Zinser and Hsieh on Health Care

Friday, December 07, 2007

The Objective Standard has just published to the web "Moral Health Care vs. 'Universal' Health Care" by Lin Zinser and Paul Hsieh. This is the most thorough and accessible pro-free market (which is to say, pro-health and pro-life) article I have ever seen on the current government-caused crises in the economy that threaten your ability to protect your life from threats to your health.

Crises? Yes. Among the many virtues of the piece is that it explicitly distinguishes between the twin catastrophes of government interference with medical insurance and government interference with the practice of medicine. Although these are related and feed off one another, the authors' approach makes it significantly easier for a reader to mentally grasp how government interference has damaged each industry and therefore, to comprehend the greater whole, which would otherwise be cognitively overwhelming. Just as the human body is an integrated whole, we must study its individual parts separately to understand it.

For example, they briefly assess the state of our medical insurance industry before moving on to explore the further difficulties presented by government-run insurance programs:

The current system of employer-sponsored health insurance is a catastrophe, and it is a result of government intervention in the free market. Such intervention violates the rights of insurance companies, employers, and consumers by granting special government favors to certain insurance companies or plans, by forcibly eliminating options that would exist in a free market, and by forcibly seizing money from insurers and the insured. It artificially places employers and insurers between doctors and patients and leads to innumerable economic distortions. Employers and insurers dictate everything from which doctors and specialists employees will be permitted to visit under the plan, to the kinds of benefits that will and will not be provided, to the co-payments and deductibles that will be paid. Because third parties are paying for both insurance and health care, the employee-patient-customer has little choice in what kind of insurance or who provides the health care he receives -- and plenty of incentive to visit a doctor anytime he has a runny nose. The fact that third parties pay for all health care increases the administrative costs for doctors as well as insurers, and those costs are passed on to consumers.
Note the explicit identification of this system as immoral and impractical, along with arguments to back up those assessments. This paragraph also foreshadows the other half of the problem: This system is making physicians unable to practice their trade as they should.

In addition to making this public debate easier to understand, Zinser and Hsieh, by examining these crises separately, name a fact that all too frequently goes unnoticed: Even ignoring Medicare and Medicaid, our medical insurance system is not currently capitalistic.
Americans typically purchase health insurance from increasingly government-controlled insurance corporations, giving health insurance in America the veneer of a free-market industry. Behind the veneer, however, the industry is subject to countless state and federal laws, regulations, and taxes -- which do not apply to all insurance companies equally.
This identification is crucial for reasons that they make abundantly clear. It will not be enough to stave off the current push for complete nationalization of medicine. We must get the government out of two industries.

This is a brilliant article and a must-read. If you do not have time to read it today, make it a point to come back to it later.

-- CAV


Mike said...

As some know, I am a senior appointee in government health care administration. My office is rather keenly aware of the universal health care topic, and most of the liberal ideologues there completely favor it. Why not, after all, since we're halfway there and they'd be the ones in charge. I know if I got to vote on whether or not I got to run things, I'd be sorely tempted to vote "yes."

However, the tenor of those arguments has changed in recent weeks. The emerging news of trans-fat bans in NY, smoking bans in private homes in CA, and such have finally forced my co-workers to confront the argument of how UHC can work if people choose to do unhealthy things and thus cost the system more money. A few dismiss the argument with a call to force, saying "we'll ban [those things] for peoples' own good." I am gratified to see, however, many of the more moderate participants in this conversation realizing the precariously slippery slope of the loss of personal freedom that portends. Time will tell.

My grandparents-in-law stridently argue that once upon a time, people could just pay their own doctor and the rates were no worse compared to the rest of their income than people today paying to maintain their car. All that was before the government barged into the health insurance industry.

Gus Van Horn said...

Your report from the bowels of the bureaucracy is interesting, especially when one compares it to the dull roar (by those who would be bossed around) I hear in favor of more government coverage where I work.

I take this to be a combination of altruism and a short-sighted pragmatic belief that by joining this foolish crusade, they can at least have input on what they regard as inevitable.

I suspect that you see such foolishness in any industry that is about to be put under the yoke.

The end result is that the bureaucrats end up sounding more pro-freedom than the physicians (as a whole).

Burgess Laughlin said...

In reality, of course, there is no "slippery slope" involved here. Terms such as "slippery slope," "a fine line," and "extremes," often arise when "moderate" individuals don't have objective, explicit principles to guide them. Such individuals want X, but they don't want to "go too far."

In a society that has a large measure of freedom of speech, the only solution that I can see is the long-term approach of repeatedly and bluntly stating the principle involved, without compromise, and then connecting it to particular situations as illustrations.

Conservatives, when they have principles, fear naming those principles and therefore avoid doing so, relying instead on minute criticisms of "big government."

"Slippery slope" does apply to the psychological (not ontological or epistemological) condition of individuals who want a certain result but are ignorant of or evading the principle that applies.

For example, a man who knows that eating certain foods is bad for his health, eats "just a little," and then a "little more," and so forth. He does not have a guideline to tell him either where to stop or that he should not start at all. He relies on his subconscious to guide him, but the subconscious, in this case, isn't programmed to do that because it has no explicit principle to call up for reference. He is instead guided only by a wish to be slim or healthy.

Wishes aren't principles. Getting conservatives, leftists, and other enemies of liberty to even state their principles is the hard part. Once that is done, then one can state one's own, and then do battle.

Gus Van Horn said...

"'Slippery slope' does apply to the psychological (not ontological or epistemological) condition of individuals who want a certain result but are ignorant of or evading the principle that applies."

That is quite a valuable insight.

Thus, some of those who speak of "slippery slopes" (the merely ignorant ones) are likely receptive to our arguments and some (the evasive) probably aren't.

The approach of naming principles explicitly will both determine which is the case and get whatever conversation is going at the moment headed in the direction it needs to go.