Comments on: Medical Misunderstanding

By: Rich H.

Rich H. — Sun, 24 May 2009 16:38:26 +0000

Anyone who thinks we are talking about insurance when we talk about “Health Insurance” needs to read the following article. Dr. Szasz makes clear, at least to me, that what we have is a government ponzi scheme to redistribute wealth in the name of “helping” those in need. No, our government would never do that…

http://www.thefreemanonline.org/columns/the-therapeutic-state-the-myth-of-health-insurance/

By: Darren

Darren — Sat, 23 May 2009 20:31:33 +0000

Michael Liss,

The cost problem is well covered in another article written a several years ago:

“”Bad Medicine” or Bad Economics?”
http://mises.org/story/917

By: Michael Liss

Michael Liss — Sat, 23 May 2009 16:54:20 +0000

I see the health care debate as having two dimensions – but these are inevitably lumped together. The first is the spiraling cost of health care, and the second is how to insure our citizens so that they can take advantage of the best health care system in the world. It is misleading to think that “government insurance” will have an substantive effect on costs. These two problems may be related, but they are not the same thing.

While I am firmly in the free enterprise camp, I must admit that in the realm of health insurance I am conflicted. The source of this conflict is the data that shows that many people (perhaps most people) who have “health insurance” can be bankrupted upon needing any sort of catastrophic care. This, coupled with the fact that private health insurance companies routinely cull the ranks of their subscribers of the ones most in need of medical care says to me that the private insurance methodology is not working. And when you add into the mix the people who can not afford insurance it just seems that this is broken.

So I find myself wondering why a single-payer system is not the answer to the coverage problem. Or put another way, I am at a loss to come up with any other system that would ensure that the citizens of our great land can get medical treatment while spreading the costs across the largest population base. A single payer system does not require that doctors or hospitals fall under government control – only that the payment and cost system is amortized across the population. If there is another way I am all ears – because I generally despise central government programs.

And let me reiterate that a single payer system does not address runaway costs. That is subject for another day.

By: Steve

Steve — Fri, 22 May 2009 23:57:09 +0000

Sheldon,
I was going to use the analogy of the knee pain and joint replacement, not a compliment to you that we are thinking along the same line!
Regarding the analogy of auto insurance possibly the more valid point is that auto insurance does not pay for routine service like oil change, new tires, etc. As you pointed out, our working definition of health insurance is not real insurance. To bad, otherwise this all would not be the problem we are dealing with today.
One last question. I think a low rate, flat tax on earned income would be the best tax, if we must have a tax. No deductions. Now, where would that put the nonprofits in the equation? Would they take on the role you prepose? Maybe you don\\\’t agree with my presumption re: a flat tax?

Dr. Steve

By: william white

william white — Fri, 22 May 2009 23:19:17 +0000

Unhappily the proposed ship left harbor decades ago. Between the AMA and the FDA government run healthcare goes back decades. My favorite example is EDTA vs. doing nothing vs. bypass vs. angioplasty is the correct order of efficacy for most forms of cardiovascular disease according to every double-blind or longitudinal study I am aware of. That order is reversed in terms of recommended treatment. The one good thing that is likely to come out of the US socializing medicine is that it will bankrupt the European advocacy of such stupidity. Of course every silver lining has its cloud.

By: Less Antman

Less Antman — Fri, 22 May 2009 21:32:49 +0000

Great article. With respect to patents, it is worth noting that they massively increase R & D costs, since constant investigation is needed while developing new treatments to ensure they aren’t violating the overwhelming number of existing patents (and sometimes R & D is stopped dead because of discovery that they are). Legal and court costs are also breathtaking in this area.

More broadly, because intellectual “property” isn’t actually property at all, but the power to prevent other people from using THEIR actual property in certain ways that duplicate ways you’ve used yours, it can only exist with an absolutely massive amount of government power to enforce it, and all those costs are a part of the cost of patents.

As far as I know, nobody has ever shown that patent laws result in a faster pace of discovery, and there are plenty of examples where they stopped progress cold because competitors couldn’t improve on existing patented products.

The urge to discover, to be first, and to help others all drive innovation, and history suggests that the protection of property rights in scarce, tangible assets is what is needed for economic growth. Patents actually violate such rights and probably retard growth as well.

By: Sheldon Richman

Sheldon Richman — Fri, 22 May 2009 16:03:03 +0000

Steve, you make a good point about insurance and “need.’ That is not what we have. With real insurance, the company would write a check to the person and he could do what wanted with the money. That’s how auto insurance works. I don’t have to buy a new car when mine is totaled and the company pays. I can choose to take a vacation instead and the bus thereafter. What we call health insurance is merely prepayment for virtually all kinds of services, many of which are not truly insurable either because they are certain (babies’ ear infections) or because they are elective. If you were willing to pay the high cost, you could probably talk someone into writing you a haircut insurance policy. But since few people realize they are paying for their insurance, they participate in this bad deal. If they faced the real costs, they’d think differently.

Regarding “need”: not long ago, older people lived with bad knees and pain. The doctor prescribed aspirin, etc. Did they need knee replacements? There was no such thing! Today, thanks to medical advances, people can get them and therefore they “need” them. That really boosted our total medical bill. A rich, advanced society can be expected to have higher medical bills than a poorer, less-advanced society. Where’s the problem or need for government intervention?

The absence of patents might well take the profit out of some things. That’s no reason to have patents if we are convinced they violate rights. It just means that in a free market, models other than for-proft enterprise would play a larger roll, such as nonprofit foundations. The open-source software industry is instructive too. See The Freeman article on the subject.

By: Steve

Steve — Fri, 22 May 2009 15:01:38 +0000

As a physician I agree with most of what you assert. I would offer a few additional thoughts, some my own, some from what others have written.
1) The public doesn\’t want health care. They want inexpensive, prepaid, wellness assurance. They have been misled to believe it possible. It is not!
2) I believe it was Jane Orient who said we should think of the insurance as sickness insurance and start to understand that we are all responsible for our own health.
If one wants to be healthy, first choose your parents well, then do what your mother said, eat well , get enough sleep, get exercise, don\’t take chances, don\’t use drugs, don\’t smoke….. you get the idea.
3) Much of our collective medical spending in this country is elective. There are options that were available years ago that we still could exercise today, but because we have had the greatest economy in the world, we have had to spend less for food and shelter and have elected to indulge in the advances research has offered. Now the public has been led to believe these wants are in fact needs, and that the individual somehow has a right to this. We are not entitled to have our needs met, let alone our wants.
4) Re: patents, licensing, etc., I still have some reservations
with your position. The cost of R & D and the liability has to be covered, but you\’re sharper than I on this. The public does need some way to be able to seperate the smooth talking snake oil salesman from the legitimate resource. After all, look what is happening when we elected a smooth talkin\’ snake oil salesman president!

By: Dave

Dave — Fri, 22 May 2009 14:00:25 +0000

Thank you for this article. The government has been the prime culprit in the costs of health by control of services as reported above and by not promoting full information.

We were fully informed of much of the problem by our local MD who insisted on our reading “The China Study” by Campbell and “Prevent and Reverse Heart Disease” by Esselstyn. These two books provide the patient with full demand control and free choice supply control.

We hope that FEE will expand on the full discloser failings of our government.