Congressional Issues 2012 MORALITY AND CULTURE Health Care
The 113th Congress should:
Repeal "Obamacare" entirely
Take the following steps along a path leading to the complete separation of medicine and state:
Eliminate all transfer of tax money from patients to government and back patient providers.
Eliminate all government licensure and regulation. (Here's why.)
Begin with individual ownership of insurance policies. The tax deduction that allows employers to own your insurance should instead be given to the individual.
Leverage health savings accounts (HSAs). HSAs empower individuals to monitor their health care costs and create incentives for individuals to use only those services that are necessary. Offer a simplified set of flexible medical savings account options to all Americans;
Allow interstate purchasing of insurance. Policies in some states are more affordable because they include fewer bells and whistles; consumers should be empowered to decide which benefits they need and what prices they are willing to pay.
Reduce the number of mandated benefits that insurers are required to cover. Empowering consumers to choose which benefits they need is effective only if insurers are able to fill these needs.
Reallocate the majority of Medicaid spending into simple vouchers for low-income individuals to purchase their own insurance. An income-based sliding scale voucher program would eliminate much of the massive bureaucracy needed to implement today’s complex and burdensome Medicaid system. It would also produce considerable cost savings.
Eliminate unnecessary scope-of-practice laws and allow non-physician health care professionals to practice to the extent of their education and training. Retail clinics have shown that increasing the provider pool safely increases competition and access to care, and empowers patients to decide from whom they receive their care.
Reform tort liability laws. Defensive medicine needlessly drives up medical costs and creates an adversarial relationship between doctors and patients.
Abolish the FDA, which unnecessarily raises R&D costs for new drugs and lethally denies health choices to consumers
provide a fixed-dollar tax credit option to taxpayers who purchase health insurance;
expand consumer choices that increase market-based accountability by health plans, instead of enacting a patients’ bill of rights;
reform Patent law to increase competition and choice;
fundamentally restructure Medicare to expand competitive private health plan choices.
not add comprehensive prescription drug benefits to Medicare unless and until it enacts structural reform of the entire program;
encourage states to adjust Medicaid eligibility criteria and covered benefits to serve fewer nondisabled, lower-income individuals—but then provide remaining beneficiaries with higher-quality core health services and make greater use of cost-sharing incentives;
facilitate state efforts to adapt defined-contribution-style financing as an option for Medicaid beneficiaries;
provide a tax credit option for taxpayers who choose to purchase health insurance that is not sponsored by their employers;
expand consumer choices that increase market-based accountability of health plans; and
improve access to health care through incentives to purchase less-comprehensive insurance, expand high-risk pool coverage, finance charitable safety net care, and deregulate state insurance regulation.
What YOU Can Do:
Restore consumer-controlled health care The politicians tell us free market health care doesn't work, but we haven't had a free market in decades:
The government already pays for nearly half of all health care. This means we're half-socialized already.
Starting with depression era wage and price controls, and continuing with government tax policies, the politicians have made Americans dependent on their jobs to get health insurance.
State government policies have made insurance too expensive by piling on special interest mandates dictating specific types of coverage.
Medicare and Medicaid have fixed the prices we pay for health care, causing the extraordinary paradox of both price inflation and shortages in areas like primary care.
Anyone who signed the Declaration of Independence would think we have the greatest healthcare system there could ever be. He would be astonished that anyone would say we have a "healthcare crisis." After all, we have:
antibiotics
smallpox, polio, and other vaccines
anesthesia
Medical imaging: X-rays; computed tomography (CT scans), positron emission (PET scans), magnetic resonance imaging (MRIs), and ultrasound help diagnose diseases that would have remained untreated generations ago.
DDT, which has saved millions of lives and hundreds of millions of people from the horrors of malaria.
All of these things would have been available only to the super-rich a few decades ago. They are available to the ordinary working American today, and charitable hospitals make them available to the poor. Congress can be credited with inventing precisely zero of these inventions. Congress can be credited with manufacturing exactly none of these inventions. Congress can be credited with raising the prices of all of them -- just not as much as "greedy capitalists" have lowered the prices in an effort
to sell them to a larger number of consumers and make larger profits.
Take Vitamin D And save more than $1,300 a year in sickness costs.
Wrecking Your Genes Bill Sardi on what some common pharmaceuticals can do to you.
So what would a libertarian approach to health care policy look like? At a minimum it would have to include:
1. Repealing laws that have the effect of cartelising the medical industry (e.g., the licensure monopoly granted to the A.M.A.), thus artificially boosting the cost of medical care.
