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Source link: http://archive.mises.org/10460/a-four-step-healthcare-solution/

A Four-Step Healthcare Solution

August 14, 2009 by

It’s true that the US health-care system is a mess, but this demonstrates not market but government failure. To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government controls. It’s time to get serious about health-care reform. Tax credits, vouchers, and privatization will go a long way toward decentralizing the system and removing unnecessary burdens from business. But four additional steps must also be taken: FULL ARTICLE


C August 17, 2009 at 10:01 am

“[P]ersonal health care is seldom a matter of choice: one does not get sick by choice… and frequently the choice of health provider is dictated by urgency/proximity.”

“If you get shot, you are going to call 911, not want to research your options…”

To expand on others’ arguments, the sensible consumer joins a “health emergency club,” just as drivers join AAA, so that when they are in an accident or precipitously ill, they call their HEC (AAA), which dispenses an ambulance (tow truck), to take them to the nearest affiliated hospital (auto repair) on the approved list for the HEC. hospitals would compete to earn the high ratings from the HEC, because it would bring more customers.

Calling 911 is using a govt service. How is fixing your body different from fixing your car or a flat tire? We don’t ask govt to determine who we can call for roadside automobauble help! Why must we have them determine how we get help for our body’s ailments?

Just as OnStar wireless services today can solve the problem of how to get urgent assistance through a privately subscribed service, future free market “911″ services could use technology to improve on the current govt controlled system of dispensing emergency help.

Michael A. Clem August 17, 2009 at 10:40 am

C, bringing up the examples of AAA and OnStar is very good. When we talk of getting rid of government licensing and regulation, people seem to assume that it’s supposed to be replaced by nothing, but there are and would be private alternatives with certification and such. Will people pay for them out of their pocket instead of through taxes? They will if they think such services are valuable. If you’re really concerned about the competence of a doctor, aren’t you going to do the research necessary to check up on the doctor? And if a private organization already does such research and makes it available for a small price, isn’t that price worthwhile to pay? Obviously only each individual can decide how much they are willing to pay, but it’s absurd to think that there’s no market at all for such services. And if there’s a market, there will be private organizations providing these services.

RWW August 17, 2009 at 11:13 am

But hold both them and their private licensing agency and any advertiser liable for damages if harm is done.

Why would the licensing agency be liable for damages? This is nonsense. If a practitioner is licensed by XYZ Co. and, some time later, causes harm, this is through no direct fault of XYZ Co. XYZ does not employ the practitioner. However, XYZ’s reputation is likely to take a hit.

But ask them to include a ‘pro bono clause’ in their policy that allows them to pay a slightly higher voluntary premium to cover the uninsured and uninsurable.

What does “ask them” mean? Who is doing the asking?

Where this clause is taken up by the members the insurance provider is obligated to cover the uninsured family and others with connections to members.

If insurance companies wish to enter into such a contract, they may do so. Or they may not.

2nd Amendment August 17, 2009 at 3:27 pm

I don’t get it, WHY should it take insurance to pay for healthcare in the first place ?

I don’t need insurance to pay for groceries !

trund August 17, 2009 at 5:42 pm

great article……i’d add one more thing no one mentioned but would reduce medical fees immediately……

The losers in med-malpractice suits must pay the court and lawyer fees of the winner. Simple.

Shay August 17, 2009 at 6:29 pm

2nd Amendment, please stop posting your drivel to every thread and often in multiple messages in a row. In answer to why (some) health care should require insurance to cover, it’s the same reason that many people need insurance to cover their home burning down. Your insistence that all health procedures, no matter how long-term they are, be cheap enough that anyone can afford them is like insisting that people shouldn’t need home insurance. The only solution to the latter would be to have everyone live in tents which cost only a few dollars to replace. In the medical case, nobody’s forcing you to get expensive care, as there’s always the option of living (or dying perhaps) with whatever the condition is.

wesleybruce August 18, 2009 at 5:36 am

RWW you miss the point, if a licensing entity is not held responsible you will get fly by night licensing entities with high sounding names similar or identical to the reputable ones. Just as there are quacks claiming to be doctors you’ll get phony entitles claiming to be the medical consumers society, AMA or whatever. By adding one word to the name, say ” of Oceania” they create an entity that may confuse people.
You ask who asks the insurers for the pro bono the answer is ‘ the drafter of the legislation’ the libertarian parliament (or its equivalent). With out such an entity able to make requests you have no libertarian society.

RWW August 18, 2009 at 9:16 am

[I]f a licensing entity is not held responsible you will get fly by night licensing entities with high sounding names similar or identical to the reputable ones.

So do your due diligence.

You ask who asks the insurers for the pro bono the answer is ‘ the drafter of the legislation’ the libertarian parliament (or its equivalent). With out such an entity able to make requests you have no libertarian society.

Ah, so you advocate unabashed aggression. This was my fear, which is why I asked for clarification.

