A free market in medical insurance

    One of the great false arguments being offered in the current debate of government-run health care is the assertion that the “free market in health care” has failed.

    As a libertarian, I have to ask the obvious question: “What free market?”

    Health care is already run almost entirely along corporatist/fascist lines. Let me explain this, as the word “fascist” is often bandied about as a loaded word that says little more than, “I don’t like this.”

    Fascism, in the purely economic sense, describes a system in which the government controls the economy, but allows businesses to be privately owned, at least on paper. However, in a fascist economic system, the government orders businesses to conduct business only as the government sees fit. In economic fascism, the government can tell a business how much to produce, how to produce it, who to sell it to, and who not to sell it to. If, after all this, some amount of profit remains, the government allows the business to keep a little as a reward for faithful service.

    This is most certainly NOT a “free market.”

    Economic fascism is exactly what we have today in health care. The government tells medical insurance companies what they must include (or not include) in the policies they write. The government forbids medical insurance companies (in the case of group policies) from charging different rates according to the age or medical history of the individual customer.

    In medical care, the government exerts powerful pressure on doctors to treat patients according to bureaucratic “standard of care” cookbooks that may or may not be appropriate for an individual patient. Doctors even use the term “cookbook medicine” to describe–derisively–a doctor who follows the bureaucratic standards, whether or not they are right for the patient.

    And of course, the care of the elderly has been virtually taken over by the Medicare system, which tells doctors exactly what they can be paid for each procedure, no matter how simple or how difficult it is. And, to control costs, Medicare orders–via cookbook–just how much of what type of care an elderly person can receive. Thus (to cite a personal example), my mother, in her last years of life, was able to check into an intermediate care facility for only a certain number of days per year. If she went over that–regardless of whether or not the intermediate care facility benefitted her–she was no longer covered.

    No, there are no EXPLICIT “death panels.” It’s all IMPLICIT. This makes it much nicer, don’t you think?

    There is very little “free market” left in medicine. What Obama wants to do is merely take the seventy-five percent government controlled, corporatist/fascist medical system, and make it ninety-nine percent corporatist/fascist.

    The difference, by the way, between economic fascism, in which the government controls businesses, but allows ownership on paper and varying degrees of profit to businesses; and communism, in which the government owns everything, is really very slight.

    This is the starting point in any meaningful discussion of our current medical system. Big Pharma and Big Insurance, who contribute generously to election campaigns, get the inside track in the corporatist/fascist economy. They get to make huge profits. Small, upstart firms that want to enter the market and offer competitive products at lower prices, are simply forbidden to do so by the regulations.

    The solution to our health care shortcomings is not to add more and more regulations on an already thoroughly economic fascist system. The solution is to move in the exact opposite direction, towards freedom.

    I shall discuss the details of freedom in medical care in future postings. In the interest of brevity, I will make this simply the opening statement: Don’t criticize our current health care system by saying the free market has failed, because a free market in health care does not exist!

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