2. Repealing laws that have the effect of rendering the labour market oligopsonistic, thus artificially lowering people’s ability to pay for (and collectively negotiate for) medical care.
4. Repealing laws that transfer the power to make medical decisions for individuals from those individuals to centralised bodies, thus increasing the impact and scope of fatally bad decisions and suppressing the
competitive signals that allow the identification of better and worse policies.
5. Repealing laws that wiped out the old mutual-insurance systems (basically HMOs run by the patients instead of by corporations) and empowered insurance companies at the expense of patients.
6 Simple Ways to Dramatically Cut Costs of Medical Care - at Zero Expense to Taxpayers by Michael Cloud
Imagine that the federal and state governments imposed laws, regulations, restrictions, and mandates on medical care that drastically increased the cost - without improving medical care. What if it were possible to cut your medical care costs by 20% or 30% or even 50% now -
while keeping current levels of quality and service - by repealing and removing these government-created burdens and barriers? If this were possible, would you want it? Would you want the U.S. Congress to repeal and remove these laws, regulations, restrictions, and mandates? Would you want your state legislature to do the same? Yes? Well, these government-imposed burdens and barriers DO exist - and your federal and state
legislators CAN repeal and remove them. Would you like to see a small sample? 1. Allow price advertising. Let pharmacies, doctors, hospitals, and laboratories to publish their prices for goods and services. Eliminate all laws, regulations, and government provisions that hinder or prevent medical providers from posting their prices. Charges for the same medical procedure can vary 30% to 300% within a 100-mile radius. But without price information, patients can't shop for the
best value. In the 1970's, U.C.L.A. Economist Sam Peltzman compared the costs of eyeglasses in states that allowed price advertising and states that outlawed it. Results? Much lower prices in states that allowed price advertising. 2. Let all Americans buy prescription drugs outside the United States. Do NOT force them to travel abroad. Allow them to have the prescription drugs shipped to their homes. I've seen the 30% to 60% savings in prices of prescription drugs purchased
in Mexico. International competition for prescription drugs will drive down domestic prescription prices. 3. Let all people buy medical insurance across state lines. In New Jersey, a single man would pay $4,000 for medical insurance. If he lived in Pennsylvania, he'd pay $1,500. If the New Jersey man could buy medical insurance from a Pennsylvania provider, he'd save $2,500 a year. Imagine this all across America. This would cut medical insurance
costs for millions who already have needlessly overpriced premiums. AND, if the American Enterprise Institute study is correct, this would make medical insurance affordable for 12 million uninsured Americans. 4. Let doctors and patients negotiate discounts for paying cash. If a patient saves a doctor the time, trouble, delay and cost of dealing with insurance companies, Medicare, or Medicaid - let the doctor and patient share the savings. 5. Let patients, doctors, and hospitals enter into into
legally binding, limited-liability contracts. This would reduce the cost of medical treatment by reducing the cost of malpractice insurance. Just as Prenuptial Agreements limit marital risk, limited-liability contracts will limit medical risk. 6. End all government mandates that require businesses or individuals to buy medical insurance. End all government mandates that punish and tax those who do NOT buy medical insurance. Make insurance companies earn our business with lower prices and better
quality - rather than lobby government to compel us to buy medical insurance by force of law.
*Note: Since original publication of this column on April 13, 2006, it was learned that Tennessee is relatively lax about permitting the operation of free medical care clinics. However, free clinics appear to remain effectively prohibited throughout most of the United States. If you find a clinic that is neither sanctioned by government nor free of government subsidies, i.e., an unencumbered health care clinic charity, please let
us know by contacting the Center For Small Government. It is worth noting that while free clinics unaffiliated with government are largely prohibited, many individual medical professionals generously donate their services and/or give price breaks to those in need who lack financial means.
Licensing laws and regulations give us the illusion of safety. In reality, these laws constitute aggression against our neighbor, and our aggression boomerangs back to us, costing us our wealth, our health, and our very lives.
Licensing laws designed to protect consumers actually cause harm. The number of service providers goes down, and prices go up. People either do without the service or try to provide it themselves.
Consequently, states with stricter licensing laws for electricians have more accidental electrocutions; states with the most requirements for optometrists have more blindness; states with the most restrictive licensing for dentists have poorer oral hygiene.
Likewise, licensing for medical doctors creates physician shortage and overwork, as well as higher prices. Innovation, especially in nutrition and alternative specialties, is compromised both by licensing and by use of taxes for funding research. Our nation’s health suffers as a result.
