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Health See other Health Articles Title: Free Market Healthcare Alternative to Obamacare The cost of medical services rise each year faster than the rate of inflation. There are many reasons for this, but one primary reason, seldom discussed, is the effect of Medicare on those costs. Because any change to the Medicare entitlement brings with it shrieks that the sky will fall, no serious free market alternative has ever been entertained in Congress. Nevertheless, if we are to avoid destroying the American economy by saddling the nation with insurmountable debt, there is but one true alternative to Obamacare and that is a true free market in medical services. Medicare is the archetypical example of socialized medicine that Obamacare will promote and expand. Under Medicare, insurance carriers under contract with the Center for Medicaid and Medicare Services, lord over physicians and hospitals dictating the kind of care that can be provided and the costs that can be imposed. The limitations on kind of care create a one-size-fits-all approach to Medicine for just about everyone 65 and older. Repeatedly those who are chronically ill fall through the cracks and receive less than optimal care because the carriers hamstring the physicians who dare not deviate from parameters of Medicare covered services or they may suffer a Medicare audit. Medicare audits are the federal government’s equivalent of the Spanish Inquisition. Because there are no clear guidelines on what constitutes “adequate” recordkeeping, no physician in the United States can survive a Medicare audit if the carrier wants to recoup monies paid from the physician. There is always a way to construe the record keeping as sub par and to demand reimbursement. Medicare applies a statistical extrapolation to the universe of patient files from a small subset audited. So it is not uncommon for ten thousand dollars of Medicare payments to the physician thought wrongly paid to be multiplied ten or twenty times with the resulting figure constituting the reimbursement demand. Medicare sets the amount of money a physician will be paid for every Medicare covered service and, unless the physician opts out of the Medicare system entirely (effectively reducing his patient practice to those not on Medicare), he cannot contract privately with any Medicare beneficiary to provide a service other than ones Medicare covered or to receive payment other than that allowed by Medicare. Medicare has a firm chock hold, in other words. Because Medicare pays for all or almost all of the cost of covered services for the patient, the patient has little incentive to do anything to prevent the onset of diseases or to avoid visiting the hospital for care of less than urgent health matters. Because Medicare promises to cover these costs, few entering senior years have set aside money to cover anticipated costs of health care. The effect is enormously inflationary. Resort to services is almost unlimited, yet the cost capable of recoupment by the institutions providing care fails to meet the actual costs of the care. The distortion of market forces is significant. To recoup, physicians and hospitals try to charge more for other services provided that are not covered by Medicare. So those not in the Medicare system pay more and those in the Medicare system tend to pay more for items outside of Medicare. The solution to this broken system is not to centralize and expand it as Obamacare promises but to dismantle and replace it. That requires courage from political leaders, a trait they notoriously lack. Consider the alternative to socialized medicine. There are at least four systemic problems that beset the current health care system that, if removed, would usher in lower costs of service, high quality care, and vast improvements in the health of the American people. As you will see, the current system, which already is socialized through Medicare for everyone 65 and older (i.e., for the part of the population that relies on medical services the most) not only fails to provide adequate medical care, it also reduces life expectancy, while the free market alternative does the opposite--provides superior care and extends life expectancy. (1) Socialized medicine creates unlimited demand for medical services. That ensures public reliance on the system to exceed resources and causes those in true need of urgent care to enter cues and have to wait for what may be care that if delayed will cause permanent injury or death. (2) Socialized medicine destroys innovation in medicine. The key to effective medical care is treatment tailored to address the peculiar characteristics of each person’s condition. Disease does not conform itself to bureaucracy. A bureaucrat loves set definitions and parameters. Diseases mutate and express themselves in varied ways within the bodies of each person. Each person comes with a host of variables that influence disease expression and progression. A one-size-fits-all approach to medicine fails because it either provides too much, too little, or insufficiently tailored care to the patient. The Medicare system removes the incentive for physicians to come to know each patient intimately. It is enough, under Medicare, to diagnose the condition and then prescribe the services that Medicare will allow (the