Hazarding Morality to Rebuild American Medical Care
The medical system in the United States is a very ill patient and we all suffer from the incessant increases in prices. A plurality of US citizens have placed their hope and trust for the diagnosis and treatment of the health system into the hands of US politicians.
A good doctor will evaluate a patient’s history, assess symptoms carefully, create a differential diagnosis list, and recommend a course of therapy for the patient to consider. A bad doctor will skip steps, leap to an incorrect diagnosis, and brow-beat a patient into accepting as absolute fact the conclusions of his personal brilliance, take offense if questioned, and provide treatment for a condition the patient does not have.
In regard to the US medical system, politicians are bad doctors. They have ignored the history, misinterpreted the symptoms, made the entirely wrong diagnosis, and prescribed a contraindicated therapy that they then force the patient to take.
The politicians have jumped to the ridiculously false conclusion (and managed to convince a sufficient number of voters) that our sick medical system suffers from an inadequate supply of health insurance and this deficiency causes costs to rise. It is wrong, they tell us, for people to use expensive emergency rooms and pass on their bills to others, and that everyone therefore must be required to have health insurance to cover those costs.
Their logic fails immediately. An overwhelming majority of the population (84% or more) has had abundant health insurance for decades, and yet medical prices have inflated annually in the double digits. Of course it is not lack of health insurance that has caused medical hyperinflation. Lack of health insurance was a horrific misdiagnosis of the true disease and now the corresponding mistreatment is placing the patient at fatal risk. If these politicians were held to the standards of physicians, they would be found guilty of criminal malpractice.
Health insurance is a therapy designed to treat the symptom of “fear of financial devastation” in the event of a calamity, and used in small and appropriate doses, it can treat that fear well. It becomes at higher doses a poison, just as most medications do. The toxicity of excessive doses of health insurance results in a fatal symptom complex known as “moral hazard.”
For a good physician, it is actually easy to arrive at the accurate diagnosis of why the medical care system is sick, why the symptoms of price hyperinflation are so painful and paralyzing. The real diagnosis, the one that politicians entirely missed and refuse to examine, is indeed the poisonous toxicity of excessive health insurance and the resulting moral hazard. In the health care realm, moral hazard is when someone else pays the cost for your medical decisions. Imagine a person giving a random stranger his credit card and saying, “Buy whatever you want and don’t shop around. Just pay whatever they charge without question.” That credit card bill is going to be exorbitant as the shopper will have no incentive to contain costs and the vendor will have an incentive to price gouge. Sadly, that’s the economic state of the western medical system today. Prices skyrocket because there is neither buyer-seller negotiation nor free market discipline to keeps prices low. There is little price transparency as most patients are apathetic and expect one of two things: 1) that insurance will pay it or 2) they will get screwed by horrible bills and there is nothing they can do about it.
Moral hazard is a complete and sufficient explanation for medical price hyperinflation. Other factors often blamed such as no-risk medical liability nuisance suits are a relatively tiny factor. High technology is not at all a factor in cost increases. Have laptops and cellphones exploded in price because they are high technology items? Indeed it is the very same moral hazard that allows defensive medicine to occur and prevents price competition on high technology in medicine.
The health insurance-induced price hyperinflation makes the personal financial risks of even modest illnesses enormous. Fear encourages individuals to buy more insurance, which further worsens the systemic moral hazard. Obamacare (crafted by special interests and their political cronies) may now mandate insurance, but even before Obamacare, hyperinflated prices caused by health insurance obliged most people to obtain insurance anyway. Obamacare just codified what was already a toxic reality.
The politicians have subsidized and manipulated us for decades into a crony-government medical system, culminating most recently in mandated health insurance, which injects into the sick health care system a larger dose of the same poison that sickened it. The relevant politicians are so inherently narcissistic that they fail to recognize that their poison causes the sickness to worsen, so they throw more nasty toxins into the veins of the system, such as price controls. The patient just gets sicker of course. Why don’t the politicians just cut our veins and let it drip into a bowl? Bloodletting may not be a long discredited, but it might be less dangerous than the therapy the politicians have chosen.
To end medical hyperinflation and the associated loss of access to care, one needs to prescribe appropriate therapy that treats moral hazard. There is only one known therapy for moral hazard: we must have individual medical decisions made by the same entity that pays the bills.
In this regard, the decision we need to make is not whether the government-insurance complex or we ourselves should be paying for our medical care. The real decision is whether you want to make your own medical decisions or leave those decisions to the politicians and bureaucrats in insurance companies. If you pay, you choose. If the government-insurance complex pays, then it will choose. Those are the only two routes that put the brakes on moral hazard. Anything short of these two options will lead to ever increasing prices along with decreasing access to care.
The relative merits of unfettered free markets and socialism are pointless to debate. Instead, let’s just get to the crux of the matter. If you are willing to have the politicians and bureaucrats make your health care decisions, okay… that’s up to you. I think you are insane to trust politicians. But you certainly cannot expect the sane amongst us to accept the bureaucrats and politicians as their decision makers. We know that many or most people will want to maintain their health decisions in their own hands. And given that socialism has to be forced upon all, socialism is ruled out as an option as morally unacceptable from the very beginning.
The free market is the only rational and moral therapy for our sick health care system. Those of us who recognize that the current system is undergoing death by health insurance must not allow the government to prevent us from opting out of their mandated poison and opting into the wonders of the free market to obtain our own medical care.
And here is the exciting thing: there is some free market out there now! In their fortuitous incompetence, the writers of Obamacare accidently encouraged some free market to flourish by triggering insurance prices and deductibles to increase markedly. It has already happened in the individual marketplace and will come to the employer-paid market soon. With higher deductibles, patients will care about costs again, and that is good. There is a new free market forming to supply the new demand, but it will struggle against the government subsidized disaster of the crony medical system. The government-insurance complex is rushing to establish more barriers to freedom, such as separate deductibles for in network and out of network charges.
Now you can help the free market simply by letting it help you. Find the Free Market! Liberty.Me has published my free brief guide “Surviving Obamacare” that will introduce you to the concepts, and there are many other resources such as Sean Parnell’s website www.selfpaypatient.com. There are also wonderful resources for doctors seeking freedom from the manacles of health insurance. The Association of American Physicians and Surgeons is the place for them to start. We can fight Obamacare individually by opting out of it in many different ways, and each of us opts out, moral hazard is decreased.
When a physician misdiagnoses and maltreats a patient as egregiously as the politicians have for so many years, and now has the nerve to compel a poisonous therapy on the patient, it is time to move to another physician and hold the first physician to account. The free market is the physician that can best heal our dying health care system, make health care costs decline by 80% or more, and thus make available to the poorest in the nation the benefits of medical science. If we don’t choose the free market, there will be so much wasteful hyperinflation that only the wealthiest will be able to afford medical care. If we do choose the free market, medical care will be affordable by almost all and there will be money left to help those who still can’t.
Health insurance at the current doses prescribed by politicians is a deadly poison. Let’s take control back before the politicians commit murder.