Americans Deserve Freedom in Health Care After Century of Central Planning
Washington is selling a false choice in health care. The American people are expected to be content with one of two masters – big business or big government controlling our most personal decisions.
Not for a moment does Washington want us to consider the third option: true freedom.
For most of history since the advent of medicine, physicians and patients have had direct relationships with each other. There were no guards – no cartel of hospitals, insurance companies and government agencies – dictating terms and extracting tolls.
Today, third-party payers impose taxes and compulsory contributions on the public representing 72.5% of all health expenditure (up from 42.4% in 1970). These guards justified themselves, claiming that hospitals would rip off patients more. Meanwhile, they are drowning independent doctors with paperwork, forcing doctors into the hands of these monopoly hospitals that are gobbling up the industry. From 2012 to 2016, independent medical practices in America decreased by 48.5%.
At some point, we have to ask ourselves: does this really help the American people?
Remember the “old lady who swallowed a fly”. In the children’s rhyme, she swallows a spider to eat the fly – solving a small problem with a bigger one – requiring an even bigger solution. Then she swallows a bird, then a cat, a dog, a goat and a cow. When swallowing a horse, she quickly dies.
The lesson is the “do no harm” principle, which modern medicine is supposed to follow, but government medicine certainly does not. Over the past century, chasing Frederick Bastiat’s “great fiction” that “anyone can live at everyone’s expense,” Washington has pushed one failed intervention after another down the throat of America’s health care system.
The main objective of insurance is to pool risks for rare, unforeseen and catastrophic events. However, by freezing wages during World War II, Washington pushed companies to compete for the workforce by offering employment-based health plans covering routine care. Since then, Americans have paid inflated bonuses for the privilege of being run by corporate bureaucrats.
As premiums continued to rise, Congress responded in 1954 and 1974, further deducting a third from direct payment with preferential tax treatment. Since many Americans remained unable to pay for healthcare and corporate bureaucracy, Washington instituted its own centrally planned systems in 1965 with Medicare and Medicaid. In 2010, ObamaCare made participation in these third-party systems mandatory.
How it works ? Health care is more expensive than ever. Per capita health spending has climbed 600% since 1970. The fastest growing cost driver is the bureaucracy itself, which accounts for a third of the overall price.
Now Representative Alexandria Ocasio Cortez (DN.Y.) and the socialist wing of her party want America to swallow the horse. Often referred to by pleasant terminologies, such as “Medicare for all” or “Single payer”, this is the last step in consolidating control. By monopolizing payment to the Department of Health and Human Services, even the limited choices Americans have today will disappear. As the old saying goes: “He who has gold makes the rules”.
Milton Friedman observed that third parties who neither pay the expenses nor receive the benefit of a transaction have the worst incentives to maximize quality and minimize costs. That unelected bureaucrats (with almost unlimited access to taxpayer wallets) be responsible for rationing care for three hundred million Americans they have never met is the worst combination imaginable.
The solution is not a payer, but millions.
Competition works. Discretionary procedures, usually discovered by third-party payers, rely on direct payment and defy inflationary tendencies. For example, the National Center for Policy Analysis found that the price of LASIK eye surgery fell 20% from 1999 to 2011. If the client is still right, we can make health care affordable, accessible and responsible by putting back patients in this position of power, restore direct payment options and rule out third-party payers.
Expanding the freedom to save tax-free in health savings accounts (HSAs) will allow middle-class Americans to cover routine care and buy the best value for their money. The legalization of high deductible insurance will make coverage affordable for Americans for unforeseen disasters. Personalizing Medicaid – putting safety net dollars in the hands of patients rather than bureaucrats – would remove America’s biggest wellness cliff and allow low-income people to engage directly with doctors.
Rather than helping the American people, a century of federal law has established a public-private health care cartel that drives up prices and dictates terms. We deserve solutions to lay off guards and reestablish the direct doctor-patient relationship.
Americans deserve the freedom of health care.
Eric Brakey is the senior spokesperson for Young Americans for Liberty. He served two terms in the Senate of Maine as Chairman of the Senate for the Committee on Health and Human Services.