MayerBlog: The Web Log of
David N. Mayer

Health Care “Rights” and Wrongs

            As members of Congress are maneuvering to pass so-called “health care reform” legislation – a major change in the nation’s laws that is overwhelmingly opposed by the American people – the critical questions in the national debate over the country’s health-care system aren’t even being asked.  (They’re certainly not being reported by the major national news outlets, who continue to act as if they’re the propaganda organs for the B.O. administration and for the Democrats who control both houses of Congress.)  Yet the health-care debate raises the most important issues facing Americans today – and arguably, the most important set of issues the nation has faced in the past half-century or more.  What’s at stake here isn’t merely the health – literally, the lives – of all Americans, but also the future of the American constitutional and economic system.   

            The health-care debate dramatically illustrates the historic crossroads at which American policy-makers find themselves today.  In one direction – the direction that Democrats in Congress and in the White House are trying to push their so-called “reform” efforts – there’s the institutionalization of European-style socialized medicine.  With it would come not only the death of the best-quality health care system in the world, but also the end of the American system of market capitalism and limited government, and the individual freedom that system makes possible.  In the other direction – the direction that a small number of courageous Republican members of Congress and a coalition of conservative and libertarian political commentators are advocating – lies true reform, in the right direction:  reform that would solve the problems of American health care by restoring and rejuvenating the free-market, capitalist system that has made American health care the best in the world.  And with that sort of real reform would come a restoration and rejuvenation of our constitutional system of limited government and the individual freedom (and responsibility) that it makes possible. 

            The issue of health care today best illustrates the fundamental truth behind the famous statement that Ronald Reagan made in his First Inaugural Address over 28 years ago, on January 20, 1981:  “In this present crisis, government is not the solution to our problem: GOVERNMENT IS THE PROBLEM” (emphasis added).  What’s wrong with health care in the United States today can be traced back to bad governmental policies and programs that have distorted the free market in health care.  The solution to those problems isn’t more government regulation, more government programs that would further distort and eventually destroy the free market.  Rather, the solution is to repeal the laws that stand in the way of allowing the free market to work.

The “Right” to Health Care, Real and Imagined

Advocates of so-called “universal health care” – that is, monopolization by the federal government of the provision of medical services in the United States – claim that such a radical move is necessary to guarantee that all persons have a “right to health care.”  And many Americans, influenced by the way left-liberal political activists and politicians (from both the left and the right) loosely talk about “rights,” naively believe that if individuals don’t already have a “right” to health care, then they ought to have such a right.  

            There is no such “right,” properly speaking.  A “right to health care,” as meant by the advocates of socialized medicine, is really a perversion of the concept of rights, as that concept is understood under the American constitutional system.  And, ironically, in their effort to guarantee this pseudo-right, the advocates of socialized medicine would bring about the destruction of the genuine right that Americans have, pertaining to health care:  their right to freedom, freedom of choice in the purchase of health-care products and services. 

            According to America’s founding principles – the philosophy of government held by the consensus of America’s founders and expressed so eloquently in the second paragraph of the Declaration of Independence – the legitimate function of government is not to “protect people” but rather to protect people’s rights.  “Rights,” properly speaking, apply to individuals (there’s no such thing as group rights, for groups have no rights); they pertain to an individual’s freedom of action, in a social context; and they are “compossible,” or capable of equal co-existence, meaning that one person’s exercise of his rights cannot conflict with another’s.   Legitimate rights are all aspects of the fundamental, natural, inalienable rights that human beings have – the rights of life, liberty, and the pursuit of happiness (including property rights).  

The so-called “right to health care,” as advocated by the proponents of socialized medicine, isn’t a legitimate right at all.  It’s a pseudo-right, one of a category of rights that advocates of a paternalistic “nanny state” have been pushing for the past century or so, including such things as the so-called “right” to housing,” or the “right” to “a job,” or to a “fair” wage.  These “welfare rights,” as philosopher David Kelley calls them, pertain not to a person’s freedom of action but to an end-result.  Moreover, such supposed rights “to X” – where X is some material thing that needs to be produced by someone else in society – necessarily involve conflicts with others’ genuine rights.  As Kelley explains in his splendid book A Life of One’s Own, 

“[W]elfare rights impose on others positive obligations to which they did not consent and which cannot be traced to any voluntary act.  If a person has a right to food, come what may, then someone else has an obligation to grow it.  If the first person cannot pay for it, someone else has an obligation to buy it for him.  A welfare right is by nature a right to a guaranteed positive outcome that is not contingent on the success of one’s own efforts.  It must therefore impose on those who can produce the goods the obligation to share them.

“Reality cannot be forced; the need to produce a good before it is consumed cannot be legislated out of existence.  Goods can only be redistributed from one person to another. . . . The price of [welfare rights] is the sacrifice of genuine liberty.” 

(Kelley, A Life of One’s Own: Individual Rights and the Welfare State (Washington, D.C.: Cato Institute, 1998), pp. 24, 75.) 

            Robert Bidinotto reveals the “moral inversion” involved in the claim that “health care is a right,” in an insightful op-ed posted on the Internet earlier this year.  He begins by doing something that many commentators on this issue fail to do – by defining terms: 

“Health care” means:  goods and services produced by doctors, nurses, hospitals medical equipment manufacturers, medicine R&D companies, pharmacies, nursing homes, etc.  To declare that one has “a right to health care” means: One has a moral-political entitlement to all these goods and services regardless of whether one pays for them.  Translated, this can only mean: One has a “right” to enslave the producers of such goods and services.  The latter, you see, have a boundless duty to provide all these things to the “rightful” claimants, regardless of compensation – or at compensation terms set unilaterally by the claimants (or by the government, acting in their name), without any corresponding right of the providers to say “No!”  The “right to health care,” in other words, denies the rights of all those who are supposed to fulfill it.”

Bidinotto adds that the advocates of the “right to health care” really aim to sever any relationship between work and reward:  “Ultimately, they are claiming an entitlement to a guaranteed existence – to a life without want, privation, or injury of any kind, regardless of one’s own actions or inactions.  In their socialist system, no matter how productive or lazy, how rich or poor, one is `entitled’ by `right’ to `equal’ benefits – or privations” (Bidinotto,  “ObamaCare’s Moral Inversion,” Sept. 13, 2009.)  In other words, advocates of such a so-called “right” seek to deny individuals both their freedom of action and the responsibility for the consequences of their actions that such freedom entails. 

