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July 11, 2007

New Medical Reform in the Works

I'm rather nostalgic for the time when I was jaded by the loyalty to the Republican Party and I couldn't see the bleak outlook for our future. Now the veil has been lifted, and I'm scared. I am seriously scared for the future of the country, especially after reading articles like this one from a writer at the Heritage Foundation:

With the support of the Bush administration, or at least with its acquiescence, Congress appears on course to enact a huge new entitlement aimed at middle-income Americans. President Bush likely will sign whatever bill emerges. As Nancy-Ann DeParle, a Medicare administrator for President Clinton, puts it, "In signing it, as he will surely be forced to do, he will preside over the biggest expansion of government health benefits since the Great Society."

And what exactly does Congress have in mind? Oh…just an entitlement program for middle-income seniors with an expected budget of $400 billion over the next 10 years. Well, this is what people think it will cost; however, since technically it is an entitlement program, there is no definite budget for it.

Moreover, evidence from both the private and public sectors in recent years suggests that future costs will likely exceed projections. But even if they're accurate, it isn't the next 10 years that matter. It's the years after that, when the full force of the baby boom generation hits Medicare and Social Security.

Why are they doing this? Well, this time it's not to defeat the terrorists. Rather, it's to help the seniors through the tough times of old age, when they either have to choose between the heating bills or prescriptions.

Excuse me while I fetch my violin.

What Congress seems to forget is that this isn't exactly the problem they make it out to be. This, of course, on top of the fact that it isn't a problem Congress should be dealing with in the first place. The article states most seniors already have private healthcare plans, and most at reasonable prices (funny how the private market works).

To be sure, many lower-income elderly do need help. But today about three-quarters of all seniors already have private insurance against onerous costs.

Another funny mechanism of the private market is that it doesn't like regulations and controls put on it. Congress has also neglected to remember the history of the last time they tried to do something like this:

Hard lessons from the past suggest that few private plans will join the program. Mass withdrawals of plans from the existing Medicare+Choice program show what happens when Congress imposes regulations and controls in an effort to cut costs.

Adding:


When Congress last tried to provide a drug benefit that jeopardized coverage many seniors already had (in 1988) the backlash was so severe that Congress repealed the legislation within a few months.

It's ironic how in just eight years the Republican Party, who used to pride themselves in the days of Reagan on their vast knowledge of the free market, have completely rejected any philosophical or practical application of market economics. Democrats never had any sense about these things.

But rather that take a firm leadership role in the legislative process, President Bush sent Congress a framework and invited lawmakers to fill in the details. The result was predictable. The process is becoming a political feeding frenzy, in which short-term partisan advantage trumps responsible action. Today's politicians may reap the benefits, but future generations will have to pay for this unforgivable failure of leadership.

The whole "compassionate conservative" shtick Bush must be using to justify more entitlement programs is starting to cost him support. He's only got 29 percent of the nation left behind him now. Hopefully, voters will soon wizen up and put a Libertarian in office with the brains and the brawn to put America back on track.

So, with the Democrats proposing bills that will surely cause the tax burden to explode, and Republicans putting the rubber stamp on them like sheep being led to the slaughter, you can understand my trepidation about the future. One can only wonder in 20 years, how much of your paycheck you'll actually get to see before the government takes it out of your pocket to pay for mistakes like these.

Posted by Andrew Davis at July 11, 2007 11:20 AM

Reader Comments:

They just keep inventing new things for government to do. I wish these people would try their hands at private business instead of government. We might actually flourish as a nation.

Posted by: Coach Jim at July 11, 2007 01:03 PM

how abnout complete deregulation- worked for the airlines

Posted by: WTP at July 11, 2007 01:21 PM

Healthcare has, as of late, become a main concern for me politically. Of course, the best healthcare plan the government can possibly provide is getting-out-of-the-way and letting-the-free-market-handle-it. But neither the Democrats nor the Republicans will let that happen.

When one considers how many people the FDA is killing every year through regulation, and when you consider how Medicare and Medicaid have driven up medical costs making it ever-the-more hard for poor and working class citizens to get decent healthcare, one would think a sensible politician would notice these things and work to deregulate. In the very least, they should recognise that allowing free international trade of medicines would help to cut down on costs for the poor and elderly, but they remain blind to even this most basic element of economic reality. What is their solution? More government involvement, or worse yet, importing Canada's nightmarish system.

