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Source link: http://archive.mises.org/10576/universal-coverage-means-suppressing-human-choice/

Universal Coverage Means Suppressing Human Choice

September 2, 2009 by

To derive a measurement for efficiency is both theoretically absurd and practically impossible. Economists don’t know which quantities, prices, production processes, and types of employment are efficient. FULL ARTICLE by Eric M. Staib


Barry Loberfeld September 2, 2009 at 8:36 am

RE: “Universal Coverage [i.e., Socialism] Means Suppressing Human Choice”:

Marx his due: He was absolutely correct in identifying the political
freedom of liberalism — the right of each man to do as he wishes with
his own resources — as the origin of income disparity under
capitalism. If Smith is now earning a fortune while Jones is still
stuck in that subway, it’s not because of the “class” into which each
was born, to say nothing of royal patronage. They are where they are
because of how the common man spends his money. That’s why some writers
sell books in the millions, some sell them in the thousands, and still
others can’t even get published. It is the choices of the masses (“the
market”) that create the inequalities of fortune and fame — and the
only way to correct those “injustices” is to
control those choices


Tina Brewer September 2, 2009 at 10:40 am

I agree with the general point about removing restrictions in the health care market. It is going too far, however, in our mixed health-care market, to describe people who refuse to prioritize insurance coverage over other spending as engaging in some sort of should-be-sacred personal freedom. In fact, such individuals know quite well that the community will provide for their needs, should they become acutely ill, and that this cost will be passed on in the ever-rising prices everyone who chooses to act responsibly in this matter must pay.

USA Today September 2, 2009 at 11:01 am

Barry Loberfield,

The masses are stupid, ignorant and poor. It’s funny that they are the ones who “make” the fortune and fame of the bright, knowledgeable and wealthy.

You never heard of the self-made man, haven’t you ?

Jorge Borlandelli September 2, 2009 at 12:37 pm

I agree with the position, but the implications are that if the uninsured get ill, and they eventually will, they must be treated either by a charitable hospital limited by the size of its endowment or by a Mother Theresa helping them to die. But to solve this problem by a creating a socialist national health care system is overkill. I agree with Tina that under the interventionist model we have now its logic suggest more controls and restrictions on choice. Eventually it will go all the way to socialism or collapse. Perhaps some middle ground can be found. The subject has similarities with the obligation for drivers to have liability insurance if they want to use the roads.
Hard subject.

Barry Loberfeld September 2, 2009 at 12:56 pm

The kind of argument libertarians must confront:


Note especially this line:

“Such a critique could go on, but perhaps the larger point is this: While private health insurance plans vary in quality, there is no private insurance-based employer health plan anywhere that can adequately address the broad health care needs of the American public.”

USA Today September 2, 2009 at 1:36 pm

Why must we pay for healthcare with insurance ?

When was the last time you paid your groceries or gas fillup with insurance ?

When was the last time you paid for an oil change with insurance ?

When was the last time you paid for your vacations plane tickets with insurance ?

When was the last time you paid for your pizza delivery with insurance ?

Insurance should be for catastrophic but very unlikely events, not for everyday routine medical maintenance.

I don’t have insurance, I pay out of my pockets and if I can’t pay well I can die, freedom has a price and I’m ready to pay that price.

Giant Joe September 2, 2009 at 1:56 pm

“Such a critique could go on, but perhaps the larger point is this: While private health insurance plans vary in quality, there is no private insurance-based employer health plan anywhere that can adequately address the broad health care needs of the American public.”

What makes it impossible for the private sector, and possible for the public sector to provide this? Both sectors are made of people in the end, and the private one is the one that has to perform under the scrutiny of people, not the public one.

DC September 2, 2009 at 3:32 pm

The America’s Affordable Health Choices
Act of 2009 (H.R. 3200)

“The public option will operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self-sustaining – financed only by its premiums.”
If the government forces people to purchase the insurance, then the words “premium” and “level playing field” are Orwellian Newspeak; let us call it what it really is. It is a tax to be handed over to Big Insurance and the medical establishment.

“…individuals will be responsible for obtaining and maintaining health insurance coverage. Those who choose to not obtain coverage will pay a penalty of 2.5 percent of modified adjusted gross income above a specified level.”
So if the serfs do not obey the tyrant and hand over their hard earned property to Big Insurance, then they pay higher taxes. The rationale for this theft is the myth that those who are not covered by a third party are the people who receive uncompensated care, when in fact the uncompensated care is the result of Medicare, Medicaid and Big Insurance refusing to pay the full sticker price which the uninsured do pay. The billions reported as uncompensated care is money which providers did not receive from the Big Insurance, Medicare and Medicaid; now the government will force the uninsured, who have been paying more all along (full sticker price) to hand over their property to Big Insurance which has not been paying full sticker price and claim it is the uninsured’s own fault. WOW! Talk about privileged elites…did someone say feudalism?

Ian September 2, 2009 at 3:58 pm

I agree with the basic ideas here, but as a physician, the problem is that when a person without wealth or insurance gets sick and goes to a hospital, someone else ends up paying the costs.

We have to have universal access to insurance that is affordable, and see then how many people buy insurance. I believe that the uninsured numbers will drop precipitously.

HayeksHeroes September 2, 2009 at 5:19 pm

It is interesting that health insurance companies are the only business that is practically immune to recessions. They get too much government protection.
Obama’s plan would ruin their business. The free market reforms would threaten their comfortable position in the market. The status quo, which under serves the public, is the optimal position in terms of risk to profits ratio. Insurance companies have it made.

Franklin September 2, 2009 at 5:45 pm

“….there is no private insurance-based employer health plan anywhere that can adequately address the broad health care needs of the American public.”

Who’s this guy “American public” and precisely what ails him?