            When government uses the coercive force of law to guarantee a “welfare right,” such as the so-called “right to health care,” what it’s really doing is abridging rights, properly speaking – the right to freedom and the right to property (including one’s property in one’s own body and in the wealth produced by one’s own productive efforts).  The right to freedom in health care, furthermore, includes liberty of contract:  the freedom of consumers to enter into contracts for the purchase of health-care goods and services, including health insurance, and the freedom of health-care providers, insurance companies, and other businesses to offer a variety of products and services that best fit individuals’ choices.  These are the genuine rights that would be abridged by the effort to provide “universal” health care. 

As I warned in my 2008 New Year’s essay on “The Prospects for Liberty,”  

the most serious threat posed by nanny-state fascism to individual freedom in the United States  . . . is the imminent threat – the “clear and present danger” (to borrow a phrase from early 20^th-century Supreme Court free-speech decisions) – of socialized medicine.  It’s no longer politically correct to call it socialized medicine, but that’s exactly what the advocates of so-called “universal” health-care coverage are really proposing:  government monopoly over the U.S. health-care industry.  In the name of supposedly guaranteeing a so-called “right” to health care for all Americans, what the advocates of “universal” coverage are really proposing is some form of government takeover of the U.S. healthcare industry – a takeover that will have disastrous results, not only bankrupting the country by further exacerbating the problem of rising healthcare costs, but also destroying what’s best about the U.S. system and, ultimately, endangering the lives of all Americans by taking away their only legitimate “right” with regard to health care, their freedom to enter into contracts for healthcare products and services with providers of their choice. 

The Wrongs of a Government-Run Health Care System: 

A Brief History of Socialized Medicine

Socialized medicine, although advocated by self-styled “progressive” politicians and political activists today, isn’t a new idea.  Nor is it “progressive,” in any true sense of the term.  The dream of today’s left-liberal “progressives” – “cradle-to-grave” government-provided “welfare” – really is a centuries-old idea, paternalism (the “nanny state”), adapted to the circumstances of an industrialized society.  In ancient societies government treated the poor as wards of the state; in the Roman Empire, both in the Roman West and the Byzantine East, emperors stayed in power by placating the masses with bread and circuses (literally).  The “poor law” passed by Parliament during the first Queen Elizabeth’s reign introduced government-mandated (and taxpayer-funded) poverty-relief programs into early modern English society.   

The origins of the modern “welfare state” may be traced to late-19^th-century Germany.  It was in the 1880s that German chancellor Otto von Bismarck first put into practice the concept of “social insurance”:  mandatory government programs that forced workers to pay taxes for government programs providing them with “benefits.”  National health insurance was first:  the German Reichstag in 1883 passed a bill forcing workers and employers to pay a portion of wages into “sickness funds” that had already been created as voluntary private associations.  The German government then in 1886 mandated insurance for industrial accidents (the equivalent of American “workers’ compensation” programs) and in 1889 old-age and disability pensions (the equivalent of Society Security in the United States).  The stated rationale for these programs was to “protect” workers against the costs of industrialization, but the real motive of Bismarck’s government was primarily political.  As David Kelley explains, Bismarck “wanted to curb the growing appeal of socialist parties to the workers by preempting the socialist promise of state-sponsored benefits.  He also sought to limit the growing independence of the industrial workers, who were forming mutual assistance societies, including the sickness funds, and were losing the spirit of deference to paternalistic masters.  Bismarck’s goal, first and last, was to strengthen the state by breeding dependence on it” (Kelley, A Life of One’s Own, p. 39). 

“The newly unified Germany” in the late 19^th century “did not have a deeply rooted liberal, individualist, laissez faire tradition,” Kelley notes, observing that its dominant culture was “Prussian authoritarianism.”  Bismarck adopted older paternalistic, or patriarchal traditions, to the circumstances of an industrial society, creating an absolutist state – one that, not surprisingly, a few decades later, easily morphed into the fascist “National Socialist,” or Nazi, regime of Adolf Hitler. 

The “neoliberal” thinkers and political activists in Britain and America in the early 20^th century “did not share Bismarck’s Prussian aristocratic conservatism, but they did adopt the social insurance programs he introduced,” Kelley adds (p. 40).  By the 1880s in Britain a coalition of paternalistic Tories, or Conservatives, and “pragmatic” Liberals supported expanding the already-established late-Victorian welfare state.  Sir William Harcourt, a Liberal member of Parliament, famously proclaimed in 1889, “We are all socialists now.”  When the Liberal Party came to power in 1906, it moved to create a welfare system on the German model.  Kelley notes that “Winston Churchill, after visiting Germany as head of the Board of Trade, proposed `to thrust a big slice of Bismarckianism over the whole underside of our economic system.’”  In 1908 Parliament adopted the Old Age Pension Act, providing pensions for the elderly poor – a poverty program that was replaced with a social insurance program, funded through payroll tax “contributions,” in 1925.   The National Insurance Act of 1911 instituted both unemployment insurance and mandatory “contributions” for health insurance.  During the Great Depression, these social insurance programs were further expanded under the Beveridge Plan, which created Britain’s current welfare state, including its system of socialized medicine. 

In the United States during the first two decades of the 20^th century, the so-called “Progressive” movement – a diverse coalition of various special-interest groups – agitated for bigger government, and paternalistic policies, at all levels, local, state, and federal.  Included among the ranks of “Progressive” activists were many German immigrants to sought to institutionalize in America the same sort of Bismarckian “social insurance” programs that had been created in Europe, including socialized medicine.  Yet the German model that so inspired “Progressive” activists also inspired opposition by advocates of American individualism, as Kelley observes.  “At the 1920 convention of the National Association of Manufacturers, compulsory old-age and health insurance was denounced as `one of the vicious German ideas yet existent in this country.’  M. W. Alexander of the General Electric Company argued that social insurance was out of place in a country `founded to secure individual liberty of thought and action with opportunities for working out one’s own salvation.’” (A Life of One’s Own, p. 41).  (It’s ironic that this defense of American individualism was voiced by an officer of GE, which today is the parent corporation of NBC and its affiliated cable channels, including MSNBC, which are in the forefront of the propaganda campaign in support of socialized medicine as proposed by the B.O. administration.) 

Given this history, it’s ironic that advocates of socialized medicine call themselves “progressives.”  As I more fully discuss in a previous blog essay, there’s nothing truly “progressive” about their policies; they’re really quite reactionary (see my “Reactionary Progressives,” March 16, 2006). 

