03 PM
Posted by The Gimlet Eye on 06/16/10 02:45 PM
The rational affluent society has free markets, and only such a society can effectively help the needy. The great irony is, as Adam Smith so sagely pointed out, that a society in which men see to their own economic affairs and interests without all the coercion and interference from some nosy Big Brother, actually do far more good for their fellow men, even if their intentions are selfish.
It must be remembered that the intrepreneur does not act in isolation. He has a symbiotic relationship with his fellow men/ customers and performs an extremely valuable service for them, in spite of himself and his selfish motives. He must constantly find ways to please and cater to his fellow men. There is plenty of room for charity in that equation as well.
If the U.S. had the true free markets it ought to have, charity would grow to such levels as would make the present state of affairs in the "Welfare State" look positively miserly.
Posted by Noah on 06/16/10 11:20 AM
As expectations are moved from self-reliance to state-reliance, we see the natural progressive decay of the traditional family and community. (And progressives call that "progress"?)
The move from individualism to collectivism gives each individual the ability, even the incentive, to say "that's not my job, it's our job". And how easy it is to move from "our job" to "their job". Excessive taxation helps allow "we" to become "they", the state. But the first and only true job of the state is to maintain the "statist quo" " to feed itself.
Statist governments excessively write laws of phony morality just as they print reams of fiat currency. They debase morality in the same way they debase money. It is slowly sucked from people without their knowledge or consent.
How do we remove the bloated tic without worsening the infection that makes us ill? The irony is that we must all collectively act individually to fight collectivism!
Reply from The Daily Bell
The irony is that we must all collectively act individually to fight collectivism!
Yes, thanks ... Human Action
Posted by The Gimlet Eye on 06/16/10 02:11 AM
Posted by Duane Bass on 06/16/10 12:48 AM
Posted by Keith Goodenough on 06/15/10 10:11 AM
Meantime, hard-hearted people such as myself would be free to assist people we believed to be deserving of our charity.
In spite of the simplicity of this solution and the apparently vast number of warm-hearted people, I saw it proposed clearly in print only a few years ago on Lew Rockwell's Column, I believe by Mr Stefan Molyneux. However, for the Christians among us, I wish to point out that Jesus Christ Himself recommended charity, which, of course, cannot be anything but voluntary.
What is unacceptable to anyone but a slave, is that money for such assistance be extracted on pain of imprisonment, or, in the case of resistance, death. But perhaps warm-hearted people believe that is ok in a "civilized" society.
Reply from The Daily Bell
It is so very obvious that people in a free society would freely take care of the less fortunate. It is more than a moral imperative. it is a hard-wired instinct that is only short-circuited by authoritarian interference and the infliction of government services.
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Posted by Leonardo Pisano on 06/15/10 10:01 AM
But then, again, neither are government "services." [DB]
I am aware of such charity-based, free-society mechanisms. The subtle psychological difference from the patient viewpoint is that the charity is something they have not deserved and may bring shame/rejection to accept, and also patients may become victim of the same kind of dependence that we are all try to avoid.
The gov service is a "right", and a patient then doesn't have to fall on his knees. To be clear, I don't support this view. But like I said, it's not so easy to find a solution. Some government backed fund as a safety net for cases that don't fit in MAY BE considered (sorry to kick your heart, DB!), but it should be subject to control by the people.
Reply from The Daily Bell
Yes, private, free-market societies tend to be religious and shame-based. Government-controlled societies tend to be increasingly authoritarian.
Where would you rather live?
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Posted by Leonardo Pisano on 06/15/10 09:30 AM
1. Do you let them die/send them away if they knock on the hospital door uninsured?
2. What are you going to do with people that have an acquired illness (eg, diabetics) and need to get insurance AFTER (for instance, they were insured but lose their jobs and their insurance " as Dr Paul stipulates? They cannot get insurance because they ARE already ill.
3. What are you going to do with infants that have a genetically acquired disease, or otherwise show the illness the moment they are born? Insurance companies are likely not willing to accept such new client.
