...usually with an attempt at historical and economic context
Tuesday, July 28, 2009
Another Shot at Health Care “Reform” – Part 1 of 2
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” — C. S. Lewis 
I have written several items in opposition to the proposed Obamacare legislation. At the risk of repeating myself a little, here is another attempt to show that it is bad legislation and would be harmful to our health and economy, as well as being incompatible with our Constitution. I am writing partly in response to mattwion’s BloggersBase article claiming that health care does not fit a free market model, and his comments in response to my comments in which I generally ranted against President Obama’s desired “reforms.” Here I have provided some supporting documentation that I think ought to be considered.
1. The Proposed “Reform” Legislation Is Unconstitutional “The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.” – Tenth Amendment to the U.S. Constitution
There is no constitutional authority for the Federal government to run health insurance or health care in the manner proposed. States could constitutionally act, perhaps with some federal help under existing programs. Gov. Rick Perry (R-TX) has said Texas may assert its 10th Amendment rights to avoid participating in this plan if it is enacted.
2. The Free Market Has Been Working and Will Work. Ronald Reagan said that an economist is someone who has observed something that works in practice and tries to find out if it will work in theory. Apparently Kenneth Arrow tried this with health care in a free market environment and thought he showed that it won’t work in theory. Of course, care provided is a “loss” to the insurer. Any service in the economy is a cost, or “loss,” to the provider and the payer. So? If Paul Krugman’s idea held up, all providers of, or payers for any services would have to be considered untrustworthy and just out to grab a profit without providing a corresponding value in exchange. There are always bad apples, but this is certainly not the norm in insurance or elsewhere in our economy. The fact is that insurers are (as government would supposedly also be) careful about handing out large sums of money, but it doesn’t follow that they are always or very often trying to deny legitimate claims. Also, if people “don’t trust” HMO’s, why should they trust government? I understand Mr. Krugman is a respected Nobel prize winner, but I still disagree with him. Milton Friedman was another Nobel laureate and champion of the free market, with whom I very much agree.
As in any industry so regulated (as it is now), you will have something considerably less than perfect competition, but nevertheless, competition is present and functional, and people have meaningful health care and insurance choices.
3. Politicized Health Care Some diseases and conditions are politically correct and others are not. The favored sufferers will get preferential treatment. An example is given by the Heritage Foundation. In Belgium, multiple sclerosis sufferers had to resort to protest demonstrations, etc. to finally get access to an expensive new treatment, while around the same time, AIDS victims, better-connected politically, had only to request a very costly new drug to receive approval. 
4. There is ALWAYS rationed care. This is an economic fact that is true of all economic goods and services. The question is, do we want care rationed through a centralized government authority? Or rationed by the free market, which encourages individual choice, innovation, improvement and competition? A person does not have to be a medical expert to learn which features and qualities of insurance and health care are preferred by him/her. It is possible to find something acceptable and appropriate, and this usually happens. If dissatisfied, the person can go elsewhere. If the government rations care, there is no “market” and everything awaits a bureaucratic decision. England, Canada, and Spain experience severe rationing in their “universal” health care programs. There’s usually no “elsewhere” to go to without leaving one’s country.
According to an article in the New York Post by Betsy McCaughey, "[Rahm Emanuel’s brother, Dr. Ezekiel Emanuel] has been appointed to two key positions: health-policy advisor at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research.”
“[Dr. Emanuel] believes that ‘communitarianism’ should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those ‘who are irreversibly prevented from being or becoming participating citizens … An obvious example is not guaranteeing health services to patients with dementia.’” 
I find that more than a little disturbing. You may say that this type of thing won’t happen under Obamacare, but if not, it’s alarmingly close. Government-rationed care leads to enforced eugenics.
Also at the extreme, Heritage Foundation cited a Belgian magazine report of “economic euthanasia” in hospitals, where patients were killed by giving them higher levels of morphine or injecting them with pentothal when more beds were urgently needed. 
5. Health Insurance vs. Health Care We need to distinguish between health insurance and health care, but if government controls insurance, it will control health care, whether there is a “public option” or not. If there is a public option, it will, in a relatively short time, put health insurance companies out of business. “Public” insurance does not have to post a profit. Others do. Forget about a “level playing field,” or “competition.”
6. Obama – Another Big Reason To Oppose This Health Care “Reform” Proposal The President is an announced proponent of single payer health insurance (2003). He is also a power-seeking socialist-fascist who uses what I consider unethical methods to get Congress to vote on bills no one has read, and probably couldn’t understand them if they did, without help. Rep. John Conyers recently complained of this. People may hear what the spokesmen are saying, but who knows what’s really in the bill?
(CNSNews.com) - During his speech at a National Press Club luncheon, House Judiciary Chairman John Conyers (D-Mich.), questioned the point of lawmakers reading the health care bill. “I love these members, they get up and say, ‘Read the bill,’” said Conyers. “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?” 
The proposals as discussed will reward Obama’s allies (unions, trial lawyers, etc.) and punish his “enemies” (doctors, insurance companies, pharmaceutical companies, etc.) Obama wants to go after their profits. He thinks business profits are his piggy bank to tax as desired.
Strange as it may sound, I am convinced that Obama doesn’t care about the economy (except as a PR issue) and welcomes more unemployment, which should lead to more demand for government health care. It should be abundantly clear, even to liberals, that the Administration’s current policies cannot help the economy. If it recovers at all, it will do so in spite of the actions of Obama and Congress (on their current path), not because of them. If they were interested in helping the economy, they would reduce taxes and provide incentives for economic activity. These things, they aren’t doing. Don’t expect any quick recovery.
Even if some economists say the recession is over, unemployment remains high and is still increasing. The tax increases mentioned in connection with financing health care “reform” would bring about more unemployment and actually less revenue to the government. When Obama says “deficit neutral” and “I mean it,” he means that taxes will be raised and care rationed as needed, even though the statement itself is unreliable. I suppose he “meant it” when he said any family earning less than $250,000 a year would see no tax increases of any kind.
Obama does not mention tort reform , which could actually do a lot to help our healthcare situation. When asked about it by the AMA, he would not commit to doing anything about it. Malpractice lawsuits, and fear of them, contribute greatly to health care costs in the U.S. and would be a stronger disincentive to medical practice under government-run health care.
I have sworn upon the altar of God eternal hostility against every form of tyranny over the mind of man.