In America the only government welfare programs that enjoyed political success in the early 20^th century were state-level pensions to aid widowed or abandoned mothers.  Not until the Great Depression of the 1930s, with the FDR administration’s “New Deal” programs, did the United States follow Germany, Britain, and other European countries in creating a national welfare state.  The Social Security Act of 1935 created federal pensions for the elderly and disabled as well as a system of unemployment insurance, operated by the states – with both systems funded by payroll taxes.  In addition, the act created a program of public assistance for unmarried mothers, the forerunner to the modern Aid to Families with Dependence Children (AFDC) program (now called Temporary Assistance to Needy Families). 

Socialized medicine – that is, a government-funded and –controlled health insurance program – was noticeably absent from the American welfare state created in the late 1930s.  There was little political support for socializing medicine in America because the free market – including a wide variety of voluntary mutual-aid societies providing medical insurance benefits to their members – did a remarkably effective job, empowering all Americans (including those in the working class) to have both the means and the incentive to provide for their own health care.  During World War II, however, Congress imposed wage and price controls – a governmental policy that had a profound effect on the American free-market health-care system.   Unable to effectively compete for the best workers because of the wage freeze, employers were able, under the federal tax laws, to offer their employees fringe benefits, including health insurance.  Thus began the employer-based health-insurance system that is both a strength and a weakness of modern American health care (as will be discussed more fully below).  Unfortunately, one unforeseen consequence of these federal wage-and-price controls was that they helped undermine the market, and thus eventually helped destroy, the robust system of mutual-aid societies that had so effectively provided health insurance for millions of American workers.   

Socialized medicine finally did get established in the United States with the LBJ administration’s so-called “Great Society” programs of the mid-1960s.  In 1965 Congress created two massive government health care programs – Medicare and Medicaid.  As Sally C. Pipes (president of the Pacific Research Institute) notes in her splendid book The Top Ten Myths of American Health Care: A Citizen’s Guide (San Francisco: Pacific Research Institute, 2008), socialized medicine – that is, a government-run “single payer” health-care system – is “already here” in the United States, with these two huge government programs (plus other aspects of socialized medicine also instituted in the USA, as discussed below).  They illustrate most of the disastrous problems associated with “universal” single-payer systems in Canada and Europe today.   

Medicare, the primary insurance program for Americans over the age of 65, is funded entirely by the federal government – that is, by taxpayers.  Sally Pipes reports that in fiscal year 2007, Medicare spent $427 billion, accounting for 16 percent of the federal budget.  By 2017, it is estimated to spend $884 billion, requiring a payroll tax of 6.4 percent just to keep the program afloat.  Although the program is horribly wasteful – with studies showing that Medicare officials waste as much as $1 out of every $3 the program spends – it also imposes price controls by setting low reimbursement rates for doctors and hospitals.  Because of these low reimbursement rates, many doctors are refusing to see Medicare patients, causing nearly one in three seniors to struggle in their search for a new doctor (Top Ten Myths, pp. 16-17). 

Medicaid, the insurance program for poor Americans (as well as long-term nursing home and end-of-life care for the elderly), is administered at the state level and receives about 50 to 70 percent of its funding from the federal government.  Originally set up as a safety net in 1965, Medicaid has grown into an enormous welfare program, serving 53 million Americans – some 15 million more people than those estimated to be living in poverty, and almost 10 million more than Medicare.  As Pipes summarizes Medicaid, it too “is a model of inefficiency.  And there’s an enormous amount of fraud.  The total federal state cost of Medicaid in 2007 was $338 billion and is projected to be $717 billion in 2017.”  In New York State alone, a retired chief fraud investigator estimates that as much as 40 percent of the state’s Medicaid claims are fraudulent, costing the state about $18 billion a year.  The costs of Medicaid are so out of control that it is on the verge of bankrupting state governments around the country, with outlays for Medicaid averaging 22 percent of state spending, surpassing even education as the number one drain on state budgets.  Yet attempts to control costs by imposing price controls, in the form of low reimbursement rates to doctors and hospitals (as with Medicare), have prompted just about half of all doctors to stop seeing or limiting the number of new Medicaid patients (pp. 17-18, 95, 99). 

Despite the grim realities of these failed programs, Pipes adds, the expansion of government health care continues in the United States today.  In 1997 the State Children’s Health Insurance Program (SCHIP) program was established with the goal of providing health insurance to low-income children in households with low incomes that nevertheless exceed Medicaid eligibility.  By 2008 SCHIP covered about six million children and was on the verge of spiraling out of control because the program’s funding formula gave states an incentive to add middle-income children and even adults to the SCHIP rolls.  When Congress attempted to expand the program in 2007 – seeking to offer SCHIP to families earning up to 300 percent of the federal poverty level – former President George W. Bush vetoed the bill (pp. 18-19).  However, with the support of the B.O. administration, the current Democrat-controlled Congress succeeded in expanding the program earlier this year. 

The Department of Veterans Affairs (VA) also runs a government health-care program.  “Like Medicare, Medicaid, and SCHIP, it too is trotted out as evidence that government-run health care can actually work,” Pipes reports, adding that the VA system is hardly a model for anything that’s workable.  “Thus far, the VS has proved inadequate for the many wounded veterans who have returned home from Iraq and Afghanistan.  Better suited to the needs of much older veterans from World War II, Korea, and Vietnam, the VA is simply unable to react with the speed and efficiency needed to deal with the injuries of modern warfare.”  She adds that a claim takes between 127 and 177 days to process – well above the private industry average, which is 89.5 days – and that an appeal takes a staggering 657 days (pp. 19-20). 

One additional “myth” about the modern American health care system – and the extent to which it already has been socialized – that Sally Pipes exposes in her book is the widely-held notion that America’s poor are routinely refused treatment.  She notes, “Any poor person can walk into any hospital in America and be treated for an accident, injury, or disease.  According to the federal Emergency Medical Treatment and Active Labor Act, passed in 1986, hospitals are not allowed to deny treatment to patients with no health insurance.  The costs of such care – given free to poor patients who have neither insurance nor resources to pay – are routinely absorbed into a hospital’s operating costs” (Top Ten Myths, p. 94).  

All told, the U.S. government – that is to say, American taxpayers – already pay for more than half the nation’s health care expenses.  “As lawmakers contemplate expanding that slice of the pie” – expanding these supposedly “excellent” programs to cover all Americans, “Medicare for all,” as the late Sen. Teddy Kennedy liked to call it – Pipes comments, “it’s worth noting that some European and Canadian leaders are pushing their nations to reduce the government’s role” (pp. 16, 138). 

