Healthcare the NPR way or healthcare the Libertarian way?

I found interesting a recent NPR podcast with James Morone, author of The Heart of Power. The interview is framed as a positive discussion on the need for national health care. But without hearing the  orgasmic pleasure in their voices over the idea of government control; looking only at sections of the transcript one would swear the interview intended to expose the negative side of the issue.

Morone talks about LBJ instructing a young Ted Kennedy saying:

“The first thing you’ve gotta do, is don’t let them predict those costs. This vibrant, big Lyndon Johnson, he just suppressed the cost figures.”

Tactic number one, just lie and ignore the truth.

“If we would have had accurate projections for Medicare, we never would have never passed the program.”

And this is a statement of victory, not of shame. He continues to say:

“Somehow the debate has become ‘can we afford this?’”

Somehow? Medicare is already going bankrupt, doesn’t that seem relevant? The fact that the program will be so grossly short of funds from day one that rations and a diminished quality of care will be the only result, I think maybe we should talk about the fiscal reality.

“The most important thing is you cant duck healthcare, you’ve gotta feel it in your gut. If you listen to the economists you’ll find you just cant afford it. Every successful president says to the economists ‘I hear you, now get out of my office’”

Don’t think, feel. Don’t listen to reason, live in fantasy land.

“If you look around the world…generally we’ve gotten the system in place first, then rationalized it, then worried about cost. And that’s how the debate aught to proceed”

This is the ideal? Shouldn’t we make a case for the need first, then see if it is feasible, THEN pass the system? Not with liberals. Act first, think later, and then when it is too late and the money isn’t there… inflate the dollar.

Morone goes on to discuss Hillary Clinton’s mistake. “You’ve got to move quickly. The Clinton’s waited a full year.” Forbid it that we should take the time to plan something so important as healthcare. 1000 page pieces of legislation, unread, with 8 hours of debate, rushed through Congress before the people have a say, and signed by the President without the promised waiting period – that’s not a good system.

Let’s talk instead about a Libertarian ideal – a full, thorough debate; a plan that makes economic sense and actually improves quality of care instead of stifles it.

First, remove the tax incentive toward employer provided healthcare. If I choose to buy my own healthcare, I shouldn’t be penalized. Then when I hold my own policy, when I leave my job and need it most, my healthcare comes with me. We need to move back to this as the standard.

Second, remove the restriction on purchasing across state lines. This will increase competition and choice many times over rather than “increasing choice” with one additional solution (Government insurance) that eventually puts all others out of business.

Third, remove coverage mandates. I should be allowed to choose the policy that fits my needs. If I am a healthy individual wanting only emergency coverage I should be allowed to have that. Mandated coverages on drug rehab, abortion, and health issues I have no concern over only drive my costs up.

And finally, something I’ve heard no proposals on how to achieve, but we need to increase consumer participation and cost transparency to introduce market pressures. There is probably also something to say about medical malpractice reform as a means of reducing the cost of healthcare, though the issue is more complicated.

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4 Responses to Healthcare the NPR way or healthcare the Libertarian way?

  1. Micah Green says:

    Great post! Not to get off topic, but the general perception of LBJ’s presidency has puzzled me ever since I started reading about his time in office. So, here’s: 1)a southern democrat, 2)at the height of the civil rights movement, who 3)pushes for an expansion of the welfare state (the “Great Society”). The result? A system that disproportionately targets blacks and makes it difficult to get out once they are in. A bonus: They have their own schools, because public housing is in one section of town. The dems “fought” against school integration, while promoting it at the same time.

  2. Betty says:

    Something else that needs to be addressed is pharmaceutical companies and PBM’s (pharmacy benefit managers). This is where a lot of inflation for drug prices come from. If there is legislation to cap profit for drug companies, you would be surpised at how low your cost for drugs would fall. At my pharmacy (I’m a pharmacist) drugs cost over $2,000 (specialty pharm.) with us making less than $100 profit. The rest is going straight to the drug manufacturer.

  3. bchallies says:

    The interview should be titled: A Moron discusses healthcare.

  4. Rick says:

    Hi Betty – the problem the pharmaceutical companies have is they have tremendous overhead for research. For every drug that goes to market, several do not and they have to make up those costs in order to continue bringing new advancements. So what we don’t want is a system that forces artificially low prices which will result in either 1) subsidies – so we pay for it still, just through taxes or 2) no medical advancement because there is no way to fund the research and no economic incentive to pursue the advancements. What we can do is ease FDA regulation. My dad works for a large medical company and has seen meaningless bureaucracy hold up new products. Or compare the cost of pet meds to human meds. The identical medicine is cheaper for pets because it doesn’t have the regulatory overhead.

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