Posted on 08/04/2009 10:45:25 PM PDT by 2ndDivisionVet
The American debate on comprehensive health coverage is instructive both because it illustrates the extremes of welfare society—Israel’s as well as America’s—and because it shows how socialists take some very questionable propositions for granted.
The American health problem is the overregulation of the medical profession which has led to spiraling costs and cartel prices. Filling a tooth costs upwards of $200 in America, but as little as $10 in Russia, and the quality of the work is comparable. Absurdly long medical education drastically increases doctors’ wage requirements. Plenty of medical operations can be performed proficiently enough by less skilled personnel; it doesn’t take a registered nurse’s training to administer a shot. The relatively low out-of-pocket expenses of insured medical treatment leave patients little incentive to control costs. The medical lobby demands ever higher standards, which increases costs exponentially. Medical professionals use licensing to create both a cartel and a trade union, making health provision the ultimate monopoly. Like any trade union, the medical one increases its profits by milking consumers rather than investors, who simply don’t receive enough profit to be milked. The solution is to break the monopoly: anyone should be able to practice medicine, and patients should be able to choose among various types of providers, such as those licensed by a semi-official association, less pompous licensees, or even Mexican and Indian medical graduates. Medical liability should be legally limited to a sensible amount, which would allow the number of expensive tests to be limited when patients cannot afford them. The government must stop dictating to insurance companies their policies; there is a huge demand for medical insurance that only covers low-quality treatment by non-AMA doctors.
Stories of working single mothers being unable to buy medical insurance for their kids are nonsense. What kind of mother doesn’t buy her child a $50 health insurance policy? That’s not a critical amount even for minimum-wage earners. No doubt she manages to pay $30 per month for cable TV. In order to arrange health insurance for almost all children from poor families, slap a few hundred such mothers with long jail terms for gross negligence and endangering the lives of their children. Just look at the mother’s bank statement, and if she purchases anything non-essential before buying health coverage, send her to jail. Publicize such cases. Many such mothers are paid cash, and their expenses don’t show on their bank statements; search their homes to obtain incriminating evidence. Send their ex-husbands who evade child-support payments to jail, too. Universal health coverage legalizes parental negligence. That’s sort of like the government compensating victims of robbery and abandoning prosecution of robbers.
Poverty has nothing to do with the absence of health insurance. Jews in tsarist Russia were poorer than inner-city blacks can imagine. American blacks and Mexicans are not poor in any meaningful sense, but filthy rich compared to 90 percent of the world’s population. If white society really wants to integrate the blacks, it should make them responsible. Universal health coverage enshrines personal irresponsibility. A mother who routinely feeds her children hamburgers is guilty of manslaughter.
Universal health insurance encourages negligence. People who don’t brush their teeth properly are still assured of taxpayer-funded dental coverage. Those who sit for entire evenings in front of stupid TV shows get an ophthalmologist’s help at public expense. Instead, one should have to prove due diligence when applying for public funds—prove that he exercises regularly, adheres to a reasonable diet, and overall leads a healthy lifestyle; McDonald’s customers should not be eligible. The Torah establishes the right to charity only for people who positively cannot provide for themselves, such as widows and orphans in the ancient economy. Following the biblical logic, modern states might offer charity only to people who accidentally lost the ability to work through no fault of their own. Such definition makes old people generally ineligible for public assistance: they should have accumulated enough money during their working lives to provide for retirement and should also have raised enough children to care for them. Drunkards, drug addicts, homosexuals with AIDS, and similarly degraded elements are also ineligible for public help: not only have they inflicted harm on themselves, but the costs of maintaining them are staggering; the money can be more efficiently spent elsewhere. Health coverage, like any paid activity, is subject to limited resources: societies may spend infinite amounts on health care, but can actually spend only so much. Instead of wasting $50,000–$150,000 annually on treating drunkards in emergency rooms, society can just accept the simple fact that every system produces waste—like human waste—and not all waste can be recycled. “If I’m not for myself, who would be for me?”
The government formally submits to criminals when extending free health coverage to illegal immigrants, including children. The case is often misrepresented as “illegals and their children.” No, the children are also illegals. A society has zero moral obligation to those who join it illegally: a duckling among swans must not be treated as a swan. The children might not be contentious criminals like their parents, who entered the US illegally, but they are not members of American society either. Sponsors of legal immigrants to the US are required to prove their ability to pay for the new immigrants’ medical coverage; how much longer until the illegal immigrants care for themselves instead of relying on the public purse? The American defeatism towards illegal immigrants is akin to the Israeli defeatism about the swelling numbers of Israeli Arabs. The question, “What can we do about them?” is absurd. The US keeps millions of its citizens in jails; surely it can deport a few million illegal immigrants. They would go by themselves if the government cracked down on their employers.