Canada’s health-care system is frequently touted as a model by advocates for “universal” government health care, yet it is “government monopoly health care that is heartless and uncaring,” as summarized by Sally Pipes (who formerly lived in Canada, where she was assistant director of the Vancouver-based Fraser Institute, Canada’s leading free-market think tank, before coming to America to head the Pacific Research Institute in 1991 and becoming an American citizen in 2006).  In Canada today, where slightly more than 33 million people live, more than 800,000 citizens are currently on waiting lists for surgery and other necessary treatments.  Fifteen years ago the average wait between a referral from a primary care doctor and treatment by a specialist was around nine weeks; today the wait is more than 18 weeks – almost double what doctors consider clinically unreasonable.  “As Brian Day, a Canadian physician and immediate past president of the Canadian Medical Association, explained to the New York Times, Canada `is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years.’” (pp. 122-25). 

These waits are due in part to a severe doctor shortage.  When the government took over the health care system in the early 1970s, Canada ranked second among nations in doctors per thousand people.  Today, Canada ranks 24^th out of 28 countries surveyed by the Organization for Economic Cooperation and Development (OECD).  Over the past decade, about 11 percent of physicians trained in Canadian medical schools have moved to the United States, where doctors’ salaries are not (yet) negotiated, set, and paid for by provincial governments, as they are in Canada.  (Today, the average Canadian doctor earns only 42 percent of what a doctor earns in the United States.)  Many Canadians can’t even find a doctor: about 10 percent are currently seeking a primary care physician, and some provinces (Nova Scotia, for example) have actually resorted to using a lottery to determine who gets to see a doctor (pp. 125-26). 

Other severe problems plague the Canadian health-care system.  Access is limited to common medical technology:  Canada ranks 13^th (out of the 24 OECD countries) in access to MRIs, 18^th in access to CT scanners, and 7^th in access to mammograms.  And although it provides “free” health care, “the Canadian government doesn’t provide universal prescription-drug coverage.  The Canada Health Act, the federal law that guarantees health coverage, only requires each province to cover drugs delivered to patients in the hospital.  Provincial prescription drug coverage plans differ, but about two in three Canadians pay out-of-pocket for drugs.  Private insurance is also available for services not covered under the Canada Health Act” (p. 127). 

Only in recent years have Canadians legally been entitled to purchase private health insurance, thanks to a successful lawsuit by George Zeliotis, a retired salesman from Montreal, who took the Quebec government to court in challenging the constitutionality of socialized medicine.  “Faced with the prospect of waiting an entire year for a hip replacement, Zeliotis attempted to make private arrangements with his doctor, . . . to pay privately for surgery.  But that would have been illegal.  So he went to court, arguing that while his wait saved the government money, it cost him plenty in pain and endangered his life.  Zeliotis lost in two Quebec provincial courts, but the Canadian Supreme Court agreed to hear his appeal – and in June 2005, the court ruled in his favor.  The decision overturned the ban on private insurance in Quebec, opening the door to private sector participation – and legal challenges – across Canada” (pp. 127-28).  Canada’s high court found that “delays in the public health care system are widespread and that, in some serious cases, patients die as a result of waiting lists for public health care.”  As Chief Justice Beverly McLachlin wrote, “Access to a waiting list is not access to health care.” 

“The problems plaguing Canada’s health care system – long lines, lack of access to the latest technological equipment, and dwindling doctor supply – are unavoidable in a single-payer system,” Pipes observes, adding that Canada’s problems are not unique – “they’re characteristic of all government health care systems” (pp. 127-28). 

In Britain, more than one million people in need of medical care are currently waiting for hospital admission, while another 200,000 are waiting to get on a waiting list.  Each year, Britain’s National Health Service (NHS) cancels around 100,000 operations” (Top Ten Myths, p. 129).   In a recent article published in National Review, John C. Goodman reports that Britain has only one-fourth as many CT scanners per capita as the U.S., and one-third as many MRI scanners.  “The rate at which the British provide coronary-bypass-surgery or angioplasty to heart patients is only one-fourth the U.S. rate, and hip replacements are only two-thirds the U.S. rate.  The rate for treating kidney failure (dialysis or transplant) is five times higher in the U.S. for patients between the ages of 45 and 84, and nine times higher for patients 85 years or older.”  Studies show that only 5 percent of Americans wait more than four months for surgery, compared with 36 percent of Britons” (“Socialized Failure,” May 25, 2009). 

Such is the sorry record of countries that have fully socialized medicine – countries whose “universal,” or “single-payer,” government-controlled health care systems are touted by advocates of a similar system in the United States as the “model” we should emulate.

Health Care in the USA Today: 

What’s Right – and What’s Wrong

Measured by quality of care, the U.S. healthcare system is the best in the world; that’s because the portion of it that has not yet been socialized – the free-market portion that covers more than half of Americans – provides the necessary incentives for innovation in care, including new drugs and new technologies for treatment.  For example, America is much better at treating cancer than Europe or Canada:  Americans have a better survival rate for 13 of the most common 16 cancers.  The U.S. market for medical innovation is robust.  “Today, the United States is far and away the world’s leader in medical research and development.”  America produces more than half of the $175 billion of health care technology products purchased globally.  In just a three-year period, from 1997 through 1999, one hundred new drugs were launched in the United States (compared to just 43 in Canada during that same period).  Moreover, while brand-name drugs are generally more expensive in the U.S. than in countries with socialized medicine (and the price controls that accompany their systems), generics – which accounted for 65 percent of the U.S. drug market in 2007 – are dramatically cheaper in the U.S. than anywhere else in the world.  U.S. firms are responsible for almost 90 percent of new drugs worldwide.  As Sally Pipes observes, “Perhaps that’s why tens of thousands of foreigners come to the United States every year for medical treatment.  They’re usually seeking advanced and sophisticated procedures that are simply unavailable – or rationed – in their home countries” (Pipes, Top Ten Myths of American Health Care, pp. 9, 27, 55, 62, 135.) 