The higher income that practitioners gain from licensing laws is more than offset when those unable to afford the higher prices demand tax-supported care.
Certification provides a better way to insure quality while honoring the choice of each consumer (e.g., electrical equipment certification by Underwriters Laboratories [UL]).
By using aggression to avoid medications that might harm us, we lose access to lifesaving drugs.
If a loved one were dying, we’d never snatch lifesaving drugs from their grasp. Yet, we unwittingly do just that with FDA “consumer protection” regulation.
The FDA’s mandate to approve only drugs that are completely safe and effective can be fulfilled only by approving no drugs at all. Because the FDA is unfairly blamed when drugs affect some people adversely, it drags out the approval process.
Consequently, drug development time and cost has increased five-fold since the early 1960s without any improvement in either efficacy or safety. We pay five times as much for drugs as we should!
The true cost, however, is measured in lives, as tens of thousands of people die waiting for the FDA to approve breakthrough drugs.
The FDA limits the information that drug companies can share with doctors and consumers. Consequently, 10,000-100,000 Americans died needlessly from heart disease each year because aspirin makers couldn’t advertise aspirin’s role in prevention; 25,000 children were born with preventable deformities because vitamin sellers weren’t permitted to advertise folic acid’s protective effects.
The biggest cost of regulation, however, is the stifling of innovation that could transform life-threatening diseases (e.g., infection) into a mild inconvenience.
Innovation lowers the cost of health care dramatically. In the 10 years after its introduction, ulcer medicine slashed the cost of treatment from a $28,000 surgery to $140, a savings of 99.5%!
When certification replaces aggressive regulations, prices drop, safety improves, and innovation thrives. More treatments become available, lessening the chances that quackery will prevail.
For more information, we highly recommend Healing Our World by Mary Ruwart.
The principle of "Liberty Under God" is a defense of your ownership of your health. You should have the liberty to choose the best medical advice for yourself, with or without the approval of politicians.
One of today's great ironies is liberals who extend a woman's ownership of her own body to include the right to kill other people's bodies (the unborn), but then propose "National Healthcare" systems in which bureaucrats will make all
other decisions for the woman, including whether or not she can get a mammogram or other tests, procedures or surgeries which a woman might want for her body.
Health care also involves seeing the healing arts as a "work of mercy" that should be motivated by true religion:
Pure and undefiled religion before God and the Father is this: to visit orphans and widows in their trouble, and to keep oneself unspotted from the world. James 1:27
Healing the sick is a Christian "work of mercy." Hospitals are the product of a Christian worldview. When Muslims copied the work of the Red Cross, they felt compelled to change the symbol to a Crescent.
Today's health care debate centers around the government. Should health care be motivated and controlled by people of faith, or
should it be controlled by bureaucrats answerable to lobbyists for special interests?
Would it be too extravagant for a political candidate to promise a healthcare system in which:
low-cost health insurance is available to virtually everyone -- including people with existing medical problems;
doctors have the time to understand your problems and know you personally -- and even make house calls;
a hospital stay costs only a few days' pay, rather than many months of your income;
charity hospitals are available to take care of families that can't afford the low-cost hospitals; and
free clinics take care of the everyday medical problems of people too poor to afford regular doctors.
This is exactly the healthcare system we had in America until the mid-1960s. It was then that the federal government moved in -- with Medicare, Medicaid, the HMO Act, and tens of thousands of regulations on doctors, hospitals, and health-insurance companies. That's when health care started going downhill.
If a child skins his knee, whose responsibility is it to put on a band-aid: a parent, or the government? If your child gets brain cancer, who would you trust to heal him, 435 Congressmen, or a cancer clinic set up by greedy capitalists who make millions of dollars a year successfully treating brain cancer? If your neighbor can't afford to take his child to the capitalistic brain cancer clinic, whose responsibility is it to help him get the money he needs? The IRS and the Government healthcare police, or your church?
“If American Christians simply gave a tithe rather than the current one-quarter of a tithe, there would be enough private Christian dollars to provide basic health care and education to all the poor of the earth. And we would still have an extra $60-70 billion left over for evangelism around the world.” Book Review: The Scandal Of The Evangelical Conscience - Acton Institute PowerBlog
Do No Harm by Jane M. Orient, M.D. "If government forces us all into a bureaucratically managed system, we will still have something called “health care,” delivered by persons called “health care providers.” But such a system will have
no place for ethical physicians, whose Oath forbids them to accept a situation of conflict of interest with their patients."
Drugs by Dr. Mary Ruwart The good doctor answers tough questions on illegal drugs in a free society.