Drugs and medical care work like any other commodity, and the government-based "solutions" being offered will create scarcity for those using the programme. When I pointed this out to proponents of universal healthcare, they pointed out to me that people could still go to private healthcare providers as well, if they wish. Oh, the tragic irony! Who will be able to afford to go to private healthcare providers? The wealthy! It's the poor who suffer the most from governmemt involvement in healthcare, the very same class of citizens the proponents of universal healthcare think they will help!

Since I myself am not wealthy at all by American standards, I stand to suffer greatly from the increase in government involvement in healthcare. And when one considers the increased tax-burden that these needless regulations and bureaucracies cause, it becomes abundantly clear that the economy itself is also hurt by such government activity.

Posted by: Alexander S. Peak at July 11, 2007 05:14 PM

Thgy will never stop "inventing things for government to do" as long as it resonates with the public. We (meaning the LP) has to take
the counter-arguments to the grassroots and show why liberty is right and liberty works. (Note:
saying "that's what the Founding Fathers believed"
is a piss-poor argument easily countered with
"times have changed; they couldn't afford it in those days.")

Posted by: Creech at July 11, 2007 05:38 PM

quote from Alexander S. Peak

Drugs and medical care work like any other commodity, and the government-based "solutions" being offered will create scarcity for those using the programme. When I pointed this out to proponents of universal healthcare, they pointed out to me that people could still go to private healthcare providers as well, if they wish. Oh, the tragic irony! Who will be able to afford to go to private healthcare providers? The wealthy! It's the poor who suffer the most from governmemt involvement in healthcare, the very same class of citizens the proponents of universal healthcare think they will help!
end quote

Actually, under the proposed Universal Healthcare plan, it will be ILLEGAL to use a private provider, moreover, it will be ILLEGAL to make a cash payment to ANY healthcare provider. Everybody will be forced into the same nightmarish system and not even the rich will be able to escape, unless they want to go overseas.

Posted by: Mark B. at July 11, 2007 06:15 PM

What's the bill number? I know the SCHIP bill is to be expanded. Is that what this is?
MHW

Posted by: Michael H Wilson at July 12, 2007 09:25 AM

The bill has not been formally introduced in either house of Congress yet. Not sure when they plan on formally introducing it.

Posted by: Mark B. at July 12, 2007 12:00 PM

I think it is interesting to note that all of these people who are proposing these government "fixes" to the healthcare crisis have most likely never faced it themselves. I think it is similiar to asking someone who was born into millions how to deal with the plight of the poor. How can you fix something that you have no way of relating to?

Posted by: Matt at July 12, 2007 12:45 PM

what is sort of amusing is a debate going on between a close friend of mine and myself. he is a green party guy and i am a libertarian. due to the fact that he is quite young, at age 22, and has many serious health problems, the debate often comes to the issue of health care. he believes in completely government controlled health care and i like privatization. i've tried explaining how in a completely socialized health care system, those advanced, but costly drugs, he takes wouldn't likely exist, as industry tends to drive research. I am however unable to gain any ground. can anyone suggest a good tact to take in this debate?

Posted by: neilwetmore at July 12, 2007 01:13 PM

You're on the right track. Too bad it hasn't worked. I am facing the same issue with my local city politics. In my case, some want our currently private ambulance service to be taken over by municipal government. Different details, same argument.

When government runs business it creates 3 major effects. One, would-be business investors take their money elsewhere since government business takes it out of the private sector. Two, government run businesses exist on the tax roll, rather than contribute to it. Meaning there will be a larger tax burden on the rest of the people and businesses, moving us toward Communism. Three, government monopolies stagnate industries, since there is no motivation to innovate; private business competition urges improved efficiency.

Disagree? Have you ever stood in line 3 hours for toilet paper? I work with people that lived in the former Soviet Union, with their government-run businesses and it is absolutely true...it sucks for the people. Eventually there is a black market for everything.

