In their desire for less expensive, higher quality, more accessible health care, Americans have accepted a false alternative: fully regulated, socialized medicine, as advocated by Democrats, or semi-regulated, semi-socialized medicine, as advocated by most Republicans. But if Americans want better health care, they must come to recognize that government intervention, great and small, is precisely to blame for America’s health care ills. And they must begin to advocate a third alternative: a steady and uncompromising transition toward a rights-respecting, fully free market in health care.
In order to see why this is so, let us first consider the unfree, rights-violating nature of American health care today.
Under our current semi-socialized health care system (which both Democrats and Republicans created), the government violates the rights of everyone who provides, purchases, insures, or needs health care. It violates the rights of doctors by forcibly subverting their medical judgment to the whims of government bureaucrats or to the heavily regulated insurance companies; it violates the rights of citizens in general by forcing them to buy insurance with a mandated set of benefits; it violates the rights of insurers by prohibiting them from selling plans of their design to customers of their choice at prices they deem economically appropriate; it violates the rights of pharmaceutical companies by forcing them to conduct trials that, in their professional judgment, are unnecessary; and it violates the rights of suffering and dying patients who wish to take trial medications but are forbidden to by law.
These instances merely indicate the numerous ways in which the government violates the rights of health care participants, but they are enough to draw the conclusion that Americans are substantially unfree to act in accordance with their own judgment—a fact that alone is sufficient reason to condemn our current system as immoral. But, as we shall see, the immoral nature of the current system is also precisely what makes it impractical. The system is in shambles because of these rights violations, a fact that will bear out on examination of the three aspects of health care of most concern to Americans: its cost, its quality, and its accessibility. . . .
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1 Patrick Johnston, “The Wrong Whipping Boys,” Los Angeles Times, March 29, 2010. http://articles.latimes.com/2010/mar/29/opinion/la-oe-johnston29-2010mar29. Accessed April 4, 2010.
2 David Gratzer, The Cure: How Capitalism Can Save American Health Care (New York, NY: Encounter Books, 2006), p. 26.
3 See Lin Zinser and Paul Hsieh, “Moral Health Care vs. ‘Universal Health Care’,” The Objective Standard, vol. 2, no. 4, Winter 2007–2008.
4 David Goldhill, “How American Health Care Killed My Father,” The Atlantic, September 2009. http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/1/?. Accessed April 2, 2010.
5 Lawrence P. Casalino, Sean Nicholson, David N. Gans, et al., “What Does It Cost Physician Practices to Interact With Health Insurance Plans?,” Health Affairs, 2009, vol. 28, no. 4, pp. w533–w543.
6 Joanne Silberner, “Doctors Say Current System Impedes Medical Care,” All Things Considered, National Public Radio, June 15, 2009. http://www.npr.org/templates/story/story.php?storyId=105419421&ps=rs. Accessed April 26, 2010.
7 Paul Hsieh, “Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America,” The Objective Standard, vol. 3, no. 3, Fall 2008, pp. 39–41.
8 Kay Lazar, “Bay State Health Insurance Premiums Highest in Country,” Boston Globe, August 22, 2009. http://www.boston.com/news/health/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_country/. Accessed April 4, 2010.
9 State of New Jersey Department of Banking & Insurance, “NJ Individual Health Coverage Program Buyer’s Guide: Delivery Systems.” http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcguide/delivery.html. Accessed April 4, 2010.
10 Steven Malanga, “To Cut Your Health Insurance Costs, Move,” Real Clear Markets, October 21, 2009. http://www.realclearmarkets.com/articles/2009/10/21/to_cut_your_health_insurance_costs_move_97463.html. Accessed August 5, 2010.
11 The fee the FDA charges a drug company just to review its application for approval of a product is $1.5 million, not to mention the millions of dollars drug companies spend preparing literally truckloads of paperwork for the application. These costs piggyback on top of the millions spent to conduct clinical trials to the FDA’s liking, including bureaucratic approval at every step of the process. It is impossible to tell just how much eliminating the FDA would lower drug development costs, but the impact would be substantial.
12 Stella Daily, “How the FDA Violates Rights and Hinders Health,” The Objective Standard, vol. 3, no. 3, Fall 2008, p. 102.
13 Andrew Pollack, “Despite Billions for Discoveries, Pipeline of Drugs Is Far From Full,” New York Times, April 19, 2002. http://www.nytimes.com/2002/04/19/business/despite-billions-for-discoveries-pipeline-of-drugs-is-far-from-full.html?pagewanted=1. Accessed April 4, 2010.
14 Russell J. Moore, “Blue Cross plans to transform reimbursement so as to incentivize physicians, members,” The Warwick Beacon, August 26, 2010. Available at: http://www.warwickonline.com/view/full_story_news/9287134/article-Blue-Cross-plans-to-transform-reimbursement-so-as-to-incentivize-physicians--members?instance=secondary_stories_left_column. Accessed August 28, 2010.
