Friday, September 11, 2009

Red/Blue dialogue on health care, part 4

Check out Colin's latest response here. I'm finding the interchange to be helpful. It's impossible to rehash the past discussion, so I'll respond point by point to the numbered items in Colin's response. It will be helpful to look at his post to get the context.

1. There is a lot we can do about health care, but the specific proposals of Obamacare are like outlawing a hurricane because to work they would have to violate the laws of economics. Extending coverage to 46 million additional people would increase demand. Supply and demand dictates that prices must go up, but Obama's promises of keeping the program budget-neutral depends on prices going down.

Much of the existing problem with the price of health care comes from government involvement. Federal law prohibits people from buying insurance across state lines, meaning that in many states, one insurance company dominates the market, creating a monopoly-like condition. In a familiar pattern, government creates a problem by interfering with free markets, blames the problem on capitalism and too little government intervention, and prescribes more government as the solution.

2. I found it amusing that the "change of heart" of the former insurance company executive was precipitated by Michael Moore's propaganda film which practically oozes with admiration for Castro and Cuba's communist government. It would be more convincing if his conversion had been based on a work of non-fiction.

3. Free market forces are the best way to get insurance companies to treat their customers fairly. If there are many companies competing for your business, if one of them is unfair, word will get out quickly and people will take their business elsewhere. Creating a government monopoly will not solve this problem, because when they start rationing care, where can you go?

4. Towards the end of my first post I proposed a number of free market approaches aimed at reducing cost, increasing competition, and addressing frivolous malpractice lawsuits. That's not inaction, but it's not government mandates imposed under threat of prison either. I also support subsidizing insurance for those who genuinely can not afford it. We pay for their care one way or another, and I think that providing basic insurance is better than just waiting until they show up at the emergency room.

5. The WHO ranking is based on factors which favor socialized medicine, such as "Fairness in financial contribution". A country which is uniformly horrible will be ranked higher than one which is unequally superior. Using life expectancy as a metric does not isolate health care, because it is influenced by many other factors. Comparing survival rates for specific diseases is a better indication of how well the medical system performs at treating those conditions, and America excels in this metric.

6. Demand will increase, but government will be controlling the supply and forcing the price down artificially to keep the program within their budget constraints. If you believe Obama's pledge to keep Obamacare deficit neutral, you must conclude that he will dramatically reduce expenditures per capita, so the profit potential will be greatly reduced. That is the factor which will squelch innovation.

7. Again, auto insurance is not required. Most states allow drivers to self insure. To do so, you must demonstrate the means to pay for the damage you may inflict to someone else. It is not acceptable to self insure and then not pay for those damages, which would be equivalent of not having medical insurance and then expecting free treatment. So people who can afford insurance but choose not to purchase it should not expect us to foot the bill. But using auto insurance as an arguement against allowing people to self insure is a non sequitur.

8. Obama and Pelosi have both said that the public option is intended as an incremental step towards a single-payer system.

9. It is true that the Constitution does not spell out every item that the government can be involved in, but it does set forth principles of freedom and ordered liberty, and it defines the government's role in the framework of the civil society. Limited government is a central principle in the Constitution, and the government is to curtail the liberty of the people only to the extent that one person's liberty infringes on another's rights. In 1864 Abraham Lincoln wrote "We all declare for liberty; but in using the same word we do not all mean the same thing. With some the word liberty may mean for each man to do as he pleases with himself, and the product of his labor; while with others, the same word may mean for some men to do as they please with other men and the product of other men's labor. Here are two, not only different, but incompatible things, called by the same name--liberty. And it follows that each of the things is, by the respective parties, called by two different and incompatible names--liberty and tyranny." When Congress dictates how we should live our lives and what we must do with what we earn, that is tyranny. The fact that they do it with the best of intentions and warm hearts, forcing upon us what they in their infinite wisdom know is best for us doesn't make it any less so. To be clear, this is not to say that Barack Obama is a tyrant, in particular. The move towards tyranny has been a gradual one, beginning with FDR and the New Deal. Johnson brought about a second major move away from liberty. Clinton attempted such a major shift, but was largely unsuccessful, being thwarted by millions of citizens like myself who stood up and opposed it. Obama is attempting to bring about a third. The line we have discussed which marks the accepted limit of government has been pushed very far from where it was intended to be, and Obama's latest expansion of Federal power represents another large shift in that line.

10. I don't think that the restriction against selling insurance across state lines is going away, although I'm not sure. If it's in the bill, I'd like to know about it. I think that what Obama was saying is that the public option will be added to the current options, not that you can buy private insurance from anywhere in the nation. His statement about malpractice reform was entirely unspecific, and there is nothing in the current bills about it, so until we get something specific, we'll have to wait and see.

11. Obama has a rhetorical talent for using language that sounds moderate or conservative to lure his listeners into complacency, but he is still pushing for hard left policies. It is really easy to think that he is agreeing with you, but in the end the result is always more government, less liberty, more taxes, more spending, more government mandates, more redistribution, more centralized control, more collectivism. He talks about competition and choice, but what you get is government monopoly and mandates. He talks about market forces, but imposes centralized controls. He talks about self-reliance but makes policies which create dependence on government. He talks about the perils of too little government, when our government is the nation's largest creditor, borrower, lender, employer, consumer, tractor, grantor, property owner, tenant, insurer, health-care provider, and pension guarantor. He promises that Obamacare will be deficit neutral. The spending increases are real and immediate, but the matching cuts are unspecified and unenforceable. I've seen too many cases when politicians promise future spending cuts which never happen. We're still waiting for the spending cuts Congress promised to Bush Sr. in exchange for a tax hike. The taxes went up, but the spending cuts never happened. Why not put the spending cuts in the bill along with the spending increases? I'm watching what he does, and it doesn't match his words.

1 comment:

Colin said...

Thanks for the post, Don. My responses are here: