Tuesday, April 14, 2009

Unconstitutional Health Care: Government is the Problem

Keeping a campaign promise that faced only vague opposition (because Republicans and Democrats are equally guilty of violating the U.S. Constitution) President Obama last week set up the executive office for health care reform, stating that because the American system “suffers from serious and pervasive problems,” the new White House Office of Health Reform will steer "the federal government's comprehensive effort to improve access to health care, the quality of such care, and the sustainability of the health care system."

Facing no principled opposition, except perhaps from the lonely voice of Ron Paul, Obama is merely doing what John McCain would have done, and what George W. Bush actually did – brazenly violate the Constitution by sticking the corrupted nose of government in a place where it holds no jurisdiction or authority.

As is usually the case when the long intrusive arm of the federal government insinuates itself where it doesn’t belong, the interference can be attacked on two grounds – constitutional and pragmatic. The constitutional argument is the easy one to make, notwithstanding that no one bothers to read the document. I would direct those I so accuse to Article 1, Section 8, which explicitly states what the national government can do. (Hint: health care isn’t there).

As to the practical argument, Americans have been so successfully brainwashed into thinking that government can or should solve all their ills, that they readily look to government to remedy problems which government caused in the first place. Brezhnev once said socialism was irreversible, and to a large extent he was right. Once weaned on the public dole, Americans reflexively look to government on matters where it has no constitutional or even practical role. The great paradox is that when Americans are asked — in a purely general and philosophical way — if more government involvement is good or bad, they overwhelmingly impart an anti-government view. But when a specific problem arises in the morning affecting their lives, they invariably turn to... government.

Health care is the perfect example of a monstrosity whose problems were caused almost exclusively by government meddling.
Pointing to its myriad problems, politicians then claim that only more government intervention can solve them. As the late Harry Browne once said, “The federal government knows how to break your legs, hand you a crutch, and then say, ‘If it weren’t for government, you wouldn’t be able to walk.’”

Republicans pride themselves on having stopped Hillary Clinton’s universal takeover of the health care system in the early ‘90’s and purport to be on the vanguard of its privatization, but by and large the Republicans have acquiesced, or at least accepted the premise that government ought to have a role in health care. President George W. Bush talked more about prescription drugs than did his local pharmacist.

Right now, government spends half of every health care dollar in America — more than insurance companies, employers and individuals. Health care costs are through the roof. Health Maintenance Organizations (HMOs) are now so powerful that politicians are fighting over whose “Patients’ Bill of Rights” is more effective in protecting people from HMOs. Of course, it was government that made HMOs so powerful in the first place.

In fact, it is really no mystery how America’s health care system, once so efficient and affordable, became such a nightmare. Politicians glory in the current health care mess and have presented themselves as the potential saviors of the system. In reality, the best thing government can do is get out of the health care business altogether. Starting today.

Before the federal government intruded into health care in the 1960’s, health insurance was affordable to virtually everyone.

Hospital stays did not cost prohibitive amounts, and doctors made house calls. Removing government can restore those days, and with modern technology, health care can once again be efficient, easily accessible and affordable.

How health care arrived at its current state is directly related to original government intrusion. Subsidies pushed up the demand for medical services, while massive regulation placed suppliers out of the market. Moreover, government affects health care costs through the federal income tax code, which allows employers to deduct employee health costs from the employers’ taxable income, but does not permit employees or self-employed persons to deduct much of their medical costs. Government has also enacted laws forcing health insurance companies to cover various treatments. And general regulations have been imposed on doctors, hospitals, insurance companies and pharmaceutical manufacturers. All of these actions have caused costs to skyrocket, while doing nothing to improve care.

Government caused all these problems, then steps in to try and save the system it already so thoroughly corrupted.

There is indeed a health care crisis in America, but it is a crisis of government.

Despite the clear evidence, socialist legislators (Republicans and Democrats) want to blame the free market and create a system in the image of the disastrous European and Canadian models, where care is rationed and people wait five years for heart surgery.

Today, insurance companies have been forced to charge more than most people can afford. Before government intrusion, the poor were not wanting for medical care. There were always doctors and hospitals that could provide low-cost care. Then government invented Medicare (for seniors) and Medicaid (for the poor) and those very people are now disproportionately dependent on those services, which have proven to be bastions of waste and corruption.

