Tuesday, June 23, 2009

Campaign for Liberty: Ron Paul on Healthcare


I am in agreement with Ron Paul’s assertions that our current mess in medicine is a result of government failure; that less competition drives up cost; that inflation is one of the reasons for higher prices; that malpractice insurance drives up cost; that freedom is better than coercion; that some people come to the United States for the best medical care; and that as a result of the failure of government, medical care have been at the direction of pharmaceutical, health insurance, and health management companies.

Even though I am in agreement with many of Ron Paul’s assertions, I am, however, in disagreement with some of his other assertions, or, to be more precise, those assertions need to be modified to include some facts as I see them.

The most important fact, of which I agree with Congressman Paul, is that medical care simply costs too much. However, high cost is not totally a result of government intervention, and inflation, which occurs as a resultant economic condition to our American money-based economic system, but also is caused by the unquenchable drive for profit that spirals cost upward. All sectors of the health care industry – pharmaceutical, insurance, hospitals, physicians, and other health care management and supply services – are, on the whole, more interested in profit/meeting their bottom line than in the welfare of their patients: profits first, patients second. The many healthcare associations lobbying in Washington make sure things go their way by keeping competition from flourishing, and are responsible for increasing cost beyond what they need to be.

I am in deep disagreement with Ron Paul’s view that free market enterprise can deliver universally affordable healthcare. The fact is that in American style capitalism and American style free market they cannot. They, i.e. capitalism and free market, have had the opportunity to do that, and they have not. To enact legislation that would essentially leave mandates for efficiency and cost reductions to the same capitalism and free market that brought our economy and healthcare down to the “mess” we are in, or as President Obama has said, keep the status quo, would be very irresponsible. The fact is, in opposition to Dr. Paul, is that high cost are a consequence of not just government, but of a free market without regulation, as well. Our economic quagmire, including healthcare, is a consequence of unregulated, uncontrolled market forces whose only real interest is profit. The healthcare hegemony has coerced government to write healthcare policy that has been self-serving to meet their agenda and to drive profits up.

Government mandated managed care, which is any arrangement for health care in which an organization, such as an HMO, another type of doctor-hospital network, or an insurance company, acts as an intermediate between the person seeking care and the physician, is not regulation; it is more the creation of monopoly than anything else: it reduces competition and increases cost. And, as Dr. Paul points out, increased competition will bring cost down

The fact is that patient expectations are high and that is the way it should be, but that does not mean we should have a responsibility to meet those expectations other than to provide that which has a certain level of qualitative value, is affordable, and accessible to every American. Dr. Paul is correct, patients expect to be medically treated for every condition whether it is catastrophic or for a black eye, and they want immediate accessibility, which more often than not results in high cost emergency room care. As a result, there certainly is a lot of abuse in the system, but the free market is not going to solve that peculiarity and consequently cannot solve this problem of abuse. What will marginalize this abuse will be universal coverage, incentives, and enforceable mandates or regulation.

People come to this country for the best medical care. Ron Paul is absolutely correct, however, the fact is that they come to this country for the best medical care only if they can afford it. For example, King Hussein of Jordan came to America for treatment at the Mayo Clinic in Rochester, MN, for non-Hodgkin's lymphoma. He could afford it, but it is not affordable for every Dick and Jane in America.

Healthcare is tethered and intertwined in very complex ways with government, politicians, special interest groups, health insurance, healthcare providers, and businesses that provide healthcare for their employees. Complexity even takes place in the payment for healthcare through the multiplicity of entities to whom the payment of treatment and services are rendered. After medical care, which may include test, radiological services, laboratory services, operating fees, physician fees … I have personally receive billing statements from each and every one providing care, with billing statements that are not itemized in a clear, understandable way, and what seems to be duplication of charges. This inefficiency and duplication drives cost up. We need a single payer system for healthcare, which a public healthcare plan would provide.

The healthcare proposals that I have read, and of which President Obama supports, includes choice. It even adds to an array of private insurance choices to include a government run plan: so called socialized medicine. And, there is nothing in any of the proposals that talks about an insurance of one size fits all. There is no proposal that suggest equalizing it. The public plan only calls for universal coverage and not equal coverage.