Posted by: Coach Jim at July 12, 2007 01:44 PM

Neil, does your friend ever offer any ways that government controlled health care would work? Or does he just want it to be free? It won't really be free, of course, because we'd be taxed to pay for it, but in addition, like Jim says there would be a glut of demand and the same current supply of medical providers and probably even more regulations to burden the system. Will the doctors work quicker because they have more patients that they are required by law to treat? Will they be less thorough as a result? Ask your friend how it will be better? The government regulations are already the reason health insurance, medical liability insurance, and medical prodecures cost as much as they do. Ask your friend why when people living in countries with socialized medicine get truly sick they come here for treatment rather than stay in their own country where treatment is free? Perhaps because they want to get the right treatment when they need it and want it to actually help them. Free maket innovations allow that to happen. Search the internet for libertarian or free market articles about the health care industry. Have him read it, then have him try to find an article about socialized medicine and why it is better, and if it just says because people need health care remind him that does nothing to solve the supply and demand problem.

Posted by: Nick at July 12, 2007 03:37 PM

Here comes the cattle, moving along, the high end big shots get the best care due to capital hill status. The rest of us peons, well we get whatever left over. Why, we are just a bunch of stupid cattle being controlled into socialism because some people think the government is going to come and save us. Tell the green party if he forgot how Katrina was handled. There your government at work. NO THANKS!!!!

Posted by: Keep bending at July 13, 2007 12:26 AM

Great. Right now I have 2 herniated disks, a bad knee, several teeth going bad, one broken off, a tendency to get respiratory issues.... can I afford to go to the Dr. to get *any* of this taken care of? No, I haven't been able to go to the Dr. for the last decade. Yeah sure I could go to the VA and they'd fix it all.... someday. Last I checked I was looking at most of a year before they'd *begin* finding out what all was wrong, much less what to do about it. Most of a year of jumping through hoops, having to rework my schedule to conform to theirs, because if *they* schedule you an appointment and you can't make it it'll be months before your next one.
So much for that idea, I guess none of this stuff will ever get done. I'm sure as hell not putting myself at the mercy of a Dr. whose agenda is dictated by a bureaucrat.

Posted by: Sam at July 13, 2007 06:20 AM

SAM as a vet you should get better then this, I have to ask you if it's ok, what state are you in? I might be able to refer you to someone you can talk to that might help you.

And you are correct with your posting.

Posted by: VETS DESERVE BETTER at July 13, 2007 09:03 AM

This is such a complex issue but it will take several things to get done in short order. They are:

Eliminate the government restrictions that prohibit individuals from forming groups to select a health plan and get a lower premium, like businesses do.

Eliminate the government monopoly on deciding what drugs and treatments are "normal," "valid," or "legitimate." Alternative medicines and treatments should not be made taboo by our government. Many of them are beneficial.

End the drug war so people can self medicate. This is huge. Pot is the cheapest pain killer in the world and many other illegal drugs have some benefit besides pleasure. The cost of these drugs would also go down. This would also force pharmaceutical companies to work harder and more efficiently at innovating and creating cures, rather than long term life support drugs.

Allow Emergency Rooms to turn non-critical patients away. Traiging works only most of the time, not all the time. Allow them to set up after hours clinics for non-critical care. Or if a local community wants to support an after hours urgent care clinic with their tax dollars, fine, but not national. Allow charities to operate at these facilities to cover costs of the indigent. Some variation of this idea at least.

Reduce overall government spending allowing the income tax to be repealed. The extra money in people's pockets will allow many of them to afford insurance.

Fast track immigration of foreign medical providers. Maybe it;s not entirely fair, but move them to the front of the line, or at least let them in on extended visas. We need more doctors.

Limit punitive damages to reduce medical malpractice insurance costs and lawsuits. No one needs 50 million dollars for pain and suffering. A reasonable amount is OK, say 1 million tops($), but for the most part payment of corrective treatment and lost wages is a legitimate penalty and substantial retribution to malpractice. It also might make some young bright people more likely to be doctors than lawyers and that's not a bad thing.

Did I miss anything?

Posted by: Nick at July 13, 2007 10:08 AM

Sam I find that interesting as I am a disabled vet myself and have never had much problem getting taken care of. I lived in Utah for several years and was seen at the SLC VA hospital and now I am in Idaho and get seen at the Boise VA. The building are old and decrepit but the care has always been top notch and I have never had to wait more than maybe 2 months for appointments, which is not great by any means but it could be a lot worse. My wife often waits 3-4 months to get in to see a specialist of any sort and it costs us a fortune to do it.