Until the paradigm is broken — the individual personification of a group, the generalization of a solution — there is no hope in changing most of the minds of voters.

K Ackermann September 2, 2009 at 7:20 pm

OK, so how do we lower costs?

Maybe this is a power grad by the government, but a seam has opened up that allows them to do it. That seam is the fact that since 2002, premium costs have gone up 87%, and industry profits have gone up 428%.

Either they are making things very efficient and not passing on the savings, or they are taking more money and spending less of it. For all I know, they only had a 1% profit in 2002, and now it’s 4.28%… who knows? The question is, how come there are no insurers that have delivered more care for less money since 2002? Isn’t that how pretty much every other business effectively tries to operate? Deliver more for less? That’s the theory of competition, at least.

I’m self employed. Where are these free market insurers?

How come none will write me a policy for close to the same rate as they charge the largest companies?

How can I be assured that my health takes priority over responsibility to their shareholders? How come 70% of people who filed bankruptsy due to medical bills had insurance?

I agree that freedom of choice is fantastic. I throw my support behind it.

Now where’s my affordable insurance?

I’ve been pretty frugal the past couple of years. I spent my last paycheck on a house, and I won’t have another product to sell for possibly a year, so I have watched my expenses. One thing I did buy was a portable defib unit. The thing is great – it will actually talk you through the procedure. I wrote on the big button, “To save life, press here,” and I’ve told all my neighbors where it is in an emergency.

So the government will let me treat a heart attack, and there is nothing they can do to prevent me from stitching myself up, but God forbid I be allowed to keep antibiotics and painkillers on hand.

I don’t know where you got the impression there is a free market for health care.

What do students do for health insurance? Do you have a group plan you can buy into? That must be nice. I feel locked out.

If I wasn’t on all these antidepressants, I might be resentful ;-)

Texas Chris September 2, 2009 at 9:23 pm

Healthcare is not a right, it is a commodity.

It may sound cold and heartless, but if a person can’t afford healthcare, then they must find a charity, or go without.

When Government got involved in healthcare, it forced most charities out of the market and limited private enterprise with regulation, thereby pushing prices up. This is the essence of rising healthcare costs; government intervention.

More government intervention cannot be the cure for too much government intervention.

HayeksHeroes September 3, 2009 at 12:05 am

Let’s get rid of one of the largest labor unions, the AMA, and get real savings, more doctors, and better care.

Sanjay September 3, 2009 at 12:51 am

I usually agree with a mixture of this site and counterpunch. On health care however, the US has not got it even close to right. Sure everything is a commodity and govt. needs to get out of people’s lives but unversal health care has unforseen advantages. You can still have a system where basic health care is provided by taxes but expedient elective procedures can be paid for out of pocket. In any case, the US spends more of it’s GDP on health but 50 million are uninsured. Every billed item, from drugs to procedures seems to cost so more in the US. Are the private insurance companies competing or collabourating ? Sometimes it takes an outside observer like me ( an Australian MD ) to point this out.

Scott D September 3, 2009 at 2:19 am


The 50 million figure is completely bogus. When you remove non-US citizens, people transitioning between jobs, college kids, people who do not have insurance but who qualify for existing government programs and do not use them, and people who make well above the median income but choose not to buy insurance, the number comes out to less than 10 million. One source claims that it is about 8.2 million. Out of those 8.2 million, it is difficult to identify how many are uninsured by choice.

Why the deception? Because if it is a “crisis”, then government is invited to step in to fix it.

If you don’t believe me, google “50 million uninsured”. You’ll find the NCHC happily quoting the “almost 50 million” figure, while the rest of the links I visited gave evidence to the contrary.

newson September 3, 2009 at 6:03 am

to sanjay:
i hope you enjoy losing half of your wages for the pleasure of working in australia.

think of the wastage that occurs in the public hospital system. observe how rapidly health has grown as a budget item since medicare (universal hospital cover, and subsidized private medical consultations) was brought in by whitlam.

the advantages are never unforeseen, but the disadvantages always are.

John David Fernandez September 3, 2009 at 12:35 pm

Fantastic but I think you could have include a bit on “the knowledge problem”.

John David Fernandez September 3, 2009 at 12:36 pm

Fantastic but I think you could have include a bit on “the knowledge problem”.

Ken MaxDonald September 3, 2009 at 5:03 pm

With all this talk about universal health care, why isn’t anyone discussing the obvious moral issue?

Seventy years ago, when I was a child, we were taught that citizens of a free society had “unalienable rights”–meaning rights that were not transferable from one person to another.

We had rights to our own bodies and to our own minds and to the property they produced together. This property, like ourselves, belonged to us alone. No one else had a priority “right” to it.

If someone we knew had medical problems they couldn’t handle themselves, and we voluntarily decided to help, we helped them and were proud of it.

But, nobody, including the state, had a priority right to take our property from us by force, through taxes, to pay someone else’s medical bills. That would be considered ordinary theft and therefore profoundly immoral.

Why aren’t our new public servants in Washington defending our moral, unalienable rights to our own property and ourselves?

Ken MacDonald

Franklin September 3, 2009 at 7:27 pm

“Why aren’t our new public servants in Washington defending our moral, unalienable rights to our own property and ourselves?”

Because most voters, and politicians, by a wide margin, prefer a model by which a little is taken from each citizen, based on a reasonably graduated code, to provide for the common good. The common good includes a safety net for those that cannot afford food, housing, medical care. This is considered “fair” and guards against the excesses and moral unfairness of the laissez-faire system. Even the Framers, long time ago, were squeamish about inclusion of an inalienable property right in the Declaration of Independence. A pity, but perhaps there was no other way at the time…

Not defending the current party line at all, just summarizing what we’re up against.

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