American health care is, indeed, costly.  In 2006 the average American spent about $7,026 per person on health care, accounting for 16 percent of GDP.  In contrast, in 1950 that cost (in 2006 inflation-adjusted dollars) was only about $500 a year – a mere 5 percent of GDP.   That’s 14 times as many dollars spent on health care in 2006 compared to 1956.  Yet, as Sally Pipes notes, we’ve gotten much value for the high cost, “an amazing return on our investment.”  Since 1950, the average U.S. life expectancy has increased by almost nine years.  From 1950 to 2000, the death rate from heart disease – America’s number-one killer – was reduced by 50 percent.  In a single decade, from 1993 to 2003, heart disease deaths dropped 22 percent.  “If you break down the cost, it comes out to just $1000 per extra year of life.  Most Americans would call that a pretty good deal.” (Top Ten Myths, pp. 22-26.) 

Pipes adds, though, “[t]his isn’t to say that we don’t need reform.  There are many inefficiencies in our health care system that are driving costs up unnessarily” (p. 29).  A significant portion of the cost problem with American health care – and particularly the high cost of health insurance – comes from existing governmental controls.  As Pipes explains, 

Over the last few decades, state and federal lawmakers have instituted a confusing patchwork of restrictions and regulations in an attempt to drive down costs.  However, these moves actually have increased health care costs and made it impossible for private enterprise to work effectively. . . .

Today, insurers who want to make health care policies available to the public have to be registered and reviewed by 50 different state insurance administrations.  Consumers are barred from purchasing policies across state lines, making it impossible for individuals and families to get the type of insurance plan that best meets their needs in terms of coverage and cost.

And most states force residents to buy one-size –fits-all insurance packages that include all sorts of services that only a small slice of the population needs.  The average state impose 38 mandates on an individual health insurance policy.  In 2007, there were 1,901 different mandates nationwide.  These extraneous mandates increase the price of basic insurance by as much as 50 percent.

(Top Ten Myths, p. 13.)  These mandated coverage requirements “severely limit the market’s ability to develop and offer inexpensive plans that meet buyers’ needs.”  Another reason why health insurance is so expensive is that the 60 percent of Americans who get their health insurance tax-free through their employer (as a result of post-World War II federal tax policy) are insulated from the true cost of health care (p. 74).  Americans generally are overinsured, using insurance to cover routine costs rather than hospitalization or other catastrophic costs for which insurance is appropriate (as explained below). 

The chief problems with the American healthcare system are basically two – the rising costs of the system overall, and the wasted time and resources devoted to paperwork and bureaucracy – and both problems would be exacerbated exponentially if the U.S. were to follow the mistaken path taken by other countries in the world, particularly Canada, the U.K., and other European nations, that have some form of government-controlled national health care.  And, inevitably, the higher costs that will result from any sort of fully socialized medicine system will lead to efforts to control costs – which will include some sort of price controls on drug companies and other suppliers of goods/services, as well as rationing of care.  That will mean an end to innovation in drugs and procedures, not only for Americans but for everyone in the world. 

Virtually all new drugs are produced in the United States because we’re the last bastion of capitalism in the health care industry today in the world; the price controls imposed by nationalized health care systems in countries like Canada and the U.K. remove all incentives for pharmaceutical companies and other healthcare companies to develop new products or procedures.  (In the medical field, research costs are enormous; companies depend on the profits they can make from the sale of new drugs, particularly during the first few years they are patented, in order to recoup those costs.  Without profits, companies would have no reason to develop new products, and so research will dry up and technologies stagnate.)  That means that some people will die, waiting for new drugs or treatments that may never come – something that happens already in the U.S. because of delays in FDA approval, and something that frequently happens in other countries with socialized healthcare systems.  And even if the appropriate drugs or procedures are available to treat people’s medical problems, there will be long delays – much like the waiting lists that currently exist for people needing organ transplants – that will jeopardize people’s health or even their lives, just as they do now in Canada, the U.K., and other countries with government-controlled healthcare systems. 

The problems already existing in the U.S. healthcare system have been caused by bad government policies since the end of World War II – bad policies that, again, would be made even worse by any form of “universal,” or socialized, medicine.  Costs are spiraling out of control in the current system because of two basic problems – over-insurance and the lack of incentives to control costs because they’re paid by third parties – and both these problems, again, would be exacerbated by socialized medicine.  

Americans are over-insured when it comes to healthcare costs.  The purpose of insurance, generally, is to cover the risks of unexpected and catastrophic costs, such as hospitalization, expensive surgeries or other treatments, or unusually expensive drugs.  Insurance isn’t supposed to cover ordinary, routine costs such as visits to a doctor’s office or common prescriptions, but Americans are used to having their medical insurance cover these costs – and therefore have no incentive to control them, because a third party (the insurance company) is paying for them – thanks to perverse U.S. tax policies.  Price controls imposed on wages during World War II prevented employers from increasing employees’ salaries, so employers began providing untaxed perks, or fringe benefits, such as health insurance, in order to compete for the best employees, at a time of labor shortages.  After the War, those ill-advise price controls, like other unfortunate wartime policies (such as income-tax withholding) remained, thus giving rise to the uniquely American system that typically ties health-insurance coverage to persons’ employment.  And which typically makes that insurance coverage far more extensive, and therefore expensive, than it ought to have been. 

Both the problems of over-insurance and inefficiency have been made worse by other perverse government policies, namely the addition of some elements of socialized medicine through government-provided healthcare for certain segments of the U.S. population:  Medicare, for elderly persons; Medicaid, for poor persons; the Veterans’ Administration healthcare system, for military veterans; and most recently, the State Children’s Health Insurance (SCHIP) program.  None of these programs, except the VA program, ought to exist, because the Constitution grants Congress no powers to provide health care or health insurance (although granting veterans’ benefits might be rationalized as “necessary and proper” powers linked to Congress’ legitimate powers to raise and support military forces).  And these programs, particularly Medicare, are hemorrhaging out of control in their costs – thanks in no small part to the former Republican-controlled Congress’s expansion of Medicare benefits to include prescription-drug coverage. 

