**continued from Part I**
THE PLEA AND ITS IMPLICATIONS
If I am going to sign up and state, as Lance Armstrong (and many others) asks, that congress mandate “no American should be denied health care coverage (aka health insurance),” does this not mean whomever is providing that coverage is morally (let alone legally) compelled and obligated to give it to me? Or, in the least, to provide it to me for far less than the amount of benefits I am about to either demand or receive? Under what moral code is it right to use force to compel others to sell any product or service to individuals or groups with whom they would otherwise choose not to trade? Or, compel others not receiving the benefits-in fact, not benefitting in any tangible way-to pay far and above amounts needed for their own insurance so that those who do not have it can obtain it at essentially zero cost?
Similarly, if I sign up and state, again, as Armstrong asks: “no American should lose their health care coverage (aka health insurance) due to changes in health or employment,” what exactly does that mean, and where does one get the moral authority to implement such an idea? Does it not imply that whomever provides health insurance (or health services) ought to be legally obligated (again, by force) to give me insurance or medical care regardless of how I may have lived my life, the risks I have undertaken, the unhealthy life I may have led?
The implications here are that society will be acknowledging that anything goes as far as your lifestyle is concerned, and you need not worry as someone else (society) will be paying for the consequences of your lifestyle choices. As a society, we would be compelled by force to tacitly approve of any and all modes of living – condoning a whole host of behaviors that we currently find abhorrent and would never subsidize or purposefully promote by removing the financial component of such behavior’s health risk..
If these are truly rights to which individuals ought to be accorded, then it can all simply be combined under a singular statement such as, “The right of an individual to health care from cradle to grave, regardless the ability to pay, and regardless of the decisions one has made through the course of their life, shall not be infringed.” Moreover, it then creates an obligation (the concept of a right implicitly includes a corresponding obligation) upon everyone else to pay for such care, again, by force. But is that the only obligation that could be implied? If the above is fully considered-and undoubtedly it is, or will be-in any legislation is there not also a correlated obligation soon to come on all who receive such subsidized services? An implied behavior obligation based upon superficial arguments by reluctant supporters who, in arguing for some sense of equity for their vote, will demand it?
After all, if you are going to have the federal government taking upwards of 70% stock in private companies for purposes of bailing them out, and then having a say in executive compensation, does it not follow that any government mandated health care similarly opens the door for bureaucrats to have a say in how the recipients of subsidized health care live their lives? Or, in fact, to force doctors, nurses, and others to provide care to those whom they would either deny services-for example, illegal aliens, or morally conflicting procedures-or refer elsewhere? What, exactly, would entail from an enforcement end in all of this, and what sort of country would we have around us as a result?
So it is, fundamentally, that this whole issue revolves around two very different, but tightly connected issues: the seemingly unstoppable upward spiraling cost of medical services and the insurance that pays for it, and the overriding ethical question of does one really have a right in this realm?
ANALYSIS AND BREAKDOWN – Health Care vs Health Insurance
In examining this, I think it critical to separate health insurance coverage from the provision of health care services. Health care is the actual provisioning of products (medications, exams, and procedures), aka medical care. Health insurance is but one means of paying for it. It is no different than much of the fundamental arguments over state-run education. Education is the training of young and old minds so that they can become independent, productive, citizens capable of taking care of themselves and their progeny, not to mention pushing forward man’s knowledge. Government-monopolized, compulsory, education is merely one (and probably the most inefficient, divisive, and ineffective) means of accomplishing the commonly desired goal of an educated public.
It goes without saying that no rational person would argue that education is unimportant; humans survive only by virtue of the use of their own mind, and the degree we use reason as an absolute. Education is the means by which humans obtain knowledge and information, perceive and incorporate abstractions, and engage in the training needed to incorporate their education and those abstractions in concrete ways to further their life. To assume the government is an exclusive, or even a logically primary, means to this end, either in education or health care, is a remarkably naive and parochial perspective. A rather anti-human, anti-life, perspective. Yet, it ought not be surprising that it is so pervasive, frankly, given the vast legions of individuals who only know education through a government monopolized conduit.
Similarly, no one argues rationally that medical care is fundamentally unnecessary. We get injured, we contract disease, our kids get sick, and it is in our best interests that we should have periodic physical examinations. For example, no rational parent allows their child to suffer (or die) needlessly by relying on supernatural appeals rather than objective medical care. To the extent a parent does this is an irrational, anti-life, sacrifice of what ought to be their highest value (their own child) for nothing more than an irrational belief in the intervention of a non-existent being-a self-delusion that such a mystical being will perform a miracle cure. The vast majority of the American population simply rejects such idiocy, such criminal behavior, and instead seeks proper medical care. Moreover, certain types of medications manufactured by our increasingly inventive and innovative pharmaceutical companies clearly enhance and extend our lives, and are therefore highly sought after. The problem, again, is simply stated: who should pay and how, and who should be delivering such care. It is a remarkably unenlightened notion that the government should be relied upon as an ultimate resource, or exclusive remedy, to address either of these questions of payment or provisioning. It is simply criminal that a parent would appeal to the supernatural in lieu of rational care to relieve the suffering of a child; similarly, it belies reason to take faith in government as a mechanism to ensure ones health.
