The Health-Care Nirvana Fallacy

Someone explain how coercive centralized bureaucratic control of medical decision-making and the purse can beat the decentralized free market with its undistorted price system. The government has many things besides medical care it wants to spend tax money on, and seemingly free medical care leads to unlimited, unmanageable consumer demand for services. What then? Will the bureaucrats never say NO to many people who need or say they need care? Where will the money come from? Will there not be intolerably long and life-threatening queues for exams, tests, and surgeries? Will doctors work for low reimbursements or be drafted? Aren't resources and labor limited and consumer demand unlimited? Someone square the circle for me.

Many people imagine a perfect medical system in which everyone can have everything he or she wants for the asking and without inconvenience. Nothing can compare to perfection, so case closed. This is the Nirvana Fallacy, judging the possible against the perfectly impossible. The government has steadily made the medical system worse, culminating in the Affordable Care Act (Obamacare) and its distorting mandates, regulations, and subsidies.

In contrast, the competitive, profit-motivated free market would expand the number of practitioners (now limited by government rules) and improve the quality and variety of services. It would create consumer price sensitivity (services would no longer appear to be free) while cutting prices through competition and increased services. As the price of medical care came down, so would the price of medical insurance, which would also be unencumbered by political mandates for coverage whether people want it or not. People would find it worthwhile to reserve insurance for catastrophic events only, covering predictable routine matters through their savings. 

This is as good as it can get in a world of scarce resources and unlimited consumer wants.

Time to Separate Medicine and State

The "progressive" coverage of United Healthcare CEO Brian Thompson's murder has an unspoken premise: namely, that we could have had a system in which medical care was instantly superabundant and free for everyone. There is no such system. We live in a world of scarcity. Socialized medical systems limit or deny care because of resource and government-budgetary constraints, and they impose high and even lethal costs through long waits for tests, surgeries, etc. Our government-saturated system is a nightmare, to be sure, but more government control would make things even worse, as Obamacare demonstrates.

It's time for the free market.

Socialized Medicine Ain't Freedom

The emergence of a pro-Enlightenment, pro-reason, anti-woke left, with its eloquent declarations in favor of freedom, is welcome indeed. But this political force still has some way to go. It is disappointing to hear the same people who effectively and properly debunk the power elite in so many ways, including its Covid policies, nevertheless stop regularly to endorse Medicare for all, or single-payer health care, or better, socialized medicine. If you understand what's wrong with a system that enables a power elite to use the state to impose its will, how in the world can you also call for putting all medical care under that elite's control? Who do they think would ultimately run it? The people?

The only thing answer I can come up with is that the anti-woke left thinks socialized medicine is the only alternative to what we have now, which they call "the free market." In fact, what we have is fascized medicine. My reference to fascism is not an emotional outburst; it's technical Fascism as devised by Mussolini is a system of total government control of the production of goods and services with a facade of private ownership. A free market in health care couldn't be more different from what we have today.

If we can disabuse the anti-woke left of its screwy notion about America's health care and insurance system -- by pointing out the many ways the government prevents the market from working -- we might get them to abandon socialized medicine. One can only hope.

Rachel Maddow, Demagogue

I know, I know. Why am I wasting time on her? Good question. But I can't let this get by me.

The other night she and state-socialist congressmen Anthony Weiner had a good laugh because all the Republicans on a congressional committee voted against his trick amendment to end Medicare. What hypocrites, they sneered. Republicans say they are against socialized medicine, but when their political careers are at stake, they won't vote to end the socialized medicine we already have for retirees. (Clip here.)

I am the last person to want to defend the Republicans. The charge of hypocrisy is easy to make, and no doubt Maddow and Weiner are right about many or most of them in this case. But they were engaging in demagoguery, and they must have known it. The principle of charitable interpretation is worth applying not only because it's decent but also because it forces oneself argue against your opponent's strongest possible case. Going for the weakest case is a wimpy thing to do--a confession you lack confidence in your own.

Someone can nonhypocritically and coherently say, "I'd vote against creating Medicare today. But since after 44 years people on fixed incomes have come to rely on it, I would not just kill it in one shot now. I favor some kind of gradual transition to a private system."

Agree or disagree with that position, it shows that voting no on an up-or-down vote to kill Medicare is not necessarily hypocrisy for one who opposes government-controlled medical care.

Maddow's schlocky program is little more than a series of conversations with guests who agree with her so she can distort the positions of those she diagarees with. She might have brought on a someone to argue the point I make above, but she wouldn't know what to do with someone who intelligently disagrees with her. That speaks volumes about her intellectual heft or confidence, or something.

Obama, Medicare, and Socialized Medicine

At his AARP event yesterday, President Obama derided those who in the 1960s called Medicare "socialized medicine." Yet later in the event he conceded the point. See for yourself:

I got a letter the other day from a woman; she said, I don't want government-run health care, I don't want socialized medicine, and don't touch my Medicare. And I wanted to say, well, I mean, that's what Medicare is, is it's a government-run health care plan that people are very happy with.

As he read this, he and the audience laughed condescendingly as if to say, "What a dolt. She hates socialized medicine but she loves Medicare. Doesn't she realize they are the same thing?"

As for people being happy with Medicare, Obama might have pointed out that retirees receive far more in medical benefits than they ever paid into the system. At the moment they can basically have all they want for free or for low cost. Now they even have drug coverage. But that will change if Obama gets his way, because he's decided "we" spend too much on m medical care and he is determined to do something about that. Part of that "something" will be to scale back Medicare, which Obama himself says is, along with Medicaid, the biggest source of the budget deficit. Anyone who thinks that "reform" won't start denying options to retirees is dreaming. It's already happening. Wait until the government inserts itself in to end-of-life decisions. I guess the earlier critics of Medicare weren't wrong, they just had their timetable off.

If government were really interested in seeing a rational medical system, it would stop forcing the taxpayers to pick up the tab for other people's medical care. How could that do anything but send costs through the roof and then "justify" government control?

Welcome to Post Office Health Care

America’s health-care system has problems — all traceable to government intervention — but it could be worse. And if the so-called reform emerging in Congress is enacted, it will be worse.

My latest Future of Freedom Foundation op-ed, "Welcome to Post Office Health Care," is here.

Bourne Updated

Health is the health of the State.

Will the “Public Option” Be a Cutthroat Competitor?

President Obama says he doesn’t want the government to run health care. He just wants a “public option” to keep the private insurers “honest.” Imagine that: A government bureaucracy keeping someone else honest. Physician, heal thyself!

But would a public option keep insurers honest? People who dislike markets often spin horrifying scenarios about big companies engaging in cutthroat competition and predatory pricing to drive their rivals out of business. But none of these folks ever see this danger in government “enterprises.” A public option will have sources of revenue no private insurer has: captive taxpayers, the U.S. Treasury, and the Federal Reserve. Do you mean to tell me this won’t permit the government program to engage in cutthroat competition and predatory pricing against the private insusers? And let’s not forget that it will be government that dictates what products the private companies can sell.

Beware Politcians' Sweet-Talk about Healthcare Reform

President Obama had sugared words for those concerned that government healthcare "reform" will violate freedom of choice. He insisted that people happy with their insurance and their doctor will be free to stick with them.

What he didn't say is what those people should do when the government's tax-subsidized "public option" insurance program and price controls drive private insurers out of the market and doctors get fed up dealing with the government.

TGIF: Medical Misunderstanding

Economic illiteracy will be hazardous to your health.

The rest of TGIF is here.