ones that the high school educated and non-physician representatives at the carrier will allow the physician to perform on the patient). Physicians are terrified of innovation. Innovation, i.e., deviating from the Medicare prescribed and recommended course, may lead to a Medicare audit (which could threaten the viability of a medical practice). So, innovation is avoided for physician survival in Medicare’s bureaucratic system. (3) Socialized medicine destroys quality medical care. When the kind of care a doctor provides is the product of coercion and cajoling from bureaucrats working for or on behalf of the federal government, that care is anything but the best. Quality medical care not only depends on innovation in medicine but also, and perhaps most especially, on close interaction between the physician and the patient along with diligent effort by the physician to ferret out the peculiarities of the disease and find the best available means to reduce or eliminate symptomology and halt disease progression. (4) Socialized medicine eliminates incentives for personal responsibility. When a system offers a free good that everyone will need at one point or another, even when that system is suboptimal, the incentive to reduce known health risks and to save for catastrophic emergencies is reduced or eliminated. The current system depends on crisis management. Few will take simple steps every day to reduce the risk of disease because doing so may require loss of time or money and, in any event, there is no financial reward for doing so. If I buy expensive exercise equipment, hire a trainer, or seek expert advice on my diet, I will be out that money presently but will not experience any change in the costs associated with future medical care. There is no financial reward but there is a cost. Consequently, most of us plod along variously doing that which we should not leading ineluctably to a major medical crisis that may have been prevented. Socialized medicine invariably becomes bogged down with urgently needed care and fails to provide services that could reduce or eliminate the need for urgent care in many circumstances. Although we are up to our neck in the failed waters of medical socialism, we do not need to drown. We can extricate ourselves by adopting a free market alternative. Taking that step requires courage our political leaders, with the exception of Ron Paul, appear unwilling to take. Here are four steps to bring about a free market in medical care in America: 1- Phase Medicare out of existence over the next ten years; phase in over that same period tax exempt status for health care institutions that, and physicians who, provide private insurance plans to patients (competitive with existing health insurance) in lieu of, or as compliments to, those plans for the coverage of part or all of the medical expenses associated with the provision of care by those health care institutions or those physicians; 2- Eliminate taxation equal in amount to payments from any health care institution, any business or individual to funds exclusively designed to provide contemporaneous drawn down electronic payments for the delivery of medical services to an indigent patient by medical institutions and physicians; 3- Exempt from taxation all funds invested by any taxpayer in a medical savings account for the taxpayer if an individual or for employees if a business entity; 4- Exempt from taxation all funds paid by a taxpayer for a health insurance plan either directly or through an employer; 5- Exempt from taxation all earnings of any business that are paid into employee health insurance plans that provide catastrophic coverage; 6- Provide a tax credit for each taxpayer who is certified by a physician not to smoke, drink alcohol, or use drugs except by prescription for each year that the taxpayer abstains from using these substances and is free of diseases associated with smoking, alcohol, and illicit drug use. In addition to these changes, it would be wise to encourage deregulation of state licensing of health professions such that hospitals and physicians would be able to enter into private contracts for health care services with unlicensed individuals who have served as apprentices under licensed practitioners and are trained in the provision of medical services and who will serve in hospitals and in physician’s offices and operate under the supervision of physicians. In this way, unlicensed apprentices skilled in the provision of specific medical services who require less compensation than licensed practitioners would be allowed to replace them in the provision of those services as a hospital or physician directs with the latter equally liable for negligence or malfeasance of the former. The effect would be to create greater competition in the provision of services by allowing skilled but non-licensed assistants to provide services within their skill set and to reduce costs associated with the provision of select services. These are a few of innumerable options to wean the nation of socialized medicine and return it to free market health care. If we were to adopt serious free market reforms, Americans would take greater responsibility for their own health, demand would lessen, costs for services would come down, the quality of care would increase, and the longevity of Americans would increase.
