Thoughts on Health Care “Reform”

One of my law partners asked me yesterday which of the Democrats’ current initiatives is worse, the tax on carbon or the health care “public option,” otherwise known as socialized medicine. I replied unhesitatingly that socialized medicine is much worse. Carbon tax-and-trade can rather easily be repealed once people realize what a dumb idea it is. However, once our health care system has been destroyed and replaced with “single payer” socialized medicine, there is no going back.

My friend Bob Cunningham offers these observations on the Democrats’ plan:

[I]n fact, having the public “option” crowd out private insurance will result in a monopsony not a monopoly….i.e., one buyer rather than one seller.

This is, of course, the whole point of the plan… constructively, a single payer system which is, by definition, a monopsony which will exercise monopsony purchasing power….in effect confiscating as much of the incomes of providers as it can get away with…and managing the resulting supply shortage by its complementary monopoly position as a seller (or provider) of insurance to the public….only one place to go on either side of the trade….nice work if you can get it.

What is being overlooked this time around compared to 1993 is this: to prevent “leakage” from the system, draining of supply to other providers of insurance/purchasers of health care services…the “public option” has to effectively outlaw them. The mechanisms will be various and include provisions in law such as a prohibition on “topping off” fees paid independently by patients to physicians or hospitals above the public option’s reimbursement rates to get better service or, indeed, any service at all in some circumstances (already in Medicare, I believe). A prohibition against taking private patients if a provider accepts ANY public patients…it’s an all or none situation…unless your entire practice is exclusively private, you must accept the government’s terms and conditions and no others. Severe penalties for the economic “crime,” probably deemed to be medical fraud, of engaging in free market medicine, for violators. Private provision and private insurance is all but forbidden in Canada (despite the provincial court decision a few years ago) and that is where we would be headed, too.

Otherwise….you get a two-tier system…wealthy people will pay their health care tax but then just opt out of the system…analogous to public schools vs. private schools…..a very few health care providers will cater to them and not need the public option…they would then “disproportionately” “consume” medical “resources” and the best resources…but only a very, very few….and there will be nowhere to hide…no suburban school district to flee to that is the equivalent of private school. So that’s how Bill and Hillary would avoid standing in that line at the clinic. And why it is ESSENTIAL that all public employees and those on public pensions be required to participate in the public option…make Congress have the exact same requirements as everyone else.

That, of course, won’t happen. Our would-be masters have no intention of relying on hideously substandard socialized medicine–that’s for those who are without influence in the Democratic Party. In what many have viewed as a watershed moment, Barack Obama, during the ABC News infomercial last night, refused to commit to treating his own family under the “public option,” insisting that he “always want[s] them to get the very best care.” Well, sure, so do we all. The difference is, Barack is special. He gets to write his own exception into the statute, along with Democrats in Congress.

Opinions vary as to whether our political system is temporarily out of whack or pushing-up-daisies dead. Congress’s willingness to adopt socialized medicine strikes me as a sort of acid test.

Responses