Thoughts, essays, and writings on Liberty. Written by the heirs of Patrick Henry.

“An elephant. A mouse built to government specifications.”     Robert A. Heinlein,    The Notebooks of Lazarus Long

June 18, 2008

Two Great Reads

by Stephen Littau

I found a couple of really great articles I would like to pass on to our readers.

The first is an article posted at Townhall.com by John Stossel entitled: Legalize All Drugs. In this article, Stossel busts several myths about the war on (some) drugs such as “Heroin and cocaine have a permanent effect,” “If you do crack once, you are hooked,” and “Drugs cause crime.” The main point to Stossel’s article, however; is that rather than arguing for legalization for one drug (i.e. marijuana), libertarians should be working to legalize all drugs.

While I share his belief that all drugs should be legalized, I also understand that short of a Barr administration putting the brakes on the war on (some) drugs, the way to realize our ultimate goal will probably have to be done incrementally.

The second article comes from Capitalism Magazine by Dr. Richard Parker, Ted Kennedy vs. Universal Healthcare: A Double Irony.

It was reported that Senator Kennedy chose his surgeon for this difficult operation after very careful research and consultation with his physicians in Boston. Using his free and independent judgment, Kennedy chose Dr. Allan Friedman, a surgeon renowned for his experience and expertise in the field of neuro-oncological surgery.

No government regulations restricted the Senator in this extremely important personal choice. Facing a life threatening illness, no bureaucrat forced the Senator to chose his surgeon nor hospital from a government “approved” list–a list not generated by Kennedy’s independent and free judgment, but by “public servants” who’s expertise is not Kennedy’s life, but the arbitrary and byzantine politics of “pull”, of favors owed and collected, of political pressure groups and the bitter reality of healthcare rationing. No, Kennedy was not forced to sacrifice his life, liberty nor property in the name of the so-called “greater public good.”

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15 Comments

  1. What kind of an example is that? No matter how much involvement the government would have been in Kennedy’s health care he had the resources to do what he wanted.

    Comment by VRB — June 18, 2008 @ 6:09 pm
  2. VRB -

    That point only makes it a better example, if you ask me. Right now, as a middle class guy with decent health coverage, I have a fair amount of latitude when choosing a doctor.

    I was in a situation last year where I had a good chance of needing knee surgery. (Fortunately, the problem healed without it.) The doctor I was referred to by my insurance company at the time was a nice guy with a terrible track record as a surgeon. Knowing this, there was no way I was going to let him operate. Period.

    When the insurance company wouldn’t cover an out-of-network doc because their guy was deemed adequate, I declined the surgery at that point and immediately moved to another insurer. By the time the paperwork was done and the new policy came into effect, the injury was healing well without surgery, but had I needed it I would’ve been able to to choose a doctor with whom I feel comfortable.

    Ted Kennedy, being a well connected politician and power broker, will always be able to doctor shop. On the flip side, if I had been dealing with a government monopoly instead of a private company, I would have been stuck having someone with a poor track record do surgery on me.

    What’s more unfair, a system where a majority of people can choose their doctor (within limits), or a system where only the insiders can choose their doctor?

    Comment by Quincy — June 19, 2008 @ 12:02 am
  3. You really wouldn’t know that until that system is defined, even thought Medicare part D sucks. I think that was intentional since the Republicans were under the gun to pass such a bill. The plan was designed to fail and piss people off. They will spend billions to prove a point; that government shouldn’t do health care and they can’t even be the safety net.

    Comment by VRB — June 20, 2008 @ 3:33 am
  4. VRB –

    There are systems all over the world that are exactly as I describe. It’s pretty easy to realize that once the customer is the politicians, the people the system is imposed on will have no choice. (See, for reference, Canada, Great Britain, Cuba, China, Soviet Russia…)

    And honestly, I don’t think Medicare Part D was a plot by Republicans to prove a point, since the modern Republican party doesn’t believe that argument. Compassionate conservatism and all the other garbage spouted by the modern Republican party means they think government should do health care, just the Republican way.

    Comment by Quincy — June 20, 2008 @ 5:43 pm
  5. Those systems are not in place here and Ted Kennedy will not be president.

    Comment by VRB — June 21, 2008 @ 4:35 am
  6. Most people do not want to depend on the “kindness of strangers” for their health.

    Since, I use health care quite a bit, I have not seen a libertarian workable plan. Its too much pie in the sky, as if the medical equipment, insurance and pharmaceutical cartels are going to suddenly change their ways.

    Health care is a conundrum.

    Comment by VRB — June 21, 2008 @ 4:44 am
  7. VRB, the problems which exist with healthcare in America are because of government not the free market. If we adopt the Clinton/Obama/Romney/Kennedy solution to healthcare we can expect similar results as the Canadians and the Europeans.