The Economics of Medical Care by George Yossif, M.D. "In voluntary markets, private medicine
included, the key knowledge necessary for trade is conveyed by freely fluctuating prices. The price system conveys knowledge of the personal and subjective utilities of the actors, that is, of the supply and demand of various commodities and services, which cannot be compared otherwise. Demand for ordinary medical care in voluntary markets is highly elastic and medical care by physicians is largely optional, except for some categories of life-threatening conditions, few in number and low in incidence, sometimes known as “catastrophic illness.” As history
shows, medical care in essentially voluntary markets tends to be accessible and affordable. Sustained price inflation in medical care is always a result of direct or indirect political intervention. The lately much-touted competition between providers is not the genuine competitive bidding for the satisfaction of the actual consumer of care, the patient, as a free market would have it. On the contrary, this politically created competition will further enhance and centralize the bureaucratic controls on medical care, thus compounding, instead of reducing, the
inflationary effects of the multiple and pervasive political interventions already in operation."
For-Profit Medicine and the Compassion Motive by Tom G. Palmer "Profits earned in the context of well-defined and enforced legal rights (as distinguished from the profits that accrue to being a brilliant thief) may provide the foundation not of coldness, but of compassion. The search for profit requires that the doctor consider the interests of the patient by putting
himself or herself into the patient’s position, to imagine the suffering of others, to have compassion. In a free-market economy, the profit motive may be but another name for the compassion motive."
A Four-Step Health-Care Solution by Hans-Hermann Hoppe "To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government
controls."
A Free Market in Kidneys? by Walter Block "There is no doubt that those presently responsible for preventing a free market in kidneys act with the noblest of motives. To them, legalizing the purchase and sale of human organs would be degrading. Far better, from their viewpoint, that people donate their bodily parts for free so that thousands of kidney disease sufferers might live normal lives. However, no matter
how benevolent the intentions of the prohibitionists, it cannot be denied that the effect of their actions has been to render it less likely that those in need will be served."
Free-Market Medicine by Larry Van Heerden "The health-care market has failed to produce high-quality, low-cost medicine for two reasons: Consumers
are insulated from the cost of medical care by third-party payers, and information on the performance of competing physicians is not available. Fixing the incentives and providing consumers with physician performance data will cause unnecessary surgery to decline, physician performance to improve, disease prevention to increase, and health-care efficiency to rise."
Free Market Medicine by James W. Brook "I am actually a part of a small, but growing, movement of doctors who have
"opted out" of the third-party payment system and simply charge patients directly. No insurance contracts, no medicare, no medicaid, just direct payment at the time of service, from the person who receives the service."
Harming Our Health by Mary J. Ruwart "Licensing of health care services gives us the illusion that we are protected against selfish others who would defraud us. Instead, our aggression boomerangs back to us, costing us our wealth, our health, and our very
lives."
Health Care by Dr. Mary Ruwart The good doctor answers tough questions about health care in a free society.
The Home-Birth Controversy by Hannah Lapp "Modern America has much to say about rights and opportunities for women, even down to the right to terminate a
pregnancy. However, when it comes to nurturing and bringing their offspring safely to birth, American women often find their options severely restricted."
The Immorality of Government-Mandated Health Care by Paul A. Cleveland "National health-care insurance, or its mandated provision, is unjust. It is nothing more than a forced charity, which is no charity at all. In this vein we might flatter ourselves into believing that we are doing good works, but it simply is
not true. True mercy is extended as a matter of voluntary choice. It is not forced. Government mandates which require some to provide for others is false philanthropy. It is fundamentally selfishness unleashed and it will thwart future prosperity."
Increasing Access to Pharmaceuticals by Doug Bandow "Paternalism remains a powerful influence in Washington. But it is time for patients and doctors, insurers and hospitals, pharmaceutical firms and device manufacturers,
senior citizens and healthy young people to together say 'No more.'”
National Health Insurance: A Medical Disaster by Jarret B. Wollstein "Throughout the world the story is the same: socialized medicine results in skyrocketing demand for nominally “free” health care, doctors are overburdened, medical services steadily deteriorate, and there are endless
waiting lists for health care. In the Soviet Union before the collapse of Communism, anesthetics, painkillers, and most drugs were rationed; 57 percent of hospitals had no hot running water; and it was standard practice to clean needles with steel wool and reuse them."
