By way of background concerning my view of the world of American politics. It is the libertarian point of view …
Other people are not your property.
In other words: They are not yours to boss around. Their lives are not yours to micromanage. The fruits of their labour are not yours to dispose of. It doesn’t matter how wise or marvelous or useful it would be for other people to do whatever it is you’d like them to do. It is none of your business whether they wear their seatbelts, worship the right god, have sex with the wrong people, or engage in market transactions that irritate you. Their choices are not yours to direct. They are human beings like yourself, your equals under Natural Law. You possess no legitimate authority over them. As long as they do not themselves step over the line and start treating other people as their property, you have no moral basis for initiating violence against them ‘ nor for authorising anyone else to do so on your behalf. The basic principle of civilised social intercourse was stated in 1646 by Richard Overton:
I see little value in following Democratic or Republican dogma.
- The feuding between Republicans and Democrats is an exercise in futility.
- Differences in policy are very very thin.
- Both parties stand for
- bigger government,
- stronger defense
- unfair taxation of its citizens
- If there is a feud that needs to be had
- it is one of personal liberty versus statism’s control over society
- It deals with whether or not the Government serves the people of vice versa
- It deals with whether or not Government has control and regulates its citizens
- or whether or not citizens have the right, the liberty, the freedom to do whatever they deem best for themselves as long as the rights of others are not violated,
- It deals with whether or not Government has the right to grow it’s reach, span and authority by forcefully taking money from citizens for programs that distribute those monies in an inefficient and arbitrary manner
- It deals with whether or not our constitution is to be followed giving to the people and to the states all powers that are not specifically asserted by the law of the land, the Constitution.
Looking at healthcare from this vantage point, I see little to no role of Government. If one takes the time to dissect the Affordable Care Act it is blatantly clear that the government is asserting powers that were never contemplated and certainly not authorised by the constitution. That in itself is enough to make one take a position opposing ACA. But, you might ask, how are we to control the cost of healthcare? I can say only this … healthcare costs will not be reduced under ACA. I will take on a gambler’s bet that they increase. Two arguable reasons are ones conservatives like to cite:
- the individual mandate will drive people away from voluntarily participating in the program.
- They favor instead accepting the chance of paying fines if they fail to comply and are in need of healthcare
- or they will “game the system” by joining the plan only just before they expect to use it!
- The poor are the most likely to be victimized
- the very people ACA is aimed at helping
- Unemployment will rise
- small businesses employing 50 full-time people or more will
- downsize rather than institute an employee insurance plan
- place their workforce on a part time (less than 30 hours) work week
- small businesses employing 50 full-time people or more will
Both stand the tests of logic and common sense. Both are simple matters of understanding human nature … individuals and employers need to preserve whatever treasures they have. They do what’s necessary to ensure that they preserve those treasures.
Other arguments are raised in support of ACA. Those 42,000,000 individuals currently uninsured are a huge cost to the healthcare system. Virtually all of the uninsured must use emergency room care … the most expensive form of healthcare. They use it for everything from taking care of their sniffles to a gun wound to attempting to get a prescription so they can get high on taxpayer purchased drugs. Why are costs so high? In 1986 United States Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA). It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. EMTALA applies to virtually all hospitals in the U.S but includes no provisions for reimbursement. That is why it is so expensive! Who then pays? The answers is “everyone who has coverage”. Healthcare costs are simply spread over charges made to those people capable of paying. Everyone’s costs rise and they rise dramatically? Who gets rich? I am not an expert but I am willing to bet that the insurance companies come out shining under the scenario. The hospitals themselves are complicit. Think also, about the bureaucracy that is in place to monitor compliance. Taxpayer’s pay …and pay a lot just to monitor the system! With each new requlation the bureaucracy grows as does the taxpayer’s cost to support it. Bottom line ??? … do we really think healthcare costs are reduced when we place those who would otherwise use ER care into an “insured” category? I would welcome a well supported argument that costs go down!