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#1. To: christine (#0)
Christine, as a group health insurnace agent 2 things things are causing the high rates. 1. You need mandatory coverage. "Cost shifting" is a tremendous problem. CS is when people who have no insurance have a high hospital bill and they just walk away and the hospital has to write it off. In my state every person that is covered by private insurnace has to pay $1.77 for every $1.00 in services they incur because of the people without insurance. 2. People need to get their obesity under control. It is major problem leading to the high rates. I have been an agent for 25+ years and have seen what high obesity leads to: heart disease, diabetes, sleep apnea, hbp etc. A group of say 10 employees 20-25 years ago had 1-2 people with medical conditions. Today it's 8 out of 10 who have medical conditions and it's almost all obesity related. I do a lot with HSA's (Medical Savings Accounts) etc but these plans do NOTHING to keep cost down. Ilegals, doctor lawsuits etcare actually down the list of what is causing the high rates-believe it ot not.
Unconstitutional, no Federal constitutional authority to mandate anything of this nature, whatsoever. 2. People need to get their obesity under control. It is major problem leading to the high rates. I have been an agent for 25+ years and have seen what high obesity leads to: heart disease, diabetes, sleep apnea, hbp etc. A group of say 10 employees 20-25 years ago had 1-2 people with medical conditions. Today it's 8 out of 10 who have medical conditions and it's almost all obesity related. Actually, agreed. However, that is something that comes only from education and individual choice.
MapQuest really needs to start their directions on #5. Pretty sure I know how to get out of my neighborhood.
#1 i believe totally...that would include illegals, no? #2 surprises me as i wouldn't have believed that obesity is that prevalent a problem.
Conservatives preach individual responsibility but then point out your comment above. When they don't take out health insurance and have a huge claim you and I get slammed for it. What is the comment about Wall Street? Socialized losses, privatized profits?? Same thing with health insurance. In my state of 20% of the populace has no health insurance (no illegals or very few in my state). I'm tired of paying for deabeats when they walk away from their health bills. I have no problem with your idea that it's againt the Constitution for mandatory halth insurance so how's this. If you do not take out health insurance when you have a claim you pay up front or no health services for you in my best soup nazi immitation. Of course this will never happen so that is why we need mandatory coverage. BTW: this is no longer 1776. We live in a scenario the founding father never could have imagined-health cost.
I'm not a conservative, one, two the quote you responded to isn't an example of responsibility, it's an example of the government overstepping its bounderies and granted powers. Should people be 100% responsible? Totally. So stop giving them a free pass, via the law which mandates treatment regardless of payment ability, and allow hospitals to turn away folks who are clearly abusing the system by hitting the emergency room everytime they get the sniffles. 100% individual responsibility, 100% constitutional, 100% the right thing to do. Mandating 100% coverage only hides who is and isn't a deadbeat, it doesn't change who does and doesn't pay for it. And I agree with that. I always hear how "of course, regular type freedom can't happen, so that is why we need fully unconstitutional huge government intrusion". You know what? I reject that as a claim and reason. I also suspect that the Founding Fathers never could have imagined the amount of unconstitutional government interference in the market which caused these very sky high costs either. When you come upon a guy who has swallowed a nearly, but not quite, lethal does of hemlock, the solution is not to pour an entire bowl of hemlock down his throat.
MapQuest really needs to start their directions on #5. Pretty sure I know how to get out of my neighborhood.
#2 surprises me as i wouldn't have believed that obesity is that prevalent a problem. #1. Illegals should be required to have health insurance coverage. Employers who hire them and do not pay workers comp and health insurnace should be sent up the river for a min 20 year sentance at hard labor. #2 Look at the populace anywhere-public areas etc-fat people and kid's everywhere. I had a list of all the drugs used and the top 50% of the R/X drugs where for obesity related issues. I was overwieght and lost over 50 lbs. My HBP and sleep apnea are gone. I hate lawyers but malpractice lawsuits do not effect healthcare costas much as people think. I think malpractice lawsuits was #4 or #5 on th list. The threat of malpractice has also helped out the cost because hospitals and providers are more vigilant against making mistakes.
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