Abject Geekery

So what would Tholan do with regard to Health Care?  I am not exactly sure, but here are some ideas  have read and I have made some embellishments of my own.

As outlined previously, I began my search to understand Health Care from a primitive prospective.  No matter how advanced we become we will never overcome our primal selves, nor should we try.  It is our primal self that rose from the great contest and became a man, the steward of all creation.

Yesterday I posted my belief that the market is the superior form of rationing, not only because it efficiently distributes scarce resources, but it does not deny people the opportunity to preserve themselves.

Before I post the skeleton of my ideas for fixing the inequities of our health care system, I must first state that the problems of health care in the United States are grossly overstated.  As pointed out by Mr. Ridley in his interview by Reason in the Friedman library, we are living 30% longer and are 3 times wealthier then we were 50 years ago.  This is significant for two reasons: modern medicine as we understand it has only existed since the development of penicillin, and people are in the prime of their productive lives longer.  There can be little doubt that much of humanities gains in science, technology, and even the understanding of ourselves can be directly attributed to medical advancement.  We will never know the full impact of our collective prosperity in the free markets of the free world.  How brief would the history of time had been if Hawking was cut down in his youth?  How far have we come standing on the shoulders of people who just fifty years ago would never had lived.

Major breakthroughs in the care premature birth including the development of artificial lung surfactant happened just months prior to my birth.  Without those advancements I would not be here today.  Without those advancements the work of my life would not be done.  Without those advancements I would not be married, nor would I have a pregnant wife.In any other country I would not have survived.  I was 27 weeks, 3lbs 10oz, and born with collapsed lungs and a heart that had failed to start.  Without the artificial surfactant my lungs would have stuck together.   I was given open heart surgery and granted a reprieve from The Reapers Scythe.  Within hours of my surgery I experienced severe cranial swelling and over the next few days dozens of cc’s of spinal fluid were drained from my tiny body.  For two month I lived in an incubator in intensive care.  I was baby Neo, still plugged into the Matrix.  When released from the hospital, I could still fit in one hand and slept in a blanket lined shoebox.

Today over 27 and 1/2 years later I am almost 100 times my birth weight (yes for those good with number that’s a very unhealthy 350lbs give or take a cheeseburger or two).  I am over six feet tall, have not noticeable defects, and suffer only from mild allergies to pet dander and some pollens and a stigmatism.  For all intents and purposes I am a perfectly normal American male.  None of this would have been possible without the health care system we are now debating so desperately on how to “fix”.

We should take note that because of doctors we live longer and more productive lives with a much higher standard of living.  That standard of living comes at a price.  What price is too much to live an extra 25 years?  I may sound disingenuous, but 1 out 5 dollars is a small price to pay for an extra 30%.  20% for 30% ?  Not bad!

But the counter argument is of course: but what if I can’t pay the extra 20%?   Work harder.  Sacrifice possessions and experiences for care and safety.  There aren’t many who truly can not afford coverage, and charity and the dole exist for those who do.  If we work harder on access and cost, fewer people will slip the cracks.

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Facet Number 1: Remove employer benefit tax benefit and transfer tax break to employee, or alternatively banish income and corporate tax all together with implementation of a national Fair Tax.  Currently the difference between individual plans and corporate collective bargaining is not as great as the public is lead to believe.  What is not understood is that employers pay 80% of the cost of the workers benefit plans.  Once this cost is known to the worker, the worker will naturally work to reduce these costs.

Facet Number 2: Transparency in provider pricing.  Doctors should be required to a) post costs for common procedures, including the medicare rates, and b) required to give a quote prior to any work being done.  Quotes should be simple to understand and communicate so that patients can easily compare with competitors.  True transparency in pricing will keep billing honest and prices lean.

Facet Number 3: Remove FDA emphasis on drug safety, renew FDA emphasis on drug approval.  This can be done by shortening and reducing drug trials to bring new drugs to market, and reducing the cost of such testing.  Also not-for-profit drug research and development may be spurred by removing trial cost for these organizations and extending patient life for these organizations with agree upon profit limits for subsequent manufacturers.  Current drug approvals and patent law are a mess.  The research costs are too high and the recovery periods are too short.  Time magazine publishes an article and has copyright for as long as 120 years.  Pfizer cures cancer and gets copyright on the drug for as little as 7 years.  Neither makes sense when the cost to create and purpose of protection are taken into consideration.  The FDA is barrier to new drug manufacturers entering the marketplace and a barrier to new drugs being introduced.  The Harry Browne argument that will always hold true is this: if a drug saves 10,000 lives a year and the government delays its introduction by 7 years, didn’t the government just kill 70,000 people?

Facet Number 4: Remove barriers to streamlining administrative process, including the claim by doctors and hospitals that a patients records are not his or her property.  All patients have a right to their medical histories.   Additionally providing protects against medical discrimination and providing for a paperless transition is essential.  The process of billing months after the fact should not be allowed to continue.  Transparency in pricing, simplification of tax code, and the other improvements should make this a simpler task.

Facet Number 5: Remove barriers to entry for doctors and allow and wider variety of practitioners.  Supply and demand dictates the desire for more professionals of all kinds, especially doctors.  Supplementing the supply of doctors with more specialists and care providers will improve the overall level of care and reduce cost.  Simply put, the government control over medical practitioners generates artificial scarcity.

Facet Number 6: Remove “standard of care” minimums on insurance plans.  If a young person wishes only to have catastrophic care, allow them too.   Allowing people more freedom in how they tailor their health care plans is essential to the system effectively managing cost.   If people want to pay out of pocket for maintenance drugs and only have insurance in case that once in a lifetime million dollar bill comes along, people should have every right to do so.

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I would like to debate these facets with people and see if they can tweek them more or less.  One thing about government is that they have no interest in solving a problem if the solution lessons government power in any fashion.  We lovers of liberty should be ever vigilant against government power grabs in whatever form the Trojan Horse is presented.

If someone makes a statement that Government should provide Health Care to its citizens, kindly remind them that if the government can giveth; the government can taketh away.  Ask them quietly if they would support government denying treatment to their family or them personally.  If they insist that the g-men would never do such a thing, inform that whenever they have had the ability to do so they always have done so.

If someone is ever bold enough to say that you are somehow being racist by not wanting “Obamacare”: frown at them, try not to cry, and tell them that it is because of what the government did to the Black men of Tuskegee that you are so adamantly against it.