I don't have the answers, but my point is that some kind of safety net for such cases should be part of a civilized society.
Reply from The Daily Bell
We have written about this many times. It is government authoritarianism, high taxes and the debasement of currency that hardens the human heart. In fact, human beings are hard-wired to care for those in their own "clan." (ie: those around them that they have daily contact with).
Thus ...
1. In freer societies, religion usually takes the place of government services - and religiously affiliated individuals help care for the indigent.
2. In freer societies, the local community is involved with the indigent and the local doctors and care facilities.
3. In freer societies, charities are established that care privately for those who need help.
Is such a safety net historical and workable. Yes.
Is it a perfect panacea? No.
But then, again, neither are government "services."
Posted by Stewart Wilcox on 06/15/10 08:05 AM
In the UK where health care is free to everybody at point of provision and is paid for through National Insurance Contributions and Taxes, health care costs per head of population are just half of what they are in the States where 30-40 million have no health care coverage what so ever. I would suggest that the UK system is good value and doesn't neglect the health issues of those who can't afford treatment.
How would you legislate for the poor person who turns up at an E.R. with a life threatening situation? Let the Nursing Staff negotiate the number of chickens they require in order stop the bleeding? Or will you do the fudge we have now " make the Health Provider provide free care if they can't collect the costs from the patient? (Not very free market, as it forces a free health care provision on a third party.) So would this be part of your free market system? or would you really let hospitals turn away emergency cases?
Reply from The Daily Bell
"I would suggest that the UK system is good value and doesn't neglect the health issues of those who can't afford treatment. ..."
Are you sure? ...
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Woman gives birth on pavement 'after being refused ambulance'
By DAILY MAIL REPORTER
Last updated at 9:56 PM on 17th August 2009
A young mother gave birth on a pavement outside a hospital after she was told to make her own way there. Mother-of-three Carmen Blake called her midwife to ask for an ambulance when she went into labour unexpectedly with her fourth child.
But the 27-year-old claims she was refused an ambulance and told to walk the 100m from her house in Leicester to the city's nearby Royal Infirmary.
Her daughter Mariah was delivered on a pavement outside the hospital by a passer-by, just before ambulance crews arrived.
Today the Trust that runs the hospital said it would look into any complaint made about the advice and care the 27-year-old received.
Ms Blake said she started going into labour at about 7.15am on Sunday, August 2.
She said: "I phoned up the Royal Infirmary, it's just across the road, and they said to go into a hot bath, and then to make my way over there.
"I went into the bath and realised she was going to come quickly. I didn't think I'd be able to make it out of the bath, so I phoned the maternity ward back and told them to get an ambulance out.
'They said they were not sending an ambulance and told me I had had nine months to sort out a lift.'
Pavement: Baby Mariah was delivered on a pavement outside the hospital
Experienced mother Ms Blake today said she knew she had to get herself out of the bath and try to get to the hospital.
'The friends with me would have had no idea what to do. I knew at that point that she was nearly here so I had to get out of the house,' she said.
'I thought if I got across the road then at least somebody would be able to help me.
'I left the house and got to the end of the close, but there was no-one around to help.'
Eventually Ms Blake and her friends enlisted the help of a physiotherapist who happened to be passing on her way to work.
She dialled 999 and helped deliver baby Mariah while waiting for emergency services.
She even helped remove the cord from around the tot's neck, Ms Blake said today. ...
'It's just lucky that the physio was there.'
Read more: Click to view link
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Posted by Zenbillionaire on 06/15/10 02:49 AM
Exactly my thought and until recently, my practice. The barrier to this becoming the norm is the incomprehensible lock the medical profession has granted insurance companies in pricing medical services and prescription drugs.
A patient that walks into a doctor's office in the US these days will pay anywhere from 30 to 50% more for services if they have no insurance or choose not to use it, which really puts the cash customer at a disadvantage. One might be led to believe MD's have a piece of the insurance industry action? Otherwise it would make no sense at all.

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