“Free” Care vs. Free Market Care

Welcome to andrewspublishing.wordpress.com. I have a libertarian, fiscally conservative perspective. I respect social conservatives, while respectfully disagreeing with them on some issues. Hopefully, we can forge an alliance enabling us to triumph over those with a progressive [liberal] world view. Please visit my web site: andrews-publishing.com to see excerpts from my ebook, Health Care Reform in a Free Market. I started this blog in order to generate a discussion regarding the conservative approach to health care reform as depicted in my book.

What is to be our response to the compelling, though false, sound bite of “Free Health Care for Everyone” emanating from the left wing? I have whittled it down to about 58 pages in my ebook. The status quo is neither a viable nor conservative approach. But if we cannot generate a cogent response that average people – voters – comprehend, the left will win by default.

I also hope to initiate other topic discussions in the future, such as illegal immigration & border integrity, private charity vs. governmental largess, tax reform, bridging the gap between social conservatives and libertarian conservatives to win elections, and gun rights & the Second Amendment. I hope to eventually initiate my take on these and other issues and then invite a dialogue on each.

Stuart Andrews, M.D. [AKA stubob, or stub0b (with a zero) on Twitter]

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Health Care Reform

Excerpts from Health Care Reform in a Free Market [andrews-publishing.com].

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Universal Buck-Passing: Socialized medicine never works. It can seem to work for about fifty to seventy years as true costs are hidden and construed as increases in the “cost-of-living” or as nebulous, ill-defined tax increases, rather than increased, dedicated health care costs. The concept of “price at the point of service” is important, since it is easy to assume that it represents the total cost of care. Taxes to fund the system are actually hidden, compelled pre-payments. They allow point of service fees [payments at the time of service] to be discounted or non-existent. This gives one the impression of paying less or paying nothing.

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….the “single-payer plan” results, essentially, in raising the cost of every good and service by raising payroll taxes and/or lowering take home pay via income taxes at state/provincial or federal levels, while pretending that socialized medicine is free. This is, in essence, a system of institutional buck- passing that hides, without eliminating, the true cost of care. Eventually these systems self-destruct due to the insatiable demand of a service perceived as free at the point of service; but not before creating severe shortages of the designated service.

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We need to uncouple people’s health insurance from their employers’ apron strings by establishing equity in the tax code. You should have the same tax break whether you buy your insurance directly or through the boss. In consumer-driven health care individuals would receive the same tax deductions on their personally purchased premiums as those receiving employer-generated insurance.

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The Miraculous Cure That Never Was And Never Will Be: Prescription drugs are expensive in part because innovative development costs money. The baseline costs have to be recouped. If development costs are not recovered, or if the finished product – the intellectual property of the pharmaceutical company – is simply confiscated [by government], all innovation will come to a standstill. There will be no new drugs. And no one will miss that miraculous medication that never was and never will be. Nor will any politician be blamed for destroying something that never existed, but might have through research driven by the profit motive. Having said that, there are artificial forces that further increase the price of new brand name drugs beyond their cost of production.

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Insurance: What Is It? Insurance is affordable because many people pay for protection from an unlikely, but catastrophic, risk. For home insurance “unlikely risk” would mean your home burning down, but not your windows getting dirty; for your car: collision damage, but not oil changes. Burnt homes are expensive to fix but unlikely to occur, whereas everyone washes their windows occasionally, and affordably. We try to avoid car collisions, but we all change our car’s engine oil regularly. Therefore, a fire protection [or collision repair] rider would cost a lot less than the price of rebuilding your house [or repairing or replacing your car], since all subscribers would pay a premium, but few would suffer fire [or collision] damage. On the other hand everyone would use the window washing [or oil-changing] benefit, so each individual subscriber’s premium would reflect the true cost of washing each individual subscriber’s windows [or replacing his oil]. To this add the insurer’s overhead and profit margin. There would be no savings over just buying the service outside the insurance arena – directly from the service vendor.

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[Insurance] Pools can be statistical creations unattached to geography or workplace, if insurers are able to compete among the 50 states. Even if confined to a specific state, multiple large pools can be created independently of any employer…. The issue of “portability” is a moot point when pools – and insurance for that matter – are no longer employer-generated. Changing jobs or moving across the country would no longer be a “health care decision.”

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…insurance, ideally, should cover a catastrophic event that is unlikely to occur. In a best case scenario, you’ll pay your premiums and get nothing…nothing…in return. In other words, your house won’t burn down, your car won’t crash, and you will not have a heart attack. To get your “money’s worth” from your premium payments, something bad must occur.

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Summary: I’ll first list the effective elements in creating an ideal health care system that will be first class, affordable, available, and non-inflationary, while accommodating pre-existing conditions.

Conservatives Defined

{Admittedly, these are my definitions.} There are 2 main groups of conservatiives. I call the one group “libertarian [small ‘L’] conservatives.” The other, “religious [or social] conservatives.” Together, I believe, they create the vast majority of voters in the United States; and – together – they should never lose an election. Yet they do.

The common denominator for being a conservative is a belief in small government, markedly reduced government spending, and low taxes. All conservatives worthy of the name must be fiscal conservatives, who will not advocate spending public money for unconstitutional programs that should not be under the jurisdiction of the Federal government. In this regard the most ignored amendments in our Constitution are the 9th and 10th.

  • 9th: The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.
  • 10th: The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

Both of these amendments define and limit the power and scope of the Federal government. The Feds can’t nullify or impose upon inherent individual rights just because they are not listed in the Bill of Rights, specifically. The 9th: Just because a right isn’t on the list, that does not mean that it either doesn’t exist or is excluded. The 10th: Federal powers are specifically listed in the text of the constitution. A power not listed cannot be exercised by the Feds. The Feds’ power is limited.

The only way to alter the Constitution is via a Constitutional Convention, to consider proposed new amendments. Successful passing of an amendment requires supermajority votes in the House, in the Senate, and among he states, a very tall hurdle designed to discourage frivolous tinkering.  [Alternatively, a supermajority of state legislatures can initiate the process.] The goal is to make change difficult.

Libertarian and social conservatives tend to be in agreement on most fiscal issues. They disagree on various social issues. This is why we often lose elections, as we split our efforts in half.

Issues That Unite Us

  • Low taxes and tax reform 
  • Decreased government spending
  • Reducing or eliminating [unconstitutional] entitlements and welfare
  • Maintaining a national defense second to none
  • Implementing incentives that reduce the cost of government in implementing its legitimate duties
  • Promoting private, voluntary charities to replace government largess
  • Free market health care reform
  • Border integrity and cultural stability

Issues That Divide Us

  • Gay marriage
  • Laws regarding abortion
  • The War on Drugs
  • Other mutually consenting adult behavior offensive to people of faith

These above issues will be discussed under their respective blog categories in more detail. The main point here: We should take the divisive issues off the table in order to win elections based on the issues that unite us. The social issues should be relegated to the states or to the civil society. Otherwise, our vote is split and diluted among “moderates and independents,” who often join forces with liberals. We then end up with bigger government and higher taxes. We need to debate these issues outside of the Federal election process as we focus on small government.

Contrary to Alinsky-like leftist propaganda The Tea Party’s common driving force is small government and fiscal sanity, not the divisive social issues above.