This week the Supreme Court is expected to issue its
long-awaited decision regarding the constitutionality of the "Obamacare" law. I recently
discussed absurd legal arguments by Obamacare
advocates that Congress can compel the purchase of health insurance, and the
dismal record of federal courts applying so-called "judicial
review" in protecting liberty. It is obvious that Obamacare's
legal apologists either are wholly ignorant of constitutional principles, or
wholly lawless in their blatant disregard for those principles.
Likewise, supporters of Obamacare
are willfully ignorant of basic economics. The fundamental problem with
health care costs in America is that the doctor-patient relationship has been
profoundly altered by third party interference. Third parties, either
government agencies themselves or nominally private insurance companies
virtually forced upon us by government policies, have not only destroyed
doctor-patient confidentiality. They also inescapably drive up costs because
basic market disciplines-- supply and demand, price sensitivity, and profit
signals-- are destroyed.
Obamacare, via its insurance mandate, is more of the same
misdiagnosis.
Gabriel Vidal, Chief Operating Officer of a U.S.
hospital system, sees this problem squarely in his daily work. As he explains, Obamacare
will only make matters worse because it fails to recognize that "costs
are out of control because they do not reflect prices created by the
voluntary exchange between patients and providers... like every well-functioning
industry."
Instead, "health costs reflect the distortions
that government regulators have introduced through reimbursement mechanisms
created by command-and-control bureaucracies at federal and state
levels," he continues. "But it is theoretically and practically
impossible for a bureaucrat- no matter how accurate the cost data, how
well-intentioned and how sophisticated his computer program- to come up with
the correct and just price. The (doctor-patient) relationship... has been
corrupted by the intrusion of government and its intermediaries (HMOs, for
example) to such an extent that we can no longer speak of a relationship that
can produce meaningful pricing information."
Absent such pricing information, our system
increasingly resembles socialist systems with centralized price setting,
shortages, rationing, apathy, and declining quality of care. As the situation
deteriorates, fewer bright young people want to practice medicine and fewer
foreign doctors seek to immigrate.
The problem is acute and worsening. Obamacare's
third party insurance mandate is only the first step toward what the
political left really wants: a single payer government healthcare system.
Meanwhile, conservatives seem resigned to a third party
insurance system and therefore fail to present a viable alternative to the
American people. They continue to speak in terms of saving the healthcare
"system," when in fact what America needs is a rejection of all
government systems in favor of free market mechanisms.
In a free market, most Americans would pay cash for
basic services and maintain inexpensive high-deductible insurance for
catastrophic injury or illnesses only. Health insurance would be decoupled
from employment, which would unleash entrepreneurs who now fear quitting
their jobs and losing their health insurance. Costs would plummet due to real
competition among doctors, price sensitivity among patients, and elimination
of enormous paperwork costs. Doctors would be happier, spending their time
treating patients rather than managing their practices.
Congress needs to let markets work by aggressively
repealing healthcare laws, including: the HMO Act of 1973; the Medicare Part
D prescription drug benefit passed in 2003; and the Obamacare
bill passed in 2010. Furthermore, we must begin scaling back Medicare
coverage altogether for younger generations so they will not rely on a system
that cannot remain solvent in future decades. Only by taking these steps now
can we begin to undo the harm done by government to the once noble field of medicine.
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