By the way, notice that I use the verb “ask” in its proper sense, as in a request — not in the sense that you mean it, as a demand backed by threats.

RWW August 18, 2009 at 9:19 am

By the way, if a company goes so far as to truly pose as an existing reputable company, it has committed fraud. But this is not what you describe.

EnEm August 18, 2009 at 10:40 am

This is my response to FarSide:

Why, exactly, does a business have “to understand… that they have to suffer the loss and eat it and NOT increase health care premiums just because they are in this for the money” ? An insurance company must recognize the fact that Risk is the main feature in their business. **When an insured claimant puts in a claim they have to honor it and pay up AND NOT RAISE THE PREMIUM BECAUSE THEY INCURRED A LOSS IN PAYING THAT CLAIM. THEY HAVE TO ACCEPT THE LOSS TO THEIR BOTTOM LINE. IF THEY CAN’T TAKE THE HEAT ….FORGET MESSING AROUND IN THE KITCHEN AND FORGET BEING IN THE INSURANCE BUSINESS. THAT’S WHAT I MEANT BY EATING THE LOSS AND MOVING ON**.
Why would an insurance company bother to exist, if they didn’t want to make money? If they “suffer a loss and eat it” all the time, how will they have any money to pay out to their claimants? **THEY MAKE THEIR MONEY OFF OF THE PREMIUMS OF HEALTHY SUBSCRIBERS WHO DO NOT PUT IN CLAIMS**. (Oh, I know, it’s because some board of super-intelligent aliens who can see into the future will set the proper prices). **Irrelevant, in light of the above explanation**
Secondly, I am sorry to hear of the heart trouble. However, pre-existing conditions is the #1 emotional tactic that is being used right now to advance this thing. **Read my post again… it was not a pre-existing condition**But the bottom line is, health insurance is NOT a right, and you can’t force a business to give you something for free. **I too do not consider it a right and nobody asked for a free handout. On the other hand, a $1000 a month premium is preposterous **
If I want fire insurance, I can’t buy it after my house burned down. **You are missing the point**
Yes, this sounds callous, especially to someone who has been at the bad end of the stick in this regard. However, I would submit that without much of the current red tape you would find some insurance companies would appear that would be better suited to address this sort of thing with people, at better prices than is currently possible. **There are no such companies out ther. If there were, I would have found them**

EnEm August 18, 2009 at 10:58 am

My response to Nick:

I’m not real sure about the point of your story. Did the existing health insurer have a clause in the contract that allowed them to drop her?
**No, they did not. They merely called and said they would not be able to carry her because she had become “high risk”. **My take on this is: Business as such, any and all business is entrepreneurial. And an entrepreneur is a risk taker. Insurance companies therefore cannot pass the risk inherent in their business to their clients**.

If this is the case, and I’m guessing that it was, then it should be self-evident that de-regulating the health insurance industry would help.
**I am with you on this. De-regulate, let smaller competitors join in that are willing to accept the risks involved and not pass them on to their customers. The big fat ones will have to follow suit or fold**.

If one was able to purchase insurance a la carte – and choose their levels of coverage and what clauses they approve of based on how much they were willing to pay, then she could have made sure she had a policy that contained no “heart patient” clause.
**She probably did not check for that clause, maybe because she was not aware that she was going to become a heart patient in the distant future**.

In other words, put the choice – and the *responsibility* – back into the hands of the individual.
**All this began when she had a bad fall at her work place. The insurance company refused to pay her medical bills because they told her that she could have avoided the fall. The employer refused to pay workers comp on the same grounds. Then when she had her first heart attack, the insurance company made selective payments of the medical bills, made her responsible for paying the bulk and then dropped her**

wesleybruce August 19, 2009 at 12:44 am

RWW Thanks for your comments but the problem as I see it is that without some entity to initiate any change you get nothing. Mises institute has a leadership that does not threaten the use of force. Leadership is not inherently the use of government force. By ask I mean ASK. Not order, badger, threaten or kill. Request, suggest, include in any writings that implements a Libertarian solution.
It needs to be a simple free choice but to minimize transaction costs it ideally should be in the insurance paperwork or software that people do anyway. And yes I agree companies can and do add such clauses today.

I agree with you on due diligence but 80% of the current population don’t even know how to start on basic due diligence and 5%, some of the people I work with, are intellectually incapable of such basic things.

If our alternative to government programs does not spell out things and the safeguards essential to its operation we hand it over to the statists forever. Also you are making a significant mistake of assuming that a libertarian/ anarchist society is a lawless entity. With out law there is no hope even where due diligence, etc, is done. In any free society there must be an agreed set of laws though not necessarily one enforced by even a minimal state. However a free state with an independent judiciary will create laws of precedent and judicial agreement. The question is whether it occurs in public or at some judges dinner table.

RWW August 19, 2009 at 7:11 am

If your organization is educational in nature, or some kind of private court, I have no objection. But “parliament” has different connotations to me.

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