Lesson 23: Health Care in Summary
"The only way to put the patient first is to put the patient in control."  Orthopedic surgeon
and U.S. Representative Tom Price.   

The cancer that plagues the American health care seems complicated, but easily distills to
one simple problem:  Government, government, government.  After all, there is really only
one major difference
between the fire, life and auto insurance you can afford; and the health insurance you can't.
 
between the over-the-counter drugs you can pay for and the prescription drugs you can't.
between the five-star resort you can sometimes afford and the hospital stay you never will.
The difference is a history of government "helping"  people.

The government's first major venture into the health care business was in 1965 with
Medicare and Medicaid for the elderly and poor.  These programs grew like all programs
do.  Recently, another one was born,  S-CHIP, which sallies into Pediatrics.  Besides these
directly-run programs, the feds have taken indirect control with sweeping, unfunded
mandates such as EMTALA.  That is the 1986 law that requires emergency rooms to treat
any patient for anything, whether they can pay or not.  There are also hundreds of health
insurance mandates (see
Lesson 22).  With each growth spurt of the government into health
care, the industry has been transformed from a functional business into a perverted
"system."  This decay was predictable to anyone who paid attention to Canada, Europe, or
to world history.  The failure rate of socialism and socialized medicine is 100%.  
Government health care is the reason sick Canadians and Europeans pay cash to get care in
the United States.  It's also why sick Americans are starting to fly to India for the same
thing.

Government has ruined health care in the same familiar ways it ruins any business in which
it dabbles:
1.  Expansion of bureaucracy and regulation (see lessons
5 & 22).
2.  Distortion of the price/value relationship, which in turn depraves consumer behavior
(see Lessons
10 & 11).  Medicare and Medicaid are, after all, subsidies. Subsidies are
simply price controls with a carrot instead of a stick.  
3.  Monopolization.  Government makes the rules and collects the taxes.  Businesses can't
compete.  How many senior citizens do you know who are not on Medicare?
4.  New opportunities for fraud and waste  (see
Lesson 12).

All this ultimately leads to the same thing every time: Lots of free nothing.  In the Soviet
Union they had free cars that didn't run, and free food but empty stores.  Many Socialist
dictators print lots of free money that won't buy anything.  Many inner cities have free
schools that don't teach.  Likewise, Communism provides free health care, but no doctor in
the hospital, no bandages on the shelves, no sheets on the bed.  Socialism is a little better.  
In Canada, you can see a doctor in about 10 hours, you can get an urgent surgery in a few
months, and you can get an elective surgery in a few years.  The reason is very, very
simple:  
Limited resources are most efficiently distributed and used when
millions of people act
freely.  They are most inefficiently used when distributed by a few people acting "fairly."  

But no matter what nightmare goes on in Canada & Europe, socialized medicine in the
United States will be much, much worse.  That's because the American doctor will have an
additional master,
besides Washington bureaucrats,
besides state licensing boards,
besides hospital staff requirements,
....oh, and besides the patient.
The American doctor also must answer to the American trial lawyer, and the U.S. has more
lawyers than anyone.  You see them on t.v. every day, begging you to sue somebody.  Th
is
is also a problem of government.  Many trials are nothing more than government-run,
government-enforced muggings.  

The solution, of course, is to reduce government.
1.  Medicare and Medicaid must be dramatically reduced.  It can be done painlessly if it is
done slowly, over decades.  "But Professor, who will pay when Grandma gets sick?"  The
same people who are paying now: you and Grandma.  (If you don't realize that, then please
go back to
Lesson 1 and start over).  The only difference is that she and you will have more
to spend by cutting out the middle man; you will spend more wisely by paying directly; and
everything will be cheaper, like it  was before.  
2.  EMTALA must be revised.  Emergency rooms are for emergencies.  E.R.'s must have
the right to turn away non-emergent cases.
3.  Health insurance companies must be
DEregulated (see Lesson 22).
4.  Tort law must be reformed.  Right now, it is too cheap for lawyers to wage senseless
lawsuits, and too easy for companies to settle.  

Part of the solution is also to combat a twisted idea that is growing in popularity: that health
care should be equal for all.  Somewhere is the best surgeon in the world.  She can't help
everybody, she's just one person.  The only way to equalize surgery is to forbid people who
can afford her from seeing her; or to forbid her from operating on anyone.  That is the
sickness of the Socialist mind.