15 Andrea Fuller, “For Doctors in Congress, Little Harmony on Health Care,” New York Times, July 11, 2009. http://www.nytimes.com/2009/07/12/us/12docs.html?scp=10&sq=refuse%20to%20accept%20medicare&st=cse. Accessed April 4, 2010.
16 For a fuller discussion of how government intervention directly and indirectly creates incentives for a doctor to provide less than the best care of which he is capable, see Paul Hsieh, “Government-Run Health Care vs. the Hippocratic Oath,” The Objective Standard, Spring 2010, Vol.5, No.1, pp.33-40.
17 Scott Riccio, “No More Death by Federal Red Tape,” San Francisco Examiner, March 25, 2009. http://www.sfexaminer.com/opinion/No-more-death-by-federal-red-tape-41877862.html. Accessed September 3, 2010.
18 Hsieh, “Mandatory Health Insurance,” p. 41.
19 Massachusetts Office of Health and Human Services, “Study Reveals Health Insurance Coverage Rates in Massachusetts Holding Steady at More Than 97%.” http://www.mass.gov/?pageID=eohhs2pressrelease&L=1&L0=Home&sid=Eeohhs2&b=pressrelease&f=091014_uninsured_survey&csid=Eeohhs2. Accessed April 11, 2010.
20 Hsieh, “Mandatory Health Insurance,” p. 42.
21 Terry Jones, “45% of Doctors Would Consider Quitting if Congress Passes Health Care Overhaul,” Investor’s Business Daily, September 15, 2009. http://www.investors.com/NewsAndAnalysis/Article.aspx?id=506199. Accessed April 11, 2010.
22 “Dr. Galt,” Investor’s Business Daily, April 5, 2010. http://www.investors.com/NewsAndAnalysis/Article.aspx?id=529344. Accessed August 5, 2010.
23 Grace-Marie Turner, “Doctors Fleeing Profession, Medicare Faster,” Orange County Register, July 23, 2010. http://www.ocregister.com/opinion/medicare-259117-doctors-patients.html. Accessed August 5, 2010.
24 The government, however, continues to target cosmetic medicine for taxation in order to pay the cost of universal health insurance.
25 Ha T. Hu and Jessica H. May, “Self-Pay Markets In Health Care: Consumer Nirvana Or Caveat Emptor?,” Health Affairs, February 6, 2007. http://content.healthaffairs.org/cgi/content/full/hlthaff.26.2.w217v1/DC1. Accessed August 25, 2010.
26 Gratzer, The Cure, p. 36.
27 Natasha Singer, “For Top Medical Students, an Attractive Field,” New York Times, March 19, 2008. http://www.nytimes.com/2008/03/19/fashion/19beauty.html?_r=3&sq=dermatology%20residents&st=cse&adxnnl=1&scp=1&adxnnlx=1269795617-D0ks1FPHK4C1GnKKW8BTVA. Accessed April 5, 2010. Note thet this is also an example of market distortion induced by government regulation. Dermatology and cosmetic medicine currently attract many medical students who desire to work less and make more money, but who are not necessarily passionate about those areas of medicine. In a fully free market, the ability to make money in other areas of medicine would increase, causing future doctors who love those fields to enter them instead of a field that attracts them simply because it is less encumbered with regulations.
28 Susan J. Lander, “Long Appointment Waits May Signal Doctor Shortage,” American Medical News, June 1, 2009. http://www.ama-assn.org/amednews/2009/06/01/prse0601.htm. Accessed April 5, 2010.
29 Gratzer, Cure, pp. 2–3.
30 “The Separation of Health and State,” Wall Street Journal, April 6, 2010. http://online.wsj.com/article/SB10001424052702304017404575166092921269652.html?mod=WSJ_Opinion_AboveLEFTTop. Accessed April 6, 2010.
31 U.S. Food and Drug Administration, “Antiretroviral Drugs Used in the Treatment of HIV Infection.” http://www.fda.gov/ForConsumers/byAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm118915.htm. Accessed April 10, 2010.
32 General hospitals argue that specialty hospitals must be prevented from taking away from them profitable procedures that cover the cost of unprofitable services they must offer, such as emergency-room care for the indigent. Under a free market, general hospitals would be free to set their own rates rather than being forced to offer free or below-cost care—thus freeing a general hospital both to set lower rates for procedures on which it competes with specialty hospitals and also to stop offering care at rates that cause it to lose money.
33 Pamela Lewis Dolan, “Retail Clinics Attracting Legislator Interest,” American Medical News, March 4, 2009. http://www.ama-assn.org/amednews/2009/03/02/bisg0304.htm. Accessed April 10, 2010.
34 See John David Lewis, “What the ‘Affordable Health Care for America Act,’ HR 3962, Actually Says,” The Objective Standard, vol. 4, no. 4, Winter 2009–2010, pp. 31–32.