If the United States can provide a tax credit for an individual’s insurance needs, as Ron Paul suggests, why can’t the government just simply provide free healthcare for all: it would be universal, there would be no need for insurance nor a tax credit.

Freedom and liberty are not just colloquialisms, they need not be syntactically used together in sequence for they are synonymous. We need only one word: Liberty. Liberty is an inclusive word meaning freedom, independence, autonomy, emancipation, and rights. Liberty in its essence means 100% liberty 100% of the time. In America, we never have had liberty, it may be more liberty than say China but it still is not 100% liberty 100% of the time. So for Ron Paul, another politician, or anyone else to use those two words in association with their argument for free (as in freedom) market as opposed to government control or socialism is disingenuous or simply faux-naïf. Neither American style free market nor American style socialism will provide liberty, or in any other system, no matter which way you cut it. Money intrinsically is coercive, it’s a tool of manipulation, and as long as we rely on money there will never be liberty.

As an aside, not addressed by Ron Paul, those who say healthcare is not a right, fail to understand the United States Declaration of Independence, which states that every American has an inalienable right to pursue life, liberty, and happiness. In that statement, whose meaning many have attempted, and in many cases have successfully achieved, to blur, it is simply commonsensical that that declaration in its essence should include personal wellbeing. To that end, we in exercising our rights within our federal republic and through our elected officials, who we have elected to pursue those rights on our behalf, have no other choice than to consider wellbeing as an essential component to our inalienable rights, which includes healthcare.

Additionally, Ron Paul and all members of congress are not concerned over their personal healthcare benefit, for it is, as some have called it, the Rolls Royce of healthcare, as addressed in the following article:

Health Care for U.S. Congress
Politicians Receive the Country’s Best Care - at Taxpayers' Expense

An excerpt from the article:

While over 46 million Americans remain uninsured and millions more underinsured, members of Congress receive health-related services that many in the U.S. will never see.

Few would deny that a health care crisis looms large in the U.S. In a country with millions of uninsured and underinsured citizens, health care has become more a privilege than a right. Indeed, the United States remains the only industrialized country in the world that doesn’t guarantee health care to all its citizens.

But this isn’t the case for members of the U.S. Congress. Representatives and Senators alike receive some of the best health care benefits in the country, much of it paid for with taxpayer dollars. Yet these same members seem unable - or unwilling - to extend similar protections to the rest of America.

Congress, our senators and representatives, in fact receive socialized medicine (meaning to place under government or group ownership or control.) The fact is that you and I pay for 75 % of their healthcare premium. It is with deep disappointment that they hypocritically complain about a public plan not to be in the best interest of America, and what it may cost the taxpayer. Healthcare insurance is costing Americans, the American taxpayer, a bundle now.

Those who say that a public insurance plan will put insurance companies out of business are simply being dishonest. The fact is that if our system of healthcare remains as it is, and individual and group policy choices essentially remain unchanged, the introduction, or increase of competition, of a public plan will benefit Americans. Americans will have a choice from the Rolls Royce to the generic choice of healthcare coverage. Americans will have the benefit of increased competition, which will reduce cost. The insurance industry will have to meet the efficiencies of a public plan by reducing cost to be in competition, which will benefit Americans; or if the public plan turns out to be costly and inefficient, the American style of free market will prevail and Americans will not opt for that choice. Either way a public plan option will only benefit Americans. Insurance companies are simply showing their true colors when they say, essentially, that a public healthcare plan will drive them out of business.

President Obama’s press conference of today, as well as every healthcare message he has delivered, says it all: healthcare coverage that is universal, accessible, and affordable. Is it socialized medicine.? Yes! But it’s not as if we don’t currently have de facto, if you will, socialized medicine, in that there is government intervention in healthcare as it exists today. Republican’s will opine that President Obama is moving towards socialism without realizing -- are ignorant of it, or are putting up a smoke screen when they rhetorically turn socialism into Marxism -- that America has always had its own unique form of socialism. Sometimes it takes the form of the democrat’s style of socialism, and sometimes it takes the form of the republican’s style of socialism, but either way it is still socialism.

Additional reading:

Health care as good as Congress gets? Well . . .
By John Barry, Times Staff Writer

Bleeding the Patient: The Consequences of Corporate Healthcare, by David Himmelstein M.D., Steffie Woolhandler M.D., M.P.H. with Ida Hellander M.D.