When insurance companies were forced to cover every small service, instead of the extraordinary emergencies they were originally intended to cover, the prices ran up for everyone.

Just as automobile insurance is not used for oil changes, gasoline and basic repairs, health insurance was not intended to cover every
conceivable medical service.

By forcing this on companies, government drove up demand. When people realize that everything is covered, they are inclined to take full advantage. This has proven to be a financial catastrophe. Government, after creating this situation, insists on intruding further to make things even worse.

It is the height of government irresponsibility that so many senior citizens are locked into Medicare. The skyrocketing of medical costs has its genesis with the advent of Medicare and Medicaid in 1965. As even the most novice economic mind can deduce, when all sorts of additional non-emergency services are offered as part of a medical plan, with no out-of-pocket expense for the client, the demand increases, while the supply is limited by regulation. This natural inertia will result in higher prices.

The rules, guidelines and instructions for Medicare are all compiled in a tiny little package of 111,000 pages. And when President Obama and Congress promise to reform the system and make it easier to understand, to eliminate waste and corruption, and to provide more choice, Americans can bet their hospital gurneys that the true result will be a Medicare system even more complicated.

Medicare has bombarded doctors with regulations, forced them to undercharge and actually driven many out of the medical profession entirely. Some have resigned from the Medicare and Medicaid systems and refused to perform any service paid for by Medicare or Medicaid. By doing this they have been able to reduce their fees by half or more. So Medicare has run up the cost of health care — even for people who are not part of it.

The factual truth that has emerged about Medicare is that it turns down roughly 20 percent of all the care doctors deem necessary. If Medicare denies a claim, it can take a year for the patient’s appeal to be processed. If Medicare refuses a particular treatment or medical test, the patient cannot pay the doctor directly for it because if the doctor accepts the money, he would be expelled from Medicare and lose all his other Medicare patients for two years.

Moreover, because Medicare regulations are so cumbersome, ignorance of the law can land a doctor in legal trouble for an honest technical violation. The cruel fact is that senior citizens pay at least twice as much for health care than seniors paid before the creation of Medicare — even after allowing for Medicare’s contribution and adjusting for inflation.

The “Medicare + Choice” bill included demands that managed-care providers add more services without being compensated for them. So many providers were facing dreadful losses that over 100 chose to leave the Medicare system entirely, forcing over 100,000 senior citizens to find new plans.

Medicaid is a federally-sponsored program which provides health care to low income people and to nursing homes for the elderly. Though it is run by the states, 50 to 75 percent of the money comes from the federal government. Already, this is a recipe for disaster. In order to make up the difference for what the feds don’t provide, states generally raise taxes while upward price pressures generate. The states frequently exceed their budgets. Oregon instituted strict rationing of health care to bring medical costs under control. The Republican governor of Tennessee was forced to break a campaign promise and propose the first income tax in state history, citing out-of-control Medicaid costs as his reasoning.

Before 1965, the poor had access to charity hospitals, free clinics and low prices for health care.
Most people think that their own cost in Medicare and Medicaid is limited to what they pay in taxes. But the fact is that doctors, clinics and hospitals must make up for what government won’t pay by charging the customers.

In 1973, Congress passed the HMO Act which subsidized HMOs and forced any company providing employee health insurance to offer an HMO as an option. This requirement was repealed in 1995, but the special advantages acquired by HMOs became so entrenched that politicians began offering various “Patients’ Bill of Rights” plans to offset the problem they created in the first place.

Depending on the state, insurance companies may be forced to allow for various treatments that the average person will never utilize. This unfairly makes the price of coverage soar. Psychiatric treatment, chiropractors, drug abuse, alcoholism, cosmetic surgery, treatments to stop smoking, treatment for obesity, Christian Science practitioners and many other types of care are forced into policies. There is nothing inherently wrong with any of these treatments. But a person should not have to pay for coverage that they may never use.

Since every medical interest group lobbies politicians tirelessly to force its treatment to be covered by insurers, health insurance becomes more expensive. People in their 20’s and 30’s cannot afford it and make the choice of risking going without coverage. Then the same politicians who created this predicament bemoan the fact that millions of Americans are going without health coverage. So, they posture, the government must step in. And the cycle repeats itself endlessly.

Government involvement in health care, whether the form advocated by Barack Obama, Hillary Clinton, or John McCain, needs desperately to be euthanized — put to sleep forever, never to be heard from again.