Thursday, August 6, 2009

A Few More Thoughts on the Health Care Debate

I'm still very curious about the great numbers of people who believe that a free market in health care is attainable, and that it would be something that we would even want if it was.

Let's take just a second and consider what a free market is. Here's the Wiki definition:

A free market is a term that economists use to describe a market which is free from economic intervention and regulation by government, other than protection of property rights (i.e. no regulation, no subsidization, no single monetary system, and no governmental monopolies).

Does this sound like something that has even remotely been close to existing in this country over the last 100 years or more? It sure doesn't sound like it to me. So if you're operating under the illusion that health care reform is going to take away your free market health care, wake up. That train left the station around the time we started regulating snake oil salesman.

Like it or not, if you are defending the current system, the following facts are indisputable:

1. The government regulates nearly every aspect of health care already.

2. The government is already the single largest provider of health care in the United States.

3. If your health care is not being rationed by a government bureaucrat, then it's being rationed by a corporate one, unless you are rationing it yourself.

4. If you are in the unsubsidized individual health care market (which is the closest thing to a free market there is in this country's health care system) then you are already subject to denial of care, waiting for care, fighting with a corporation who doesn't want to pay for your care, and are at risk of having your coverage arbitrarily denied when you need it the most (i.e., when a profit-driven insurance company decides that your potential costs exceed your future premiums, and send an army of lawyers to find technical reasons on your initial application to deny your coverage. Note that they will only do this if you become unprofitable; good luck asking for your money back if you never make a claim, but YOU find something wrong with your application.)

So this is the system you're defending on a free-market basis. It's truly amazing how people can continue to cover their ears and repeat "I'm not listening!" over and over again.

Please, people. Start listening!


One of the main reasons to have a market system is to be able to ration scarce goods and services. The reason to have a market-based health care system is to separate those who can pay from those who can't. So, if you're arguing for a market-based system in health care, you are essentially arguing that people who cannot afford to pay for health should not be treated. If this is your position, then arguing for a market-based health care system makes sense. If you believe this, you have either failed to think about what that means (people dying in the streets, literally) or you are basically a total asshole. And if you belong to any of the world's major religions and think this, then you should probably go back and revisit some of the important tenets of your respective religion, all of which require you to help people in need. (And yes, right-wing, Republican religious fundamentalists, that was aimed directly at you.)

But if you think that we should give people essential health care, even if they can't afford it, then the whole market system breaks down. And the debate should shift to finding ways to do this efficiently.

The system we have right now wastes billions of dollars on strategies and resources which are designed to separate you from your money, and to deny you health care when you need it most. We could probably give health care to every indigent person in the country with the money that we're wasting on lawyers and accountants and bureaucrats whose sole job it is to help companies make profits by taking in more of your money, and giving out less of their health care. But out of some blind, reflexive, unthinking loyalty to the idea of a free market which doesn't even exist, opponents of reform defend this system with covered ears while shouting down people who want to talk about facts.

It's frustrating when a child does it. But it's far worse when adults, who should know better, use this strategy to poison a debate that is this important.

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