“Single-Payer” Healthcare? You Mean Like the VA?

VA

On May 24th The Signal published a column by Steve Lunetta entitled “Health care free market an abject failure” (Link), and I have to take great issue with much of what Steve wrote.

He claims that “All attempts to create a ‘free market’ in health care have failed here in the United States.”

What “attempts”? How can they have “failed” when there haven’t been any to begin with? Oh, there used to be a free market in health care, but it was so long ago that at 68 years of age I can barely remember it. The only thing that’s been “attempted” in the last five decades or so has been to exert ever more government control and regulation of that market segment.

In all the anecdotal “evidence” Steve presents in the column, one glaring element simply leaps out at me: he had an HMO, which he described as a “blessing”, and HE made the decision  to switch to a PPO, from which all his described problems arise.

If his organization is like the ones I worked for, as an employee I had a choice between either a PPO or an HMO. Didn’t he? Even if he didn’t, he certainly wasn’t forced by his employer to participate in their PPO program. So it seems to me that his problems with his health insurance provider are actually due to his own lack of due diligence, and his own decision to participate in a PPO that doesn’t meet his perceived needs.

His lack of due diligence is also illustrated by his example of allowing visits by a doctor without asking first what his own charges would be for that doctor’s services. Why would anyone do that? That’s a question I ALWAYS ask when a medical service or procedure is being contemplated.

The next problem here is that the insurance companies aren’t “making a mountain of money” as he claims. In fact, under the current structure, many are facing serious financial problems, and are withdrawing from many markets. Further in many jurisdictions, this state being one of them, insurance profits are limited by law.

Then the ultimate sin: proposing “single-payer”, which means government-run health care. You want to see how well that will work out? Take a look at the VA system for your answer. Now imagine that being the national norm.

How about we actually try some REAL free-market health care for a change? For years I’ve promoted three steps to reforming the system:

1.  Eliminate the artificial Barriers to interstate competition for health care and insurance products. Let real competition begin.

2.  Streamline the FDA approval process, which will significantly lower the cost of bringing new meds and procedures to market.

3.  Reform the medical tort system, which will lessen the costs involved in, and perceived need for, practicing “defensive medicine”.

Let’s do those three things, see how well they work, and only then see what else might be done to improve things.

Lastly, we as a society have to get away from the idea that there’s some magic bullet that will indemnify us from the vicissitudes of life. Some people are healthy until the day they drop dead; some are chronically ill for decades. That’s just the way things are. It’s no different from anything else. Some people have investments that make them rich; some people go bankrupt. Life isn’t “fair”.

But no one ever said it would be.

 

©Brian Baker 2017

 

(Published 1 June at my blog and in The Signal)

 

 

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Take the Bus?

bus

I’d like to respond to the Letter to the Editor by Nathan Bousefield, published on April 18th under the title “Need to change how we work”. In it, Bousefield asserts that if, instead of spending money on improving road and freeway capacity, we spend the money on mass transit – trains and buses – we’ll see a more significant impact on relieving road and freeway congestion.

In his letter, he focuses on one sole aspect of traffic: commuting to and from work. That’s the fatal flaw in his position.

People drive all the time for all kinds of reasons, to go to many different places to do all kinds of things.

Who’s going to take a bus, or a train, to go get a pizza? Or pick up some home improvement materials? Or visit grandma? Or see a movie? Or go to a restaurant? Or hit the mall? Or visit Vasquez Rocks or the zoo? Or take their kids to school? Or go to the beach? Or the mountains? Or skiing? Or to go grocery shopping?

Ain’t gonna happen.

There’s a reason “rush hour” is an all-day condition, including outside of normal “commute” times. The only time the roads are clear is WAY deep at night, when people have finally gone home to sleep.

Mass transit works fine in some places, typically older cities that were designed and built in the era before personal transportation became available: NYC, Chicago, Boston, DC. But those cities that boomed after the personal car became common developed along a different paradigm, centered on a less structured and less centralized environment that exploited the freedom of movement afforded by cars, and a centralized mass transit system won’t work.

Why would I spend at least 45 minutes using a bus system – in addition to having to walk to a bus stop, not one of which is at all close to my house – to go to the mall, when I can hop in the car at my front door and be there in 10 minutes? And then have to reverse the process to go back home, lugging my purchases with me?

Further, this is Southern California, the epitome and birthplace of the “car culture”. You are what you drive. Who wants to be “that guy who uses the bus”?

Nope. As I said, this is just one more example of the socialist utopian fantasy of turning people into ant colonies. The same “logic” that’s brought us the not-so-bullet-train-to-nowhere boondoggle. It’s nonsense.

 

©Brian Baker 2017

(Also published today in The Signal)

Political Finger-Painting

On April 5th The Signal published a column by Gary Horton entitled “America Has A Complex Complex” which brought a memory to mind for me.

When my daughter was a little girl she’d do finger-paintings for me. She’d sit at the table and smear random colors all over a piece of paper, and then turn to me.

“Look, Daddy”, she’d say proudly. “A sunrise!”

Of course, all I could see was paint smeared randomly all over the page.

That’s what we have with this Horton column: a little kid’s finger-painting of what’s wrong with America. It makes no sense to the person reading it. Only in the mind of the “artist” who created it do any of the shapes or colors coalesce into a meaningful whole, as they’re randomly selected and applied.

Horton’s painting of an “industrial-congressional-complex” makes as much sense as my daughter’s finger-painting of a “sunrise”, meaning none. It’s a very pretty picture, quite colorful, but not at all representative of anything in the real world.

He’s taken disparate elements of our society which he considers flaws or shortcomings in its fabric and tried to tie them together into a neat package of cause and effect. But the fatal mistake in this approach is that it ignores the benefits that derive from that very same system.

We live in a society unique in the world, with freedoms and liberty, guaranteed in our Constitution, that are unparalleled anywhere. We’ve also – whether willingly or not – been forced to assume the mantle of being the defender of those freedoms on a global scale, both for ourselves and our allies.

There are costs, both overt and hidden, that accrue to those kinds of benefits and responsibilities. That’s just the way the world works.

I know Horton, and those like him, have a utopian vision of how they think things should be. I’ve been active in politics for about five decades, and have been debating these issues for all of that time. But utopia doesn’t exist, and never will. That’s just a fact.

Any society with freedoms such as ours is going to be a messy place. Open debate, electoral politics, federalism, equal access of competing interests, free-market economics, free speech, property rights, individual responsibility, open competition… these are all concepts that, when put in practice, will naturally lead to uneven results.

Equality of outcome can only be assured by the imposition of tyranny.

So… which system would you prefer?

 

(Also published today in my local newspaper, The Signal)