    Quincy rightly pointed out that the Kennedys of the world (the rich and powerful) will never have to worry about healthcare. If they screw up the system here, they can go somewhere that has a free market to pay for the healthcare they need. We won’t have that luxury as we will be stuck with whatever system they give us.

    And why not depend on the kindness of strangers? What you are advocating is forcefully taking the money of strangers to provide for your healthcare. Just because you need healthcare does not mean you have the right to make someone else pay for it. It’s no different than you going around a rich neighborhood forcing residents to empty their wallets at gunpoint to pay for your healthcare.

    Make no mistake, anytime you tell the government to take from one to give to another that’s precisely what you are doing.

    Comment by Stephen Littau — June 21, 2008 @ 1:00 pm
  8. VRB -

    Do we know what works in health care? Not really. We haven’t figured out, as a society, how to efficiently deliver health care to those who need it.

    That said, we definitely know what *doesn’t* work in health care. Centralized control has proven, time and again, to be an abject failure both economically and morally. The fact that all our politicians can come up with to fix a system wrecked by centralized control is more centralized control shows just what a worthless bunch they are.

    Moreover, any libertarian plan worth its salt would depend not on pie in the sky utopian predictions, but the hard and fast reality that people are greedy and will try to get as much out of the system as possible. In theory, the structure that would best leverage this is a straight out free market, where routine health care is purchased just like routine car maintenance (no one has insurance for oil changes, do they?) and where insurance policies are reserved for catastrophic and hard-to-foresee events.

    In reality, we’re up against a culture where the unassailable expectation is that health care is provided by the employer or the state. The roots of this expectation come from a freak historical accident caused by a loophole in FDRs wartime wage and price controls. Bad policy begets worse policy.

    What’s the first step to fixing health care in this country? Decouple health coverage from employment. Individuals should get the tax credit previously awarded to employers who paid for their employee’s health coverage.

    What’s the second step? Remove laws that require routine procedures to be covered by a health insurer. Requiring an insurer to pay for a foreseeable event is a complete abuse of the insurance model and can only ever lead to problems.

    At that point, we let things balance out and see what the results are. It’s got to be incremental, or else you’ll end up destabilizing people’s lives.

    Comment by Quincy — June 21, 2008 @ 1:42 pm
  9. Quincy,
    At that rate I would be in the poor house. Just what routine procedures do you think are affordable, now. If someone has to have colonoscopy every three years and blood test every three months. What would be routine to you, may not be to others. It seem that your other assumption is that most people abused the system. Quite often employers insist that you have a doctor’s note, even if you feel it is not necessary to go a doctor for a cold or some minor discomfort you had before and know what to do. Perhaps you never had an employer like that.
    The cost of the anesthesiologist for my colonoscopy cost way more than my car maintenance has in any year. This is partly what I mean by pie in the sky. Your plan is for the healthy. There is also a difference between the chronic and the catastrophic, but if the chronic is not routinely treated it can become catastrophic.

    I have said before on this blog I can’t see drugs dropping down to an affordable rate, the actual retail cost, say like from $3400/month to $100.

    Stephen,
    I wasn’t advocating anything, but I like to see a little more thought about the people who will actually need a system where they can also pay the mortgage or rent and eat. I don’t think any of you know the real cost of health care or how depressed many people wages are or that not every body is a spendthrift or knows what a budget is; as in Quincy’s assumption, car maintenance.

    While I was using Medicare, I was paying into it from my payroll taxes and plus paying for Part B. I was not looking for any free ride, but I really didn’t want to die either.

    I also have lived long enough, where in my lifetime you could pay a doctor out of pocket and for test every so often. Also heath insurance didn’t cover all hospital cost and it would take years for people to pay off those debts, but it was doable.

    Comment by VRB — June 22, 2008 @ 4:34 am
  10. spendthrift or knows what a budget is.

    correction!
    spendthrift or doesn’t know what a budget is.

    Comment by VRB — June 22, 2008 @ 4:37 am
  11. VRB -

    Your logic is simply backwards. You’re assuming that routine procedures aren’t affordable and will never be, where the truth of the matter is that routine procedures *are* affordable, but the retail price of such procedures is grossly distorted by the current insurance-for-everything model.

    Moreover, there is no pressure for technology to develop in a way that is better and cheaper in the medical sector right now. Do you know how much a 50″ plasma TV cost in 1998? Do you know how much one would cost in 2008? $22,000 and $1,200, respectively. That’s only a $20,800 off the price in a decade. It’s the same with almost every other piece of technology–the price comes down as technology improves.

