So this week started out with Paul Ryan stating that he is still planning on the complete repeal of Obamacare. And from what he said before his keynote speech at CPAC…I’m laying even odds that he starts a chorus of “Do You Hear the People Sing” and leads a march to build a barricade around the White House.
But it’s good to know that the crusade to end what is perhaps the worst bill in memory (it’s hard to say it’s the worst bill of all time when you have to compare it to the terrible socialist bills of FDR and LBJ’s presidencies)…still this bill is pretty close to being the straw that broke the camel’s back for this country and it must go before we can fix all the other monstrosities.
But liberals, being the whiny brainless sort that they are will whine “but medical costs are too high. But people have a right to insurance. But people have a right to healthcare!”
Ignoring the simple fact that healthcare isn’t a right by any stretch of the imagination and that if you need healthcare, get a job and earn it, let’s deal with their claim that medical costs are too high.
I would agree medical costs are too high. But, like a bad doctor, liberals want to treat the symptom not the disease. Healthcare costs too much, throw money at it; that should cut the costs.
Conservatives however, like to determine the causes of high costs, which is the disease and treat that. So what are the causes of high costs (hint, it’s not the private sector)?
(Everything that will follow will assume that Obamacare has been justly killed because there is nothing in the bill that should be saved).
So what are the three main costs to medical care: Insurance, doctor’s/hospital bills, and drug costs?
So how do we cut insurance costs?
Tort Reform. Tort Reform. Tort Reform.
Every state that has instituted tort reform has seen medical costs drop, the number of doctors increase, the number of unnecessary procedures drop like a rock and even the number of deaths drop. If the federal government and every state were to institute real and sweeping tort reform you would see every single thing you buy drop in price, but you would probably see the biggest increase in the quality of medicine.
We allow insurance companies to cross state lines. Right now all insurance companies are banned from selling insurance across state lines. Look at any insurance card you have. Farmer’s Insurance of California. Blue Cross of Arizona. There may be a national corporation, but it owns 50 separate corporations in 50 different states. That’s a lot of overhead. It also stifles competition. A smaller company can’t expand beyond its own state because it can’t afford to set up a whole infrastructure to have a multi-state operation. This limits competition, and as anyone knows the less competition the higher the prices. If we remove the federal block against insurance crossing state lines you will see drops in every form of insurance you have: medical, car, house.
Just those two things would easily drop the cost of health insurance to probably 90% of its pre-Obamacare costs, perhaps more.
But why stop there? Doctor’s bills themselves also contribute to a large portion of the costs. So what can we do there?
Well a lot of the initial costs come from the fact that when doctors start their career they are laden with college and med school debt. Obscene levels of debt. So let’s fix that.
The reason why college costs are so high is because the federal government subsidizes them at outrageous prices. Subsidies always increase costs. Always! So cut all tuition subsidies and grants. Within a year you will see college costs drop. Now this won’t have an immediate effect as the doctors without massive debt will be years away from entering the market, but long term this will not only solve part of our medical problem but our massive college debt problem.
But part of the reason why doctors charge so much is because they know that Medicare and Medicaid aren’t going to pay them their full billing price, so to stay in business this has a threefold fix.
Adopt the Ryan Plan which will allow more competition in Medicare and Medicaid, which will both ensure doctors get better payment AND lower the cost to the taxpayer for these costs.
In a second step we need to move as much of Medicare and Medicaid costs to the states as possible. While the private sector does better when done on large scale, government and bureaucracy work in the exact opposite manner. The closer any government program is to the people the more efficient and the lower the cost. Lower costs means that Medicaid and Medicare will be able to get closer to pay 100% of doctors’ asking prices for their services (not to mention more doctors taking Medicare and Medicaid patients) which means they will be able to drop their prices for the rest of us and still make a tidy profit for their practice.
Increase the penalties for Medicaid and Medicare fraud. We’re talking about nearly $500 Billion in fraud every year. $500,000,000,000.00! I’ll let that number wash over you for a second. That’s one of the main reasons why Medicaid and Medicare can’t afford to pay full price to doctors. Now while I generally don’t believe the government should criminalize more things or come up with even stronger punishments, fraud is something even the most libertarian government must prosecute and fraud against the government doubly so. Penalties and enforcement need to be much stronger. If there’s $500 Billion in fraud it means the risk is much, much lower than the reward. Much lower. If we have to get a little Draconian, so be it, we need to make it very clear that the risk is now worth the reward.
Now the cost of drugs is also an issue. So how do we lower the costs of drugs (and liberals throwing money all willy-nilly at research never works).
However there are things we can do.
Allow drug patents to start when the FDA approves the drug. Right now a drug patent (20 years) begins when the drug is patented. So when a drug takes 10-15 years to get FDA approval. This means that the company only has 5-10 years to recoup all of the cost of not only research for that drug, but of all the other drugs that failed. So they have to recoup all of their investment for all R&D in only 5 years. And you wonder why the cost is so high. If we started the 20 year clock when the FDA grants approval they would have more time to recoup costs and thus would not need to charge as much.
Reform the FDA. Right now the FDA prevents human testing of experimental drugs on willing patients with terminal diseases….because the drug might kill them. You know if I have a terminal disease the last thing I care about is if a drug will kill me, because I know for a fact the disease will. A lot of medical costs are in cancer treatment; to allow willing patients to try experimental drugs could not only rapidly speed up research (thus cutting costs to a fraction of their current levels) but actually find some cures and real treatments to one of the biggest costs in the medical industry.
And then there are some other things we could do that could help medical care. Nanny’s in the government like to talk to us a lot about eating healthier which is odd since government programs are designed to make sure we don’t eat healthier.
End all government subsidies, tariffs, and controls for agriculture. We pay people to grow tobacco, we pay them to grow sugar, we pay them to leave ground fallow. We even pay people to grow corn only to be turned into fuel (ironically it takes over a gallon of fuel to produce a gallon of corn ethanol…that’s efficient.) When you subsidize something you get more of it. And you wonder why it’s hard to get healthy food. Yes, ending subsidies and tariffs on sugar would initially drop the price of sugar, but it would also result in less being produced which would again raise the price. It would also leave more ground for producing the fruits and vegetables we’re not getting right now because fresh food is so overpriced.
Suggestion # 10
And while we’re at it, if we want people to eat healthier maybe we could stop regulations on food. Stop sending SWAT teams at raw milk distributors, stop fining people for having their own gardens of fresh food, stop preventing the Amish from taking fresh food across state lines. You know little things like that.
Special Idea #11 Fluoridation
Now I usually hate talking about fluoridation. Why? Because so many wacko conspiracy theorist nuts think it’s some grand government conspiracy to control people. It’s not. It was, as with most government actions, a well meaning but idiotic plan. Let’s put fluoride in the water to strengthen their teeth (we can’t trust people with their own hygiene). Yeah let’s put a substance in the water that causes lower IQ’s, higher cancer rates and drastically lowers the thyroid gland (which might have something to do with obesity). What could possibly go wrong? You know between the expansion of the dental industry, better access to toothpaste, and personal responsibility I think our teeth are fine. Let’s stop fluoridating water.
Special Idea #12
Walmart and other such stores apparently want to get into the healthcare business. I say let them. They want to open small clinics. Honestly what they’re proposing will basically act as a triage center. They will tell all the people with just a cough to just get Sudafed, treat the small wounds, and thus clean up the real traffic at urgent care and the ER. This will almost certainly cut down costs from needless tests.
Notice something about this. With the exception of #6, involving the prosecution of criminals (a proper function of government), each and every one of these calls for less government not more. Why? Because government and regulation are what is causing so many problems.