Like Social Security – that other boondoggle of an “entitlement” program that really operates like a gigantic Ponzi scheme (see my essay “Socialist Insecurity,” Feb. 15, 2005) – Medicare is headed for a huge fiscal crisis as the Baby Boom generation retires, over the next few decades.  (80 million Americans born between 1946 and 1964 could qualify for Medicare and Social Security over the next 22 years.)  Medicare’s hospital insurance fund now pays out more than it takes in; in 2019 it’s projected to run out of funds.  Medicare’s payments for doctors and prescription drugs are projected to rise faster than the nation’s overall economic growth; and beneficiaries’ premiums, deductibles, and co-payments will rise faster than their incomes.  Fixing Medicare solely with higher taxes or cuts in spending will mean a 122% increase in the payroll tax or a 51% reduction in spending, just for hospital care, according to a recent feature article in USA Today (“Social Security Hits First Wave of Boomers,” Oct. 9, 2007).  Unfunded liability under Medicare is six times larger than under Social Security.  Looking even farther into the future, over the next 75 years, scheduled benefits for the elderly will exceed dedicated tax revenues by $33 trillion (measured in current dollars).  “Looking indefinitely into the future, the present value of the additional revenues required by Social Security and Medicare total almost $74 trillion.  To put that number in perspective, obligations to the elderly are more than six times the size of the economy and 18 times the size of the outstanding federal debt.”  (Thomas R. Saving, “$74 Trillion = Crisis,” Wall Street Journal, March 9, 2005.) 

Given the reality of the Medicare and Social Security crisis, the idea of creating yet another massive federal “entitlement” program – “universal” health care – is sheer folly. 

The “46 Million” Lie

Advocates of “universal” government health-care coverage repeatedly cite the supposed fact (according to the U.S. Census Bureau) that some 46 million Americans (sometimes the figure cited is 45 million, sometimes it’s 47 million), or about 15 percent of the people living in the continental U.S., lack health care insurance.  That alleged fact is really a myth – as close scrutiny of the allegedly 46 million uninsured people reveals. 

First, we should note that the Census Bureau itself explains that its estimate of the number of people without health insurance “more closely approximates the number of people who are uninsured at a specific point in time during the year than the number of people uninsured for the entire year.”  Thus, it’s a gross misrepresentation of this figure to cite it – as advocates of government monopoly health care do – as if all these people were permanently uninsured.  As Sally Pipes notes, “[M]any of the survey respondents who were counted as `uninsured’ may have experienced only a temporary interruption in their insurance.  And, as many know, this circumstance is quite common, especially for people who are starting their first job or who had insurance through their employer.  For those with employer provided coverage, when they quit or lose their job, they are technically uninsured.  But they are simply in transition between one insurer through their employer and another” (Ten Top Myths of American Health Care, p. 34). 

Who are these 46 million people?  They include a surprisingly wide range of people who, for various reasons, do not have health insurance, with many of them deliberately choosing to do without insurance.  Pipes notes that almost 18 million – or 38 percent – of the U.S. uninsured make more than $50,000 a year; almost 10 million of them have an income of more than $75,000 a year.  A great number of financially comfortable young Americans who are not covered by their employer choose not to purchase health insurance.  They’re known in the health care trade as “invincibles,” Pipes reports, “because they’re so sure they’re healthy and unlikely to get sick, these young singles would rather pocket their monthly insurance premiums than shell out for health care coverage” (p. 35). 

Larry Elder argues that nearly half of the 46 million uninsured fall into this category of the voluntarily uninsured, which he colorfully describes by citing the case of his 26-year-old nephew: 

“He smokes cigarettes, dates, eats out, goes to movies, and, like all young people, lives through the cell phone.

“With a slight change in priorities, he could afford health insurance, the cost of which at his age and health starts at about $100 a month.  Take a look at a Reason Foundation video (available at http://reason.tv/video/show/560.html) of interviews with a bunch of non-health-insured 20-somethings.

“These Gen Xers copped to dropping money on clothes, booze, nightlife, the latest tech gizmos and other things of interest to them.

“With a change in priorities, these young folks – far more representative of those without insurance than the forlorn husband and wife sitting on a porch swing – could both afford and qualify for health insurance.  They just consider it a low priority.”

(Larry Elder, “Why Scrap a Health Care System That 250 Million Americans Like?” Investor’s Business Daily, June 19, 2009.) 

Of the other half of the supposed 46 million uninsured persons in the U.S., another large number – according to the Census Bureau, more than 10 million of them (or almost 25 percent) – aren’t U.S. citizens, but merely residents of the U.S.  (Pipes, Ten Myths, pp. 36-37.) 

As many as 14 million of the 46 million uninsured are poor and low-income Americans who are fully eligible for existing government programs like Medicare, Medicaid, and SCHIP.  They’re just not enrolling in these programs.  (Pipes, Ten Myths, p. 37.) 

That leaves some eight million people who, as Sally Pipes characterizes them, “really do fall through the cracks.  These are the chronically uninsured working poor.  They are people who hold down jobs and struggle to support families.  They earn less than $50,000 a year, but too much to qualify for government help.  And because government is so expensive, they simply can’t afford it” – although, as Pipes adds, “they can still get emergency room care for, say, a broken leg, visit a community hospital, or a community clinic.  But they aren’t covered for routine check-ups and preventative care” (p. 39). 

“Any attempt to solve the uninsured problem should focus on this narrow slice of the 45.7-million pie,” Pipes concludes.  Unfortunately, the “reform” legislation currently under consideration in Congress does not focus on these eight million truly uninsured poor.  Yet, as Larry Elders notes in his June 19 op-ed, it is supposedly for their sake that Congress is considering a complete government takeover of the section of health care it doesn’t already run.   

Why is this so?  Because the “reformers” in Congress and the White House aren’t really interested in covering the chronically uninsured.  If they were, they’d be considering the market-based reforms – the real reforms – I discuss in the last section of this essay, below, which could easily solve the problem of extending insurance coverage to these eight million people without sacrificing a system that’s working well for virtually everyone else.  Despite the Democrat “reformers” rhetoric, however, it’s not these eight million really needy people – or the entire number of “46 million” currently uninsured people – that concern them:  it’s the entire population of 300 million Americans whose lives they want to control.  

“Universal” government health insurance isn’t about health care at all; it’s all about control – and about egalitarianism.  As the old saying goes, “If you have your health, you have everything” – and similarly, if the politicians and bureaucrats have control over citizens’ health, they would have control over everything, as well.   In the op-ed cited earlier in this essay, Robert Bidinotto quoted a Canadian who was gloating over his country’s nationalized health system, admitting, “We keep people waiting, to limit costs.  But you have to understand something about Canadians.  Canadians don’t mind waiting for elective care all that much, so long as the rich Canadian and the poor Canadian have to wait about the same amount of time” (emphasis added).  Bidinotto points out that this quotation reveals “the ugly essence of socialized medicine:  It is the envy-eaten morality of egalitarianism.” 