We’ve seen time and time again the efficacy of a government mandates … e.g., EMTALA … aimed at doing good for the poor … Is it an efficient way to run a healthcare system? Does it decrease or increase the taxpayers’ cost? Will ACA be immune to this kind of unintended consequence? Just take a look at the ACA’s objectives and one can make a pretty good guess. The act aims to provide insurance to the currently 45,000,000 ( the number may be as many or more than 55,000,000 ) uninsured. Further, it does not aim to reduce the cost of healthcare but rather to reduce the rate of increase in the cost of healthcare. Several sections of the act refer to the aforementioned cost of emergency room care brought on by EMTALA as being one of the chief cost drivers. Nothing that I have read suggests that the ACA included measures to motivate patients to stem the use of ER care. Nothing in the act suggests that participants be “invested in themselves”, to ensure they maintain healthy lifestyles. In other words, nothing in the act is aimed at reducing the real cost of healthcare. Edward Kennedy had this to say about the passage of ACA “..what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.” I take that to mean that ACA is legislation born of passion and emotion and not of logic and common sense. At least Ted Kennedy’s remarks would have you think so!
There is no one that I know who does not want to make life better for the truly uninsured poor and needy of this country. There is no one I know who will go out of his or her way to make life better for one not willing to help him or her self. Perhaps we would attempt to instill a sense of self worth and help motivate such a person to seek a more useful life. That aside, if the act is to really make life better for those in need then it should say something about how personal healthcare is to be improved by the act. It does not. It does nothing to improve healthcare per se.
While seeking background information on the subject of ACA two notions caught my attention:
- Jonathan Gruber, an influential consultant who helped develop both the ACA and the Massachusetts healthcare reform that preceded it, acknowledges that the ACA is not guaranteed to significantly “bend the curve” of rising healthcare costs.
- Insurance exchanges set up by the act are supposed to create a market for private insurance in a way that addresses market failures in the current system (such as the high number of uninsured, medical bankruptcies [the country’s second biggest cause of personal bankruptcies], coverage limits, unaffordability, inflation, etc.) through regulations.
My take is that the act does nothing more than regulate its industry by regulating procedures, processes. It really does little to reduce actual costs.
For example, insurance companies’ profits and administrative costs are regulated. Insurers are required to spend 80% – 85% of premiums on health costs and claims. Failure to comply requires that they rebate the excesses to the policy holders. Regulating the insurance companies’ profits is the best way to eliminate incentives and break down the insurance industry’s competitive climate.
If the aim of ACA is to reduce costs while expanding coverage, then let the real free market dynamic go to work. The current healthcare system long ago left the free market system. By free market is meant businesses competing on an even terrain absent the regulations that favor one firm over another. It means putting an end to corrupt practices of firms using lobbyists to create for themselves or their industry a favorable business climate. It means full transparency of “cost based” hospital charges for drugs and procedures. Gone will be the $5.00 aspirin. The $14,000 MRI procedure … gone too. Gone will be the costly trend toward non-profit Hospital monopolies and medical staffs that are more and more invading the medical field.
The answers to helping to bring healthcare to the legitimate poor, to the helpless children and to the truly needy are not within my ability to know. What I do know is that the answer lies not in big government, not in bureaucracy building, not in regulations and not in throwing more money after the problem. It lies in what I like to believe is a truly free market system free of the corruption that we experience in today’s Crony Capitalistic system. If the right people are asked to define today’s healthcare system with all of its warts and blemishes ,then dream of an ideal replacement … an effective system will be born. It will profit both sides. The needy will be properly served. The provider will be properly compensated. The Government’s only role will be to see to it that both sides have the freedom and liberty to follow their preferred course as long as they don’t trample on the liberty and freedoms of others … and to follow the mandate … “Other People are not your Property“.
We have a precious few in Congress that believe in these tenets. They are the ones being reviled by both side of the aisle. I have seen them alive at the podium. I have heard them speak. I have been impressed with their integrity, their intellect and their conviction. I have seen them impact legislation for the cause of liberty and freedom. If we really care about what is happening in our nation, we will be active in helping them push the legislative system for the cause of personal liberty. What I am trying to convey, whether it is coming through my ramblings above or not, is that we can make our thoughts and dreams come to fruition. You and I can improve healthcare for everyone … Government can’t and shouldn’t try. All we need to do is speak out. Let your legislators at all levels of government know what you think is right. Help make them hurt with the pain if they fail to legislate in favor of your cause. Make a difference!
If you’ve time, I would truly appreciate your comments