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Sunday, September 4, 2016

Get rid of health insurance!

I’m watching the GOP debate in NH. So far, the candidates’ ideas to fix health care have included:

  1. Repeal Obamacare 
  2. Allow purchase of health insurance over state lines
  3. De-couple health insurance from employment (How? Are employers going to be forced to continue paying for health insurance when someone loses their job? That will just make it ten times harder to get a new job…)
  4. Empower and expand Health Savings Account
Here’s the problem with all of the above ideas: cost. Health care itself is too expensive, which means insurance has to be expensive, too. So with the exception of allowing purchase of health insurance over state lines, most of the schemes above are the equivalent of playing musical chairs on the titanic. Health care is expensive because health care isn’t sold in a free market. You don’t purchase health care from private entities. No, you purchase health care from the health conglomerate – and they like to shut out new competition. The health conglomerate includes the FDA, the AMA, the US Patent Office, medical schools, state medical boards, and state-licensed medical professionals – all of whom have a vested interest to stop new medicines from reaching the marketplace, and to stop new small businesses from selling health care to consumers.
"Health care is too expensive." Yes. When steaks are too expensive you eat chicken, or pork, or fish, or peanut butter and jelly. You don't buy steaks. You know how much a steak used to cost. You evaluate the cost of everything else. You decide how much you really want a steak and, finally, you decide if it's worth it to you. It's not a perfect analogy. Not eating a steak or eating one is never going to be a life or death situation. Nevertheless, the underlying economic decisions are the same. How much is it worth and what does it cost?

I'll tell you something that's true and you tell me if I'm lying or telling the truth. It's true that you can call an ambulance right this second, make them come to your house, carry you to a hospital and at some point receive treatment either from that hospital or from a different hospital which they will also carry you to, and all of this without insurance, and all of this without one thin dime to your name. Is the preceding statement true or false?

Nephew Sam is right. Read the whole thing. But there's more. The insurance system itself is a huge mistake. It's our free-market answer to risk and therefore just like in a casino, there will be losers, winners, and the house. The house makes all the rules and therefore the house always wins. The lesson is simple don't play. I might not make any friends with the statement I'm about to make. You'll immediately suspect me of being a liberal, but if you keep reading, I bet you'll eventually be convinced that my ideas are the fairest and best way to care for the sick without unduly burdening the healthy. If you start with the average cost for health insurance across the nation, and then factor in inflation I.E. the COLA, and finally set into law the amount of money every person across the country pays for health care based on this moving average, you'll begin to allow every citizen to pay his fair share. In using the phrase "fair share" I'm stating categorically that fair means the rich will never pay more than double that average amount and the poor always pay at least half that amount.

I'm talking single payer health care! At this point I can almost hear the hissing of a pack of vampires confronted with a Crucifix! Yes. I said it. Single payer. However, not one like all the other socialist countries surrounding us, but more like the free-market capitalists that we are supposed to be.

Insurance companies make a profit. They have investors. They have agents. They have overhead, wages, distribution, taxes, rent, utilities, on and on and on. We don't need any of it. Doctors, nurses, hospitals don't need middlemen anymore than you do. If health professionals receive 100% of your payment, and not the grudging share the insurance company finally pays out, they'll be happier. They'll agree to charge less, knowing that the $1000.00 procedure won't be chewed down and argued over and procedured away and eventually paperworked down to a fraction of that agreed upon amount.

Suppose that you want to buy a car? You could walk in and pay the sticker price. Lots of people do that by the way. There's no sense in trying to talk sense into this kind of person. They feel uncomfortable bargaining. They'd rather pay whatever the sticker says and drive home in their new car. Meanwhile there are the other kind of people who won't even buy a yard-sale paperback for fifty cents unless they can talk the homeowner down to forty-five cents. We all understand that wheeling and dealing (or not) is freedom. Therefore, allow each individual to decide what health care treatment they want. Allow them each to make whatever agreement for treatment they want, some making good deals and some bad. Finally, incentivize buyers and sellers who cost the government the least, and also punish buyers and sellers who cost the most.

"Doctor Jones, sir, Your particular podiatry clinic charges nearly twice the national average. This statistic is based on total cost paid to your clinic divided by the total number of patients we've paid for. Sorry, Doctor but we're doubling your taxes. Have a nice day."

"Your family members have been to the pediatrician on average four times more often than the national average, and by the way, this statistic is based on both your number of children and their various ages. Sorry, but your health care charge has just been moved up one bracket."

"You've been paying the national average for five years, but you've never done more than get a once a year physical. We're lowering your medical rate to the lowest bracket. Congratulations and stay healthy!"

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