Universal health coverage creates an ethical impasse. Society needs healthy twenty-year-olds, but spends mostly on economically worthless eighty-year-olds and drunkards. A rational welfare society would pay for dental care and gym for poor youngsters rather than spend a million-plus dollars keeping Alzheimer’s patients alive in a vegetative state. State-sponsored health coverage forces state officials to solve unsolvable ethical problems, such as whether spend more on dental care for the young or Alzheimer’s treatment for the old; both can consume virtually unlimited budgets. In an ethical society, each person accumulates funds for his own medical treatment and then chooses how to spend them; families and charities can likewise make private choices as to funding this or that treatment. Universal health insurance socializes ethics and puts officials in charge of moral issues.
The relatively wide acceptance of universal health coverage among the American population demonstrates the extent of taxpayers’ alienation from the government. Even among the hardcore liberals, few would willingly part with money in their bank accounts to benefit the illegal migrants and irresponsible blacks. Americans, however, have no problem with the government spending the tax funds it has already confiscated. Americans have already submitted to the government’s confiscation of their money, and so they welcome spending with even the remotest benefit to them, as opposed to pork-barrel spending in Iraq, military procurement, and elsewhere.
Except in very narrow biblical terms, there’s no right to charity, but only a liberty to work. There’s no right to medical care, but a liberty to contract it. Charity is an ad hoc affair which shouldn’t be made into a universal policy. All recipients of charity must be investigated before being granted it; charity is an exception to the established order whereby every man provides for himself and his family. Universal health coverage is another way for the government to usurp responsibility for the people’s lives and rule over infantile subjects.
Actually, legal services is probably the ultimate monopoly, but that's a mere tangent.
> Filling a tooth costs upwards of $200 in America, but as little as $10 in Russia, and the quality of the work is comparable.
The author is welcome to have his dental needs filled by a Russian dentist. Having experienced both, I will stick with Americans.
A more appropriate comparison would be inflation rates in dentistry (for which insurance availability is minimal) and general medicine.
Create more medical schools and graduate more doctors. The AMA is a guild-like structure that limits the number of doctors in order to protect their earning power. More doctors will lead to lower costs.
Quality must be maintained but it does not have to be through the AMA.
>Many such mothers are paid cash, and their expenses don’t show on their bank statements; search their homes to obtain incriminating evidence.<
No thanks.
But the author does have some good points.
If the Salvation Army spends $100 on someone who does not deserve it, it will have $100 less to spend on someone who does. The Salvation Army, like all good charities, thus has an incentive to avoid wasting money on people who don't deserve it.
If the government spends $100 of taxpayers' money on someone who does not deserve it, such expenditure will be used to justify an increase in the welfare budget. This provides bureaucrats with an incentive to spent taxpayer money freely, regardless of whether the recipients deserve it.
Oh puleeze!!! Any woman who can quilt can whipstitch that deep cut. Just pull out the whiskey bottle, pour it over the wound, take a swig (the one doing the stitchin’, of course) and have at it. Let’s go back to them Annie Oakley days!! Yes WE Can.
This is so true and obvious that I wonder why I hadn't realized it until now.
I’m sending this to flag@whitehouse.gov. This sounds fishy to me.
The AMA has nothing to do with any of this. Only about 30% of all physicians belong to the AMA. They are a liberal political organization, but do not control the number of physicians.
And then you have the fact the costs are controlled by government regulation and insurance companies. You become a doctor and you sign on with a group of other docs to an existing insurance agreement or try to haggle your own. Haggle you own means a difference, but not a substantial one.
If people were paying cash for primary care and only carried catastrophic insurance, then the price would indeed react to market conditions. In ints current form it is FAR from a free market. And BarryCareLess is heading further in the wrong direction.
Me? I'd venture to say that if people were paying cash for primary care, they would balk at hospital prices and more urgent care clinics would come in and hospitals would be forced to conform. The urgent care clinic is already the next force in medicine. ER docs flee from a true ER due to must accept policies that force them to take illegal aliens and uninsured patients at a loss. You'll notice that most doctor-owner hospitals are in areas with a decent patient population (i.e. - low medicare). Ask a doctor a main criteria for choosing a clinic location and one will surely be the patient population.
The author makes some decent points but some of this is more government intervention to prevent government intervention. No thanks.
No, I consider them linked.
And you made a great point there. Perhaps the salient one of this issue and one that is never talked about.
One of the biggest liabilities of American medicine is the Trial Lawyers and their exorbitant awards.
I would never visit any of the above for any ailment.
Funny. I may give you a call when I get old and am told that the whipstitch operation is not available to me under Obamacare.
Guess who pays for it?
I don't know if it's still the practice, but every doc in my former state (Cali) rented 'space' to the local labs which he/she referred Pts to for the various tests.
An investigator for Soc. Sec. told me every single 'medical equipment supplier owned by Russian immigrants was fraud.
But they're are off limits for investigation.
Kick out the illegals, and all costs concerning health care will go down by 10 per cent - more in states like Cali and Arizona.
The cost saving are huge and series - but no one - and I mean no one cares. Everyone has their racket and don't want to rock the boat....
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