    Why, then, in one sector of the economy, does this not happen? It’s a customer problem. Who’s spending who’s money? Here’s a quote from Milton Friedman on the subject:

    There are four ways in which you can spend money. You can spend your own money on yourself. When you do that, why then you really watch out what you’re doing, and you try to get the most for your money. Then you can spend your own money on somebody else. For example, I buy a birthday present for someone. Well, then I’m not so careful about the content of the present, but I’m very careful about the cost. Then, I can spend somebody else’s money on myself. And if I spend somebody else’s money on myself, then I’m sure going to have a good lunch! Finally, I can spend somebody else’s money on somebody else. And if I spend somebody else’s money on somebody else, I’m not concerned about how much it is, and I’m not concerned about what I get. And that’s government. And that’s close to 40% of our national income.

    When you look at our health care system, it’s constructed entirely of people spending other people’s money on other people. Insurance companies spend employer’s money on employees. The government spends taxpayer money on recipients of Medicare and Medicaid.

    Because of this, there’s no incentive to control costs except when shareholders or taxpayers get annoyed, and then the insurance companies and the government throw their weight around and demand to be subsidized by health care provides. So, the retail price goes up for the people who can’t afford insurance but don’t qualify for government assistance. And, before you accuse me of being pie in the sky, I’ve been in *exactly* this position and paid those retail prices, which is why I’m so interested in making sure the system gets fixed the right way.

    So this comes back to my original solution. First, take employer’s out of the damn equation. They’re just one more middle man and don’t add a shred of value.

    Second, realize that insurance is for the unforseen. The health care delivery system is a severe abuse of the insurance model that largely results in insurance companies being a middle man and subsidizing the health care of some with the money of others and not controlling costs. Can I predict that I will get an annual physical? Yes. Can I predict that I will break my leg? No. Moreover, can I predict that my employer will require a doctor’s note for a cold? No. The key here is *unforseen*.

    Now, how do we deal with chronic conditions that could flare up into being catastrophic? That’s a good question, and it’s one that has to be resolved. My first instinct is that costs for procedures will come down once there’s an economic pressure on them, somewhat mitigating the problem. Still, there needs to be some sort of transitional support.

    Put simply, we need a system better than the one we have today. It’s a mishmash of cartels and centralized planning that makes health care inaccessible to people when it shouldn’t be. Those who do have access to health care often feel powerless to control their own fates at the hands of these cartels and centralized planners. And any examination of the health care system should reveal that the cartels and the centralized planners are the problem. So why are the only solutions coming from the politicians reliant on more centralized planning?

    Comment by Quincy — June 22, 2008 @ 2:37 pm
  12. VRB, this issue is very real to me. I’m in the process of changing jobs. I found that if I covered my whole family under my employer’s plan, my insurance would go up from about $350 a month to about $600 a month. This is not an insignificant expense for my family (in fact, my children would qualify for the state’s healthcare plan but I refuse to do so on principle).

    I have found some other solutions that I believe I can live with though. I have found a high deductible family plan ($4,000 per year) with a health savings account. It’s very likely that I will select this plan because it’s about half of the cost plus I can put money away in the HSA (which has wonderful tax advantages). I would much rather put aside $100 or more a month into the HSA than put a couple of hundred dollars more into an employer plan and never have the benefit of some of the services.

    While my situation is very much different than yours, I am very aware of the high cost of healthcare (its my second highest expense to housing).

    Comment by Stephen Littau — June 22, 2008 @ 3:47 pm
  13. Quincy,

    I have noticed that the industrial and medical equivalent of commercial products cost are much higher. I know for a fact that time does not always reduced the cost. It has to do with quantity of sales rather than production cost. Consumer sales are in the millions rather than thousands and that drives the price.

    I am not bothered by my taxes paying for Medicare or Medicaid. I would not want the poor wards to come back. (You may not have seen the actual care that the “kindness of strangers” actually wrought.) BTW, Medicare has done more than insurance companies in reducing cost of some procedures, like dialysis. Medicare is not entirely free and have more restrictions than some might think.

    The one thing that I don’t like is that you can’t opt out of Medicare. You too will have to sign up at 65.

    Comment by VRB — June 23, 2008 @ 4:01 am
  14. VRB –

    Medicare/Medicaid, if it were limited in scope to only those who needed it, wouldn’t be the end of the world. (To those hard-line folks who’d be agahst that a contributor to TLP would be supporting them, I’m not. I’m saying that they’re not the root of our problem but rather a symptom.)

    The real problem is the set of laws that irrationally bind health insurance to employment and require the insuring of wholly predictable events. Get rid of them, and the access to health care would greatly expand.

    Also, as for me signing up for medicare, since I’m under 30, I’m counting on paying into it only to have it go belly up before I have any chance of recouping a dime. Now *that’s* a steal deal.

    Comment by Quincy — June 23, 2008 @ 1:01 pm
  15. Quincy:

    I’m with you on that point. It would be wrong to yank the rug out from under those who are presently relying on S.S., Medicare, and Medicaid. These things have to be phased out over time.

    I’m not much older than you so we are in the same sinking boat.

    Comment by Stephen Littau — June 23, 2008 @ 1:30 pm

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