As Bidinotto observes, socialized medicine illustrates “the practical fallacy” behind socialism itself: 

[B]efore you can “equalize distribution,” you must first produce something to distribute.  When discouraged producers stop producing as much, what happens to the general availability of goods and services in society?  That’s the practical fallacy in socialism: It encourages unlimited demand, while discouraging supply.

The reason there are long waits for medical care in Canada and other socialized states is that there are shortages of medical-care providers.  Sick and tired of endless, unrewarded claims upon their productive energies and incomes, they have decided to stop being so shameless exploited and financially cannibalized.

(That’s why Canada has so serious a problem with a shortage of doctors, as discussed above.  That’s also why a recent survey of U.S. doctors, discussed in the section on “The Forgotten Man,” below, revealed that 45 percent would “consider leaving . . . practice or taking an early retirement” if Congress passes the Democrats’ “reform” scheme.) 

Bidinotto concludes,  

“The right to health care” is morality stood on its head.  It proclaims a moral entitlement to live as a parasite and to make unending claims upon the medical system’s productive hosts.  But there is nothing in such a system for the hosts.  Ultimately – and ironically – there is nothing in it for the parasites, either.  As fewer and fewer medical-care providers are willing to produce and offer goods and services that patients require, the only equality will be equality in misery.

The alleged virtue of equality is cold comfort when nobody can find a doctor when he needs one – or when there is no longer a single non-socialistic medical system anywhere on earth, where desperate socialists in foreign nations can go for the treatments that their egalitarian systems no longer provide them.

That is “the grim, immoral future that ObamaCare will bring us in America, too – if we allow it,” he warns  (Bidinotto, “ObamaCare’s Moral Inversion,” September 13.)

The “Forgotten Man” of Socialized Medicine   

William Graham Sumner, the great 19^th-century classical liberal, or “laissez-faire,” philosopher, wrote a splendid little book, What Social Classes Owe to Each Other, first published in 1883.  In his book, Sumner identified the common fallacy that underlay all the legislative “reforms” proposed by the “social doctors,” or (as some would call them today) the “community organizers” of his time, the Populists and Progressives of the late-19^th and early-20^th centuries.  “Their schemes . . . may always be reduced to this type – that A and B decide what C shall do for D.”  A and B are the “social doctors,” or reformers; D is “the poor man,” who is allegedly in need of government aid; and Sumner called C “the Forgotten Man,” because he’s the person whose interest is always overlooked in political discussions.  

Who is C?  He, or she (for, as Sumner reminded his readers, the “Forgotten Man” could be either a man or a woman), is the one “who is threatened by every extension of the paternal theory of government.  It is he who must work and pay” – not just for himself and his own family, but for C, the “poor man” and his family, as well.  The Forgotten Man is industrious and responsible; he practices of virtues of hard work, thrift, and prudence.  “He has behaved himself, fulfilled his contracts, and asked for nothing”; he’s the man (or woman) “who has watched his own investments, made his own machinery safe, attended to his own plumbing, and educated his own children, and who, just when he wants to enjoy the fruits of his care, is told that it is his duty to go and take care of some of his negligent neighbors.” 

Sumner’s analysis is just as relevant today as it was when he first wrote, over 125 years ago.  Whenever the “social doctors,” A and B, urge that “there ought to be a law,” supposedly to protect the “poor man,” D, the person who is overlooked – and who is truly harmed by the law – is the “forgotten man,” C.  (As I explain to my students, Sumner’s useful model applies to virtually any kind of government “welfare” program or to any law criminalizing so-called “vices,” whether it’s Social Security, federal government bailouts of Wall Street or of auto companies, or the so-called “War on Drugs,” anti-“obscenity” laws, laws criminalizing gambling or prostitution, or laws prohibiting alcohol to adults under the age of 21.  In all these examples, Sumner’s model exposes the “fallacy” – and the injustice – of government paternalism.)   

Who’s the “Forgotten Man” in the Democrats’ proposed health-care “reform” legislation?  Obviously, it’s any one of the millions of Americans – the 85 percent of Americans, or some 255 million Americans – who have some form of health insurance and are reasonably satisfied with it.  (According to a 2006 ABC News-Kaiser Family Foundation – USA Today survey, 89 percent of Americans were satisfied with the quality of their own health care.)  The “Forgotten Man” is the average American consumer of health-care goods and services who, thanks to that portion of the system that’s still funded by private health insurance, is able to access the best-quality health care in the world.  This “Forgotten Man” is also the average American who is likely to lose this superlative health care, and his own health insurance coverage, if the Democrats succeed in pushing any form of their “public option” scheme through legislation enacted by Congress. 

There’s another “Forgotten Man” in the current effort to “reform” out of existence America’s partially-free market system in health care.  It’s the physician, who will suffer – as physicians already do in Canada, Britain, and other countries that have “universal,” single-payer, government-controlled health care systems – because of the cost controls that such systems inevitably impose. 

Doctors, who already face the severe problem of the criminalization of medicine through current efforts to “crack down” on Medicare or Medicaid “fraud,” will be exposed to even more draconian laws that make it crimes for them to provide “unnecessary” healthcare services – “unnecessary,” that is, in the eyes of some government bureaucrat.  What the character of Dr. Hendricks said in Ayn Rand’s novel Atlas Shrugged, about “the forgotten man of socialized medicine,” will actually come to pass, as the best doctors will join him in going on strike: 

“I quit when medicine was placed under State control. . . . Do you know what it takes to perform a brain operation?  Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill?  That was not what I would place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. . . .  I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything – except the desires of the doctors.  Men considered only the `welfare’ of the patients, with no thought for those who were to provide it.  That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only `to serve.’ . . . I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind – yet what is it that they expect me to depend, on, when they lie on an operating table under my hands?”

Under such a system, only a fool or a fraud would ever choose to be a doctor.  So, yet another horrible consequence of socialized medicine, is that it will discourage the most able and intelligent men and women from pursuing careers in medicine – meaning that the quality of service will stagnate and deteriorate.  Yes, we will “guarantee” healthcare coverage for “our children”:  but they may have to wait a long time to see a doctor, even for urgent care, and when they finally do see a doctor, he or she is likely to be incompetent. 

