(This is a response to a debate held earlier today . . .)
Now then, as promised, some suggestions regarding health
care and the issue of force.
Having established that force is always wrong, and cannot be part of a moral solution, we conclude that any moral solution must be based on voluntary relationships.
Before any solution can be formulated, the problem must be defined. What are the problems with health care in the U.S.? I suggest the following, with the request for any I have missed to be pointed out.
1. It is too often prohibitively expensive.
2. It is too often ineffective or deadly.
3. It is too often haphazardly accessible.
Notice that I used the phrase “too often” in every
example. That is because I acknowledge
the inescapable truth that any system run and employed by humans will fail to
some degree. Quite naturally, the
objective of any solution would be the reduction of these failures to as
near-zero as reasonable efforts will allow.
(It should go without saying, for example, that executing every doctor
whose decision results in an accidental death as an example to the rest of them
would be unreasonable.)
Cost of insurance is driven by two factors: cost of care and risk.
The greater of either of those two, the
greater the cost of insurance. What we
see in the first factor is a troubling Catch-22 scenario. Cost of insurance goes up because cost of
care goes up, which in turn causes cost of insurance to go up, and so on. However, we may be able to determine which came
first in our chicken-or-egg situation by looking at the second factor – risk.
One of the biggest, if not the biggest, risk in practicing medicine is legal
action. Getting sued, in other
words. Let’s take a look at a very
revealing statement made way back in 2009, one studiously ignored by the
national manure-stream media, and one that probably got its speaker in a great
deal of hot water, although nothing was said about that, either.
Howard Dean, he of EEEYAAAHHHH fame, was speaking at a town hall meeting right here in good ole’ Virginny. Having the microphone handed to him by our Commonwealth’s premiere
Congressional dimwit and traitor Jim Moran, Dean was addressing a question by a
citizen who asked why, with the potential for 200 million dollars in savings
over 10 years (the questioner’s statistics, not mine) tort reform was not part of Obamacare, said this:
This
is the answer from a doctor and a politician.
Here is why tort reform is not in the bill. When you go to pass a really
enormous bill like that the more stuff you put in, the more enemies you make, right?
And the reason why tort reform is not in the bill is because the people who
wrote it did not want to take on the trial lawyers in addition to everybody
else they were taking on, and that is the plain and simple truth. Now, that’s the
truth.
And I believe him, every word. Funny how you can tell when a politician is pulling the rug out from under his own feet by telling the unvarnished truth.
By the way, if you want to see Congressional jackass Moran in action, here you are:
http://www.youtube.com/watch?v=HaMj-WUC-aE
It really is an amazing thing to see and hear, and I will give Moran points for apologizing, although he needs to spend about the next 15 years doing so for all the traitorous votes he’s cast.
And I believe him, every word. Funny how you can tell when a politician is pulling the rug out from under his own feet by telling the unvarnished truth.
By the way, if you want to see Congressional jackass Moran in action, here you are:
http://www.youtube.com/watch?v=HaMj-WUC-aE
It really is an amazing thing to see and hear, and I will give Moran points for apologizing, although he needs to spend about the next 15 years doing so for all the traitorous votes he’s cast.
A major factor in risk – being sued and having to pay stupendous fees to satisfy the lawyers and the uneducated juries that award them – was deliberately untouched because federal legislators are afraid of lawyers.
Well, that and the fact that a lot of them are lawyers.
So we have defined one problem: government.
And we have also determined one solution: tort reform as a means of reducing medical costs.
This is my first suggestion.
And we have also determined one solution: tort reform as a means of reducing medical costs.
This is my first suggestion.
(As a side note, I think the amount of
$200,000,000.00 over 10 years is absurdly low.
But I can’t back that up, so I won’t say it . . . )
Would this have any effect on the execution of force? Yes.
In order to remain financially solvent when costs begin to catch up with sales, the increase in costs must be passed on by the seller to the customer. By means of coercion, coercion that is the result of unbridled greed, doctors are being forced to charge prices that they would not, otherwise.
Do we have an example of this in action? Yes.
Doctor Michael Ciampi of South Portland,
Maine, has completely eliminated the involvement of all forms of
insurance. His costs, and therefore his
prices, have fallen off the proverbial cliff.
http://www.huffingtonpost.com/2013/05/29/dr-michael-ciampi_n_3354120.html
So we have defined another problem: costs that are the direct result of doctors doing business with insurance companies.
And we have determined another solution: eliminating the business relationship between doctors and insurance companies. All of them? No. Just most of them.