I laughed at the Walter Reed fiasco a few months back because I was sent there 6 years ago (before there was a war) and it was a run down piece of shit then. I can only imagine how bad it is now.

Are you an Iraq war vet? I believe I was reading recently that the VA has set up a hotline specifically to address these issues. I can't remember if it was VA wide or just at Walter Reed, but it is worth looking into. I will see if I can find it this morning and post it here later.

Posted by: Matt at July 13, 2007 10:14 AM

Nick:

Just a couple of things. :)

End medical licensure. Actually end ALL licensure for that matter. Let private groups like the A.M.A. certify medical professionals for the purpose of public information. Anybody who wishes to practice medicine should be able to, it is the consumers obligation to ensure that the physician or nurse is certified by a respectable authority, such as the A.M.A. Abolish the F.D.A., allow private organizations to conduct clinical trials. However, patients should have the right to take untested medicine at their own personal risk. Place all medications on an over the counter basis. Again, the consumer should be able to make this decision at his own risk.

Posted by: Mark B. at July 13, 2007 11:32 AM

Health care is one of those issues I have trouble debating intelligently. The libertarian point, of course, is that it is wrong to take our property at gunpoint for *any* purpose, no matter how noble or effective. But we do care about the consequences of change, and so does everyone else. I appreciated Nick's ideas, all but the last two belonging to the category called "Stop Controlling Us."

I see the pattern, that government control creates lousy, unsustainable, miserable situations. I've heard lots of vets say the VA is one of the worst things that's ever happened to them. We saw New Orleans turn into a synonym for "debacle." And there are countless smaller examples, experienced most often, as Matt mentioned, by the most economically challenged, who get entangled with government programs against their better judgment.

But until we have a libertarian society, I posit, we don't *actually* know what it would be like. Maybe if I were a more sophisticated economist, I'd know some theories that seem likely. But most people I talk to don't appreciate economic theory either.

I'm libertarian; I'm willing to take the leap, despite not being certain that medical care would be better, cheaper, more accessible. But most people are not willing to change unless they have some sense of some immediate and simple, obvious gratification. I don't know how to help those people along.

Any suggestions?

Thanks!

Posted by: Kirsten at July 13, 2007 02:14 PM

The reno va has a change over of doctors, personal that is screwed up and discrimination that you wouldn't believe.
I just heard from a friend that he listen to I believe 20/20 talking about a lot of Vets are being discharged with some kind of mental disability or something that the VA will not pay for while that actually have a service connect injury that is not being documented to get va benefits. Don't quote me exact on this, A iraq war vet who has been discharged would know more about this then I would. But there is a lot of upset vet with regards to this. They are being used and then fresh blood sent in. Guess what because the government can't afford to pay for their health care, jeez, is that because they overspent on the war done wrong.

Posted by: What to do at July 13, 2007 11:11 PM

thank you nick. that should help. the only problem now is learning to explain rudimentary economics to a socialist, lol!

Posted by: NeilWetmore at July 14, 2007 11:21 AM

I think to solve the VA problem, those facilities should be eliminated and the government that employs/employed the military men and women that need medical care should be able to get treatment as worker's compensation. After all it is a job related injury or mental illness, is it not? Soldiers should be able to seek out treatment at regular hospitals with regular doctors instead of getting bogged down in a government program in a government hospital that has no incentive whatsoever to remain clean, innovative, and competitive. The hospitals and doctors can send their bills to the Treasury Department and get paid the regular fee schedule. It's a unique situation since they were sent into a hostile environment (one that normally wouldn't get covered by an insurance carrier) but that's why Congress has the power to write laws, not to regulate every little thing in the world but to handle unique scenarios and legislate accordingly.

Posted by: Nick at July 16, 2007 11:09 AM

Oh, and yes to Mark's point about licensures. An added benefit would be a removal of the administrative bureaucracy. The government's role in this scenario would be to prosecute fraud and that is all. Having the AMA handle licensure or certification may even cause a second organization to be privately set up to compete. They might end up checking each other into legitimacy and prevent a level of fraud that could occur.

The FDA never should have existed.

Posted by: Nick at July 16, 2007 11:15 AM
 


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