Comments on: Specific Healthcare Changes

By: Adam Selene

Adam Selene — Fri, 05 Jan 2007 19:01:31 +0000

I’m not suggesting that you, or anyone else, should not consult a professional’s medical opinion when you need it or want it. What I’m suggesting is what Brad outlined so nicely. There is a vast difference between choosing to consult a professional and being required by law to get a permission slip from someone that the State deems is a professional. And considering the number of wrong prescriptions that doctors hand out, I’m not all that enamored of our mandatory permission givers.

By the way, I do most of the work around my house, except electrical wiring. I’m reluctant to burn my house to the ground. However, I don’t insist that my electrical workers have a state license, just experience and references.

By: Brad Warbiany

Brad Warbiany — Fri, 05 Jan 2007 17:21:33 +0000

VRB,

The analogy of choosing between a state-licensed plumber and doing the work yourself is flawed.

To make it a correct analogy, it would have to be illegal to do the work yourself, to use a non-licensed plumber to do the work, and that if any plumbing work would be done on your house, that it *MUST* be done by a state-licensed plumber.

The problem is not with state licensing. The problem is with legally requiring that you must go through that state-licensed practitioner to receive service.

By: Brad Warbiany

Brad Warbiany — Fri, 05 Jan 2007 17:14:34 +0000

VRB,

A prescription is good for that reason. But there’s the opposite side of the coin, where you cannot buy a drug without a prescription. So while it’s nice to have for informative purposes, it’s also a gateway that in order to get medication, you *MUST* go through a licensed doctor and pharmacist, rather than having that as one route and your own judgement as another.

By: VRB

VRB — Fri, 05 Jan 2007 17:11:21 +0000

Adam,
I can’t seem to finish my thought, but I wonder if you use a state licenced plumber or electrician to do that kind of work at your house or do you do those things yourself. Managing their health care for some people can nearly be a full time job, having to do research and managing their drugs would be another. I didn’t think that everyone has to be a polymath to enjoy liberty.

By: VRB

VRB — Fri, 05 Jan 2007 16:59:17 +0000

Adam,
I thought prescriptions were suppose to let you and the phamacist know precisely what you were suppose to take and how to take it. It helps the pharmacist give you all the information you need. Personally, I wouldn’t care what you take or when, but I do need help in understanding my medications. All the interactions and I don’t trust online help. If I am suspicious of the doctors opinion, I ask more questions or go to another doctor.

By: VRB

VRB — Fri, 05 Jan 2007 16:51:26 +0000

Adam, why have doctors at all?

By: Kevin

Kevin — Fri, 05 Jan 2007 16:45:30 +0000

Okay let me throw this out there, what about drug reimportation? The Lew Rockwell crowd supports it with the justification of willing buyers and willing sellers. Meanwhile CATO and every other self-described free market organization opposes it as subsidies.

By: Adam Selene

Adam Selene — Fri, 05 Jan 2007 16:16:51 +0000

VRB, monopolistic practices and laws around access to drugs are certainly a contributing factor in pricing. There is a difference between getting advice from a doctor on what drug to take and needing a permission slip. Prescriptions are one of the worst features of the Nanny State. Not only does it limit liberty (you are not allowed to choose, you may only take those drugs the State and a State licensed doctor decide you may take), but it also drives up prices through scarcity.

By: Adam Selene

Adam Selene — Fri, 05 Jan 2007 16:15:41 +0000

Doug, I don’t agree about drug pricing. Yes, some of the cost of those drugs is caused by patent laws that are excessive, but not all. The VA, Medicaid and Medicare intrusion and price fixing/controls are also responsible for it. When Lipitor must be sold to Rhode Island Medicaid at the best negotiated price available, what happens is that the best negotiated price goes up for Lipitor, not down or static.

By: VRB

VRB — Fri, 05 Jan 2007 13:42:10 +0000

At least you would need someone to recommend it. Can you understand the inserts and can you order test to determine if it would be causing muscle damage if its Lipitor? By the time you would notice the symptoms it could be late to do anything about it. Dosage is important too, not everyone would take a standard dosage, that would be determined by test also. There are other interactions with drugs, so when would you know when to consult the pharmacist. You can be responsible if you have all the knowledge, it is now possible for all people to have the knowledge of a doctor, pharmacist and lawyer too.

By: Doug Mataconis

Doug Mataconis — Fri, 05 Jan 2007 06:10:26 +0000

VRB,

If I want a drug, whether it’s Lipitor, Synthroid, or anything else that might be medically beneficial, why should I need a prescription to get it ?

By: Doug Mataconis

Doug Mataconis — Fri, 05 Jan 2007 06:08:58 +0000

Adam,

Lipitor, and its competitor drugs will not go down in price until the patents expire.

But that’s another issue entirely.

By: Adam Selene

Adam Selene — Fri, 05 Jan 2007 04:24:04 +0000

Tarran, while I’m on your side on licensing boards, I would argue that simply implementing those 6 suggestions would make a tremendous difference. Not only that, it would place tremendous market pressure on the providers that does not currently exist.

By: Adam Selene

Adam Selene — Fri, 05 Jan 2007 04:22:25 +0000

VRB, Lipitor prices are higher than they have to be for the reasons above. Will it ever be cheap? I don’t think so, but certainly could be much less costly than it is now.

Personally, I would expect the states would implement coverage for high risk folks that couldn’t afford healthcare on their own. Especially the states that have a more left wing tradition.

By: tarran

tarran — Fri, 05 Jan 2007 02:51:22 +0000

I was surprised to see one of the biggest interventions completely left out:

7) Abolish state medical licensing boards, or at a minimum abolish state imposed limits on the number of graduates medical schools are permitted to put out.

The AMA lobbied for, and effectively controls the medical licensing boards in all states. They limit the number of doctors to maintain a medical practitioner to population ratio of 247 per 100,000. They do this while 10 qualified applicants are applying for every 3 seats at medical schools (according to a back of envelope calculation I did several years ago) and are being turned away.

A critical component of a free market are low barriers to entry and exit. The AMA ensures that the barriers of entry for prospective doctors is set fairly high, in order to ensure a shortage which keeps prices high.

As a Rothbardian Anarchocapitalist, I want to see the whole government licensure thing go away, to be replaced by private licensure. However, even the compromise of allowing anyone who wants to to apply for a state license, and allowing medical schools to train as many people as they want would be an improvement over the current situation.