This is my second suggestion.
Would this have any effect on the execution of force? Yes. By reducing his risk of being sued by insurance companies as well as the staggering amount of time that must be spent filling out paperwork, Dr. Ciampi has reduced his costs, and accordingly, he is no longer subjected to the force that these things bring with them.
Another reason for the high cost of medicine is the companies that provide it are amazingly dull-thinking. If I had a hospital, I would acknowledge the simple truth that the medical industry, in spite of the stratospheric prices it charges, runs on very thin margins. This is because of the other things we’ve talked about already. Fact is, most of the money a doctor or hospital charges are paid to the government, the insurance companies, big pharma, and overhead.
So, if I were a business owner and had a hundred gajillion dollars to start a medical practice, this is what I would do . .
I would diversify the investment into virtually every medical discipline. Every facility would be kept as small as feasible, and would deal with only one discipline except where otherwise necessary. I would cooperate with the municipalities where my facilities were located to centralize critical care such as trauma units to minimize time and distance for the majority of the population, and out-lie the less critical disciplines into small but more numerous buildings. I would eliminate all insurance connections except those disciplines that require the most serious care, such as neurosurgery. And then, I would offer deep discounts to those who can pay cash.
I would diversify into other, more profitable businesses. I would own a series of hotels, a business that generally sees a very respectable 30% profit margin on average. This would draw cash customers to my facilities as I would be able to offer them discounts for family members and patients who are waiting for treatment procedures to complete. The profit gained from these hotels as they are occupied by non-patients would help offset my costs of providing care, especially experimental care. I would do the same with furniture and clothing franchises.
I would encourage local, independent doctors to rent my facilities at reduced costs to, in turn, reduce their costs. I would sponsor instructional sessions of prevention, both at my facilities and online.
I would work with local and national foundations to establish a series of clinics that would operate on a very strict basis of need.
I would not accept one dime of federal aid or state aid. Local donations, handled through a third party, would be welcome.
These and a host of other ideas to spread out both costs and profits would drive the expense of medical care down to levels we haven’t seen in generations.
These
ideas are my third suggestion. And I’m
assuming you’re getting the point about force by now.http://www.huffingtonpost.com/2013/05/29/dr-michael-ciampi_n_3354120.html
So we have defined another problem: costs that are the direct result of doctors doing business with insurance companies.
And we have determined another solution: eliminating the business relationship between doctors and insurance companies. All of them? No. Just most of them.
This is my second suggestion.
Would this have any effect on the execution of force? Yes. By reducing his risk of being sued by insurance companies as well as the staggering amount of time that must be spent filling out paperwork, Dr. Ciampi has reduced his costs, and accordingly, he is no longer subjected to the force that these things bring with them.
Another reason for the high cost of medicine is the companies that provide it are amazingly dull-thinking. If I had a hospital, I would acknowledge the simple truth that the medical industry, in spite of the stratospheric prices it charges, runs on very thin margins. This is because of the other things we’ve talked about already. Fact is, most of the money a doctor or hospital charges are paid to the government, the insurance companies, big pharma, and overhead.
So, if I were a business owner and had a hundred gajillion dollars to start a medical practice, this is what I would do . .
I would diversify the investment into virtually every medical discipline. Every facility would be kept as small as feasible, and would deal with only one discipline except where otherwise necessary. I would cooperate with the municipalities where my facilities were located to centralize critical care such as trauma units to minimize time and distance for the majority of the population, and out-lie the less critical disciplines into small but more numerous buildings. I would eliminate all insurance connections except those disciplines that require the most serious care, such as neurosurgery. And then, I would offer deep discounts to those who can pay cash.
I would diversify into other, more profitable businesses. I would own a series of hotels, a business that generally sees a very respectable 30% profit margin on average. This would draw cash customers to my facilities as I would be able to offer them discounts for family members and patients who are waiting for treatment procedures to complete. The profit gained from these hotels as they are occupied by non-patients would help offset my costs of providing care, especially experimental care. I would do the same with furniture and clothing franchises.
I would encourage local, independent doctors to rent my facilities at reduced costs to, in turn, reduce their costs. I would sponsor instructional sessions of prevention, both at my facilities and online.
I would work with local and national foundations to establish a series of clinics that would operate on a very strict basis of need.
I would not accept one dime of federal aid or state aid. Local donations, handled through a third party, would be welcome.
These and a host of other ideas to spread out both costs and profits would drive the expense of medical care down to levels we haven’t seen in generations.
It’s getting late. I’ll address the other 2 problems in another entry.