New Legal Organ Market by David Undis "LifeSharers is a non-profit voluntary network of organ and tissue donors. Membership is free, and anybody can join at www.lifesharers.com. Members agree to donate their
organs and tissue when they die, but only to fellow LifeSharers members (unless no member is a suitable match). LifeSharers members say, in effect, “You can have first dibs on my organs, but only if you agree to donate yours.” By directing their donations in this way, LifeSharers members create a pool of organs that are potentially available only to fellow members."
Our Own Silent Spring by Llewellyn H. Rockwell, Jr. "It is estimated that 800,000 children in Africa die from the disease every year, and as many as three million people altogether every year. We know how people contract it: from mosquitoes. We know how to control it: kill the carrier mosquitoes. And we know what kills them: DDT. So why has the war on malaria failed? Because governments banned the cure. Now
they claim to wonder why people are sick and dying."
Philosophy of Immunization by Mark Moyers, D.C. "Ninety-eight percent of all persons immunized under compulsory immunization laws never object! They don't know how! They don't know that they can! They don't know that they might want to, or why!"
Private is Better Than Public by David G. Green "It is in this sense of de-politicisation that
privatisation is a good thing in itself. It allows the objectives of producers of goods and services to be self-chosen not politically-chosen."
Protecting Ourselves to Death by Mary J. Ruwart "By using aggression to avoid medications that harm us, we lose access to life-saving drugs."
The Right to Medical Care by Sheldon Richman "All of this is a rather roundabout way of identifying the worst aspect of the “right to medical care”: the tethering of the citizen to the state. For all the criticism that is leveled at Medicare and proposals to reform medical care in general, too little attention has gone to that uncomfortable fact. If government controls
medical spending, it controls you, including the very length of your life."
The Rise of Markets and the Fall of Infectious Disease by Stephen Gold "True, capitalism is not a magic wand. As the former Communist countries of Europe are learning, an affluent market economy takes time to develop. Still, if the lesser developed countries of the world can liberate their economies from government control and encourage private enterprise, then future generations of
children there will look upon infectious diseases like typhus, cholera, and tuberculosis the way I looked upon scarlet fever—as a relic of bygone, pre-market days."
Self-Medicating in Burma by Kerry Howley "Freedoms are in
short supply in Burma, a country run by a hardened military, yet the freedom to treat a bout of food poisoning with pharmaceuticals was new to me. The United States is the only country in the world that divides drugs into two rigid categories of prescription-only and over-the-counter. Most other developed nations allow for a third class of drugs to be dispensed by a pharmacist, and developing nations typically do not have prescription requirements or fail to enforce them."
What the World Needs Now Is DDT by Tina Rosenberg "The move away from DDT in the 60's and 70's led to a resurgence of malaria in various countries -- Sri
Lanka, Madagascar, Swaziland, South Africa and Belize, to cite a few; those countries that then returned to DDT saw their epidemics controlled. In Mexico in the 1980's, malaria cases rose and fell with the quantity of DDT sprayed. Donald Roberts, a professor at the Uniformed Services University of the Health Sciences in Bethesda, Md., has argued that when Latin America stopped using DDT in the 1980's, malaria immediately rose, leading to more than a million extra cases a year. The one country that continued to beat malaria was Ecuador, the one country that
kept using DDT."
WPC on health care A collection of policy briefs and press releases devoted to pointing out the folly of government socialization of health care, subsidization, and other market distortions.
Two Book Reviews by Dale Steinreich, Drury University, The Quarterly Journal of Austrian Economics Vol. 9, No. 3 (Fall 2006): 75–85 (PDF)
Lives at Risk: Single-Payer National Health Insurance Around The World. By John C. Goodman, Gerald L. Musgrave, Devon M. Herrick Lanham. Rowman and Littlefield, 2004.
Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer. By Sally C. Pipes. San Francisco: Pacific Research Institute, 2004.
Media:
"Health Economics" by Walter Block, Mises University, July 31, 2009 (MP3)
"Economics of Risk and Insurance: From Healthcare to Welfare" by Hans-Hermann Hoppe, Mises University, July 29, 2009 (MP3)
Mises Blog: "Health care: the government is the problem" (Video)
Here’s a Second Opinion | Hoover Institution - Hoover Digest Ten reasons why America’s health care system is in better condition than you might suppose
The Market Doesn’t Ration Health Care | Foundation for Economic Education Economics 101 says giving more people access to the same number of doctors and hospitals means government rationing. Decisions about healthcare will be made by bureaucrats to "control costs," which MUST increase when "access" to a fixed supply of goods is increased. Our choice is between rationing by bureaucrats (including insurance clerks empowered by government tax policy)
and individual self-determination through free exchange.
Restore consumer-controlled health care