HISTORY: THE REAL CAUSE OF THE HIGH COST OF HEALTH CARE
Any responsible analysis of the history of health insurance will lead one right back to WWII where the wage and price controls instituted by the federal government initiated a cascade effect of upward spiraling costs of provisioning. This is so because of the relatively unbridled demand that was unleashed. The mere edict of government cannot alter the fundamental nature of supply and demand. In addition, after WWII labor unions got in on the act demanding employer-financed medical insurance to be part of their contracts. Non-union employers-fearing unionization-provided it too, and this is essentially how we ended up with our current method of who and how to pay for it.
During WWII, government authorities disallowed wage and price increases with certain notable exceptions; namely, employers were allowed to foot the bill for their employees medical insurance and not have that expense considered a component of wages. Clearly, this is an increase in wage cost (cost of labor), but it was allowed because the government simply did not define it that way – purposefully. So, to attract talent, or retain talent, employers used medical insurance coverage as a means. Moreover, for income tax purposes the government again purposefully wrote into the tax laws that such coverage paid for by the employer did not constitute a taxable component of wages. It should come as no surprise that employees, by and large, came to regard this mechanism from a rather abstract perspective in that their medical bills would be paid-by someone else. Thus ushered in the first significant steps towards socialized medicine in America by operation of government mandated wage and price controls, perverse tax law modifications, and all too eager labor unions. The upshot is that we now had established essentially by government edict (the proverbial point of a gun) the collectivization of medical costs and its logcial human action response: a needs-based entitlement mentality.
It was at this point in time, principally, that both health services and health insurance ceased to be market oriented, and were transformed into a state-mandated and controlled entitlement. And the degree of government intervention has increased markedly since; it should therefore not be surprising that the costs of medical services have spiraled completely out of the reach of an individual with a logical and rapid rise in the cost of the insurance used to pay for it. And this is so because individual recipients of the services did not percieve their receipt of medical care as a direct cost to them – to the extent they saw the bill it did not register as a financial burden. Whenever a consumer can obtain any good or service for far less cost that his perceived value of the good or service, he will endeavor to consume ever more of it. This, of course, led to the next bad idea: Medicare and Medicade. These two programs were instituted in the 1960’s as a response to the effects of the initial government interventions and tax preferences that caused the cost and price rises; severly affecting the elderly’s ability to obtain health care. Instead of recognizing the core issue of why costs had and were rising so as to price insurance out of the reach of most individuals-particularly those on fixed incomes-government bureaucrats and elected representatives went further towards collectivization by implementing Medicare and Medicade. This was pouring gasoline on an already hot fire.
Among the effects of these two (Medicare and Medicade) government interventions was the obvious result of re-admitting legions of medical care buyers back into the demand side of the equation, further pushing the upward spiral of costs. Added to all of this are irrational government licensing restrictions to “practice medicine” that essentially create an artificial government imposed barrier; a barrier to relieving sizable poritons of the supply constraints which add to the upward spiraling of cost. One need go no further than this to see what the fundamental problem is: government intervention and control applied to an upward spiraling cost problem caused by the initial government interventions. Moreover, it should lead one to conclude immediately upon the solution, incremental if need be, to the cost of medical care problem: deregulate and get government out of the equation!
Clearly, the culprit for the high costs that are impelling people to irrationally look to the government for answers and “solutions” is not the free-market, but rather it is the government itself. And at this late date in the mess caused by government, seeking more government mandates, controls, and restrictions is akin to seeking a remedy for decades of crime in your neighborhood from the thieves and criminals responsible for the crime in the first place. Such is utterly inane, yet this is precisely what Lance Armstrong and all the others who are clamoring for more government intervention are asking.
LANCE ARMSTRONG’S REAL PREMISE
The premise of Lance Armstrong’s appeal to the public for supporting the two aforementioned congressional mandates supposedly stems from his well-publicized experience with testicular cancer over a decade ago. He states on his blogsite that were it not for some benevolent quick maneuvering by one of his professional sponsors, getting him coverage under their insurance plan, he would not have been able to pay for the treatments he desperately needed. He states that he tried knocking on the doors of insurance companies looking for coverage-after being diagnosed with cancer-and was turned down. Clearly, in Armstrong’s case, he was not looking for insurance to cover a potential loss; rather, he was looking for someone to immediately provide the funds to pay for the radical cancer treatments and therapy he and his doctors determined he needed-right then and there. He further states that he likely would have perished from his cancer without the intervention of the sponsor’s insurer. Now, there is no doubt that Lance needed critical care-expensive therapy. This is not the issue here, what is at issue is the real cause of his facing a marketplace for cancer treatment that had been peppered with government interventions for over 50 years resulting in a cost structure for which no individual, save an incredibly wealthy one, could deal with. If Lance Armstrong is truly concerned about solving the issue of an individual not being able to purchase either insurance or directly the services needed, he ought focus on what the fundamental cause of the high price – merely advocating that the government force others to pay is no solution. Clearly, his actual premise is a philosophically and politically left leaning one: that no American ought to have to deal with the full cost, or the acquisition, of health insurance coverage to pay for the health care they believe they need-it is an individual right.
Can health care be considered a right? The short answer is no, but to explain this will require Part III.