It’s not surprising, therefore, that a recent survey by Investor’s Business Daily of over 1300 physicians across the USA revealed that 45 percent would “consider leaving . . . practice or taking an early retirement” if Congress passes the Democrats’ “reform” scheme.  Doctors are not fools (well, except perhaps for those white-coated goons who helped the B.O. White House provide its well-publicized photo-op in favor of “Obamacare” earlier this month).  Of the 1,376 physicians surveyed by IBD/TIPP, when asked whether “government can cover 47 million more people” for less money while improving quality,” fully 71 percent answered “no,” while only 25 percent (some of them the white-coated Obama goons, perhaps) said “yes.”  Respondents opposed Congress’s reform plan by 65 percent to 33 percent.  And when asked, “Under a government plan, do you think drug companies will have incentives to develop as many lifesaving new drugs,” 60 percent said “no.”  (“45% of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul,” Investor’s Business Daily, Sept. 15, 2009; “Poll: Doctors Fear End to Drug Innovation Under Reform,” Investor’s Business Daily, Sept. 22, 2009.) 

Finally, “universal” coverage through some sort of government-controlled healthcare system will also require – as Bill Clinton’s proposed “universal” program did in 1994, and as other countries’ nationalized healthcare systems do – that individuals are not permitted to buy, or to enter into contracts for, healthcare products or services “outside” the government-controlled system.  Such a system, in short, is truly a monopoly – and anyone who tries to circumvent the monopoly would be subject to criminal prosecution.  This is the part of “universal” coverage that even its most diehard advocates are unwilling to admit:  that it will take away all Americans’ freedom to do what they can now do, that is, to privately contract for healthcare goods or services.  That, incidentally, is the only aspect of a so-called “right to healthcare” that’s truly a “right.”  As I’ve discussed above, rights, properly speaking, pertain only to an individual’s freedom to act.  The one legitimate right that all Americans have – part of their basic liberty and property rights guaranteed by the due-process clauses of our constitutions, both state and federal – is their freedom to enter into contracts for medical goods and services.  That freedom – the one truly legitimate “right,” when it comes to healthcare, that all persons have – will be destroyed, by any system of “universal” coverage.

Restoring a Free Market in Health Care:

The Right Sort of Real Reform

As Sally Pipes concludes in the “Solutions” chapter of her Top Ten Myths of American Health Care book, “”true reform of the health care system requires less government interference – not more.  Only with a freer market can we lower costs and achieve quality universal health care” (p. 138).  Both she and political commentator Larry Elders, in his June 19 op-ed (“Why Scrap a Health Care System that 250 Million Americans Like?” I.B.D.) suggest some common-sense reforms that would help unleash the free market and make health care more affordable for all Americans: 

n  Allow greater competition among health-care providers.  Enable consumers to purchase insurance plans across state lines.  (Unlike the various Democrat plans currently under consideration in the House and Senate – including those that involve the Trojan horse of a so-called “public option,” allegedly to foster competition – this simple change could be done by Congress, constitutionally, as a proper exercise of its power to “regulate commerce among the States,” just as the Founders intended that power to be exercised – to reduce state-erected barriers to the free flow of goods and services across state lines.)   

n  Decrease costly regulations that increase the price tag of health care and insurance.  States and Congress should repeal the current mandates they impose on insurance – move away from the one-size-fits-all approach to insurance regulation – and instead allow companies to tailor insurance policies to fit Americans’ individual needs.

n  Change the tax code (again, something that Congress can do constitutionally – by undoing the damage it caused in the wake of its World War II-era wage-and-price controls), by giving individuals the same tax breaks that companies already receive when buying health coverage.  That would make individual insurance coverage “portable,” and help move the U.S. away from the costly employer-provided insurance system.

n    Expand Health Savings Accounts (HSAs), which are tax-free, interest-accruing savings accounts that can be used to pay for routine medical expensive.  They are purchased in tandem with inexpensive, qualified, high-deductible insurance policies designed to cover major health care costs.  “HSA holders can spend their money tax-free on health care, as they see fit, without asking their insurance providers for permission,” Pipes explains.  These plans “put `insurance’ back into health insurance.  Since their creation in 2003 and implementation in January 2004, HSAs have already made insurance more affordable, while giving people control over their health-care dollars.  Today, more than six million Americans have HSA-compatible health insurance plans.”  Congress should make HSAs more attractive by reducing the regulations on them.  (Instead, the Democrats’ “reform” bills currently under consideration would practically eliminate HSAs altogether.) 

n    Implement tort law reforms.  Unreasonably expensive and unjust damage awards in medical malpractice lawsuits have added significant costs to health care:  malpractice insurance can cost specialty doctors over $200,000 a year, and liability concerns prompts physicians to practice “defensive medicine” by ordering unnecessary tests, for example.  Sally Pipes reports that according to a study by the Pacific Research Institute, such costs drain $124 billion from America’s health care system.  Although Congress can do little constitutionally to reform medical malpractice lawsuits (which are largely governed by state tort law), state legislatures can enact reforms such as capping non-economic damage awards, limiting attorney fees, and clarifying standards of reasonable care.

n   Enact real reforms of Medicare and Medicaid.  Congress should start undoing the vast harm it caused to the American free-market system of health care by creating these out-of-control government monopoly programs.  As with Social Security, real reform of Medicare and Medicaid aim at gradual privatization, eventually phasing-out these government programs, allowing them to be replaced by competitive private insurance (much as the market for “supplemental” Medicare insurance now does).  The huge future costs of Medicaid for nursing-home care, for example, could help be prevented today by Congress enacting tax credits encouraging individuals to purchase long-term care insurance.  

n  Allow non-government-licensed paraprofessionals (nurse practitioners and others) – currently prevented by law from offering any medical services – to provide low-cost care.   Across the country, retail health clinics are sprouting up in large stores like Wal-Mart and Target, as well as pharmacies like CVS and in grocery chains like Kroger.  They charge reasonable fees and they’re generally open 24/7.  Lawmakers should remove whatever legal barriers prevent such real competition from being offered in the health-services industry. 

These and other market-oriented reforms, as noted above, would make health care less expensive and more accessible to Americans without destroying the good in the current American health care industry.  They’d also help forestall all the evils associated with socialized medicine – which are evident to anyone who seriously studies the actual state of “universal” care systems in countries like Canada or the U.K. 

Let’s keep the American health care system in line with our fundamental American constitutional values of limited government and individual freedom – and with our free-market capitalist economic system, which is the only just system, one in which individuals are free to get what they bargain and pay for.  A “free,” government-run system is too costly, not only in dollars but in our freedoms.  As libertarian humorist P.J. O’Rourke once quipped, “If you think health care is expensive now, just wait until it’s free.”

  | Link to this Entry | Posted Friday,  October 16, 2009 | Copyright © David N. Mayer