What follows on this and the linked sub-pages is an excerpt from chapter 7 “From Here To There: Health Insurance and Healthcare” of the book:
Facing an acute serious health issue or a pre-existing condition for yourself or a loved one without having health insurance coverage is one of the scariest prospects around. The thought alone may send chills down your spine. Just when you need all of your energy to focus on getting well, the burden of financial hardship weighs upon you. In such a situation, Medicare for All or some other tax-financed welfare statist health insurance and healthcare plan may sound pretty darn good.
However, it is important to realize that the main reason for the shortcomings of the current healthcare system is too much, not too little, welfare statist, rights-violating regulations and other government involvement. Today’s health insurance, healthcare, pharmaceutical, diagnostics, and medical device marketplaces are littered with tax inequalities and regulatory barriers. These measures violate the individual rights of doctors, other healthcare workers, caregivers, health insurers, entrepreneurs, researchers, scientists, and, of course, patients.
Earlier in the book, we highlighted that health insurance regulations most likely lock you into a health plan offered by your employer. This makes it impossible to price and quality shop for the best care around. And if you’re not fortunate enough to have employer-sponsored healthcare, regulations guaranteeing coverage for a host of health conditions that will never apply to you make long-lasting, catastrophic health insurance unaffordable and hard to find. And price regulations make competitive fee-for-service alternatives for routine checkups and minor health issues a rare commodity.
We pointed out that nowhere are such problems more pronounced than for pre-existing conditions such as cancer and heart conditions. Regulations prevent health insurance companies from providing policies tailored to such conditions. This removes much of their incentive to engage with the healthcare community, with the pharmaceutical, diagnostics and medical device industries, and with charitable organizations to develop new tests and treatments, implement lifestyle and wellness plans, find cures, and provide coverage for those with limited financial means.
The solution is not more government involvement in healthcare but less. You may remember the healthcare vision that we shared back in Chapter 5, explaining how safety nets flourish in a capitalist social system that respects and protects your individual right to be in control of your life.
We described how, when you and your partner decide to bring a child into the world, providers line up to offer inexpensive pregnancy insurance to cover the rare but potentially financially ruinous possibility of a medically intensive pregnancy or your child being born with, or later developing, a rare disease.
And we highlighted that insurers also offer you and your family catastrophic accident and health insurance in the event misfortune strikes. And for routine care and minor health issues, you try to find the best doctors, hospitals, and other healthcare providers your money can buy. Perhaps you choose a monthly fee plan that covers the basics and that has guaranteed prices for non-catastrophic procedures and ER visits. Or perhaps you prefer to shop around each time you need to see a doctor.
Finally, we pointed out that, as you approach old age, the catastrophic accident and health insurance that you signed up for early in life is still in place to address serious illness. And as you are in control of your retirement, your savings are large enough to provide the final safety net to cover additional healthcare needs as the sunset nears.
A capitalist healthcare market is especially important if you were born with or have developed a preexisting condition, or if you have otherwise financially fallen on hard times. A health insurance market providing coverage for present and future serious illnesses from the day you are born spreads the risks among all insured resulting in reasonable insurance rates. And, because you don’t have to change insurance when your employment changes, you are rarely put in a situation where an insurance company would reject you because of your health profile. As a result, the issue of pre-existing conditions largely goes away.
When discussing how those who are unable to care for themselves are cared for under capitalism, we explained that they reap the benefits of the freedom of all producers to pursue their quest for the unimagined. The unimagined advances in every area of society bring a continuous stream of new, improved, and cheaper products and services. Advances in retirement products, health insurance, healthcare, and medicine make safety net products affordable for more and more people over time. This benefits all of us because our dollars go further. But it is especially beneficial for those with limited means for whom it may be the difference between living day-to-day and a life in relative security. And continuous advances in medical science over time mean that doctors prevent or cure more physical disabilities. The result is that more men, women, and children can look forward to a more comfortable and healthier life.
We pointed out that those with the vision, passion and energy to bring us the unimagined are amply rewarded under capitalism; they make a lot of money and they get to keep it. And because one only enjoys so many mansions and yachts, most affluent individuals soon pursue other values, including charitable initiatives. Funding science, medicine, and education often tops the list for the wealthy. And with most of the incentives to fund political campaigns gone, as we discussed in the section on political equality, many of the wealthy focus even more of their resources on charitable causes.
We highlighted that charitable tendencies are not limited to the wealthiest in society. Most of us have a hierarchy of values that includes helping those that have fallen on hard times. And the more we are in control of our time and money—the more we have left after we take care of ourselves and our loved ones—the more benevolent and generous we tend to be toward others.
We explained that benevolence is a trait of human nature that manifests itself in acts of kindness: shoveling the driveway of our elderly neighbor, offering our seat on the subway to a pregnant woman, financing a scholarship for a child in need, giving money to people hit by an earthquake on the other side of the globe. We don’t consider suffering a normal state of life, and when others hit a rough patch most of us do what we can to help. We all share this amazing journey that is our life, we’re on the same Homo Sapiens team, and on some level that creates a bond and a kinship that inspire us to look out for one another as best we can.
And we concluded that charitable initiatives powered by the benevolence and kindness unleashed when we’re in control of our lives, our time, and our money provide the final knots in the flourishing safety net under capitalism. As more and more people ascend to a life of comfort, and diseases and disabilities become more rare, an abundance of charitable resources will be available for the least well off.
This is where we’re heading, but how do we get there? It has taken the better part of 100 years to get into the current welfare statist healthcare quagmire, so we cannot responsibly cut the government out of healthcare in a heartbeat.
The transition will take time. It’s again worth emphasizing that the main challenge is to build the critical mass of moral support for healthcare reform that centers on respecting everyone’s right to be in control of their own healthcare decisions. Once the moral tipping point is reached, the practical implementation will focus on liberating the marketplace while ensuring that those dependent on today’s system can transition with their health and their wealth intact. The many avenues of reform involve federal and state regulatory rollbacks and a transition away from government financing and control of healthcare. As with same-sex marriage, we may see court challenges to the constitutionality of many aspects of today’s system. In what follows we outline some of the main reforms.
7.3 Pharmaceuticals, Diagnostics and Medical Devices
This concludes our overview of the removal and repeal of welfare statist, rights-violating government involvement in healthcare. We have covered the big-ticket items. Many other areas need reforming as well, but the above would be a fantastic start. If you come across an area that we haven’t covered, follow the approach that we’ve used in this chapter of first removing regulatory barriers to allow the free market to flourish, and then getting the government out of financing and running the operations. That should help you figure out the proper course of action in other areas to phase out government and restore protection of individual rights, allowing people more control over their lives.
Think Right or Wrong, Not Left or Right 