Friday, October 24, 2008

If Elected President, I Will...

Free Market Physician's guide to solving the "Health Care Problem"

Of course we recognize that the fix that health care needs is not within the constitutional powers of the president of the United States. Any comprehensive plan that a presidential candidate offers is probably going to throw a wrench in the economy and is possibly unconstitutional as well.

What we offer is the hard, but true, solution to the health care problem. It's hard because it is not just an executive or legislative fix. Our congressmen are not going to pass a bill that makes health care affordable and available for everyone. No, the solution is to be found in the market and it requires politicians to do the thing that is most difficult for them- to untie our hands and stay out of the way.

And just to be clear, let's specify what the Health Care Problem really is. It is high prices due to a lack of supply of medical care. So without further ado, here are our three recommended actions for solving the Health Care Problem.

1) Remove the legislation of discrimination that denies non-traditional providers access to the field.

Spurred on by the physicians of the American Medical and American Osteopathic Associations, many state legislatures have passed strict laws regulating the practice rights of physicians assistants and nurse practitioners. Many physicians see them as a threat to their practice and believe that an unregulated medical market is somehow an infringement on their rights as physicians. However, the right to a monopoly of the medical market does not exist.

NP's and PA's, those "masters of the mundane," have the incredible potential of filling the gap in America's primary care services. Their education is less extensive than that of DO's and MD's, it takes less time, and it costs less to receive. They have the potential to drop the floor out of the costs of primary care, offering general care at a fraction of the price charged by traditional physicians. They have the potential to work for traditionally underserved populations, opening branches of practices in new locations.

NP's and PA's cannot do everything a doctor can do. They practice within a scope defined by their education, by their licensing, and especially by the market. If they provide competent medical care at low prices, the market will be very likely to reward them.

2) Remove state regulation preventing physicians from competing against each other.

In what other market is non-competition so actively advocated and enforced as in the medical market? We now have the natural effects of these efforts- a market that is not truly a market. The deliberately-limited supply of physicians and the lack of competition between physicians creates artificially high prices in health care. The medical economy is not consumer friendly. In fact it's nearly impossible to shop around. Medical prices are hard for consumers to verify, illegal for doctors to compare, and made homogeneous by insurance companies.

But remove regulations preventing physician competition, and you will see doctors scramble to please patients. Prices will be dropped, advertised, compared, and then dropped even lower. Doctors will be forced to show ingenuity in the administration of their practices, cutting waste across the board. Now empowered, consumers will swap their comprehensive health insurance plans for catastrophic plans and personally shop for price and quality. Health care prices will drop again.

3) Take the philosophical burden of patient care and place it firmly on the patients' shoulders.

After almost a century of modern medical grind, doctors are realizing that they can no longer be responsible for our patients' health. We deeply desire to keep our patients healthy and we've gone to extraordinary means to promote that health. In our frustration, we have tried to control our patients lives. We have tried to control patients by professional authority, we have tried to control patients by barring other practitioners from the markets, we try to control patients by by lobbying state and federal legislatures to pass laws regulating behavior.

We have had success in convincing them. Patients now see us as responsible for their health as well. This fact is evident in the call schedules we keep and in the onslaught of lawsuits we face. But the burden of responsibility for patient care is one we cannot truly carry. It always was the patients' and it must return to them.

When the true responsibility for patient care is established, medical care will be revolutionized. Doctors will see a reduction in status and income, but they will also see a reduction in call hours, malpractice suits, and headaches from dealing with insurance companies. America will find itself healthier and with a more efficient and less costly medical system. This truly is the final solution for all of our national woes- personal responsibility. The sooner this responsibility is acknowledged, the sooner this nation can begin to truly resolve the problems at hand.

Rusty Scalpel

Wednesday, October 22, 2008

Reader Recommendation: "Affordable" Health Care

Thanks for this suggestion to read economist Walter Williams' article "Affordable Health Care." The article points out that socialized medicine schemes in other countries have turned out very poorly. It recognizes some of the following shortcomings:

In Canada, the average waiting time for treatment by a specialist is between 5 and 40 weeks. The average wait time for an MRI or CT is 4 to 28 weeks.

One out of three Canadian physicians refer patients to the United States and the Canadian government pays over one billion dollars for health care in the United States each year.

Great Britain's National Health Services has a goal of having a maximum wait time of 18 weeks for general practitioner services and diagnostic tests. Many people in both Canada and Great Britain have illnesses that become incurable due to lack of care during long waits.

Great Britain Prime Minister Gordon Brown hopes to adopt a "presumed consent" that would essentially make the bodies of Britons property of the state. The plan makes every citizen an organ donor at the time of their death, unless they carry a card or have family at hand at the time of death that state otherwise.

Rusty Scalpel

Saturday, October 18, 2008

Reader Recommendation: Hawaii Drops Universal Healthcare Failure for Children

"And we're supposed to believe that a program that can't work in a state of about 1.3. million people is supposed to work for an entire nation?"

America seems to be in love with universal health care right now, but is any government-administered universal health care system economically feasible? Thanks for this reader recommendation: Hawaii ends universal child health care and commentary- we'll be talking about it more in the future.

Rusty Scalpel

Wednesday, October 8, 2008

A Conservative Approach to Universal Health Care

I believe that most Americans believe that all Americans should have access to health care. We believe that in times of necessity, every American should be able to receive health care despite personal economic difficulty. We can all agree that we would not have a single one of our American brothers or sisters suffer when prudent use of medical care could alleviate that suffering. In this I believe we all stand united.

The division of thought perhaps lies in how relief ought to be administered. A part of our population, often referred to as liberals, generally believe that government programs should be put into place to relieve the suffering of the medically uncared. They believe that adequate funds could be taken from the population to provide for basic medical care for the entire populace.

Another part of our population generally disagree with such government-run programs. These are those who are called conservative and the growing population of those called libertarians. There are many reasons they may oppose such programs and among those are the following:

1) They simply oppose big government. They may oppose growth of government beyond traditional constitutional bounds for constitutional reasons.

2) They see government-administered programs as ineffective. They believe that increased taxation actually results in a decrease in tax revenue. They believe that the collected funds are ineffectively administered. They believe that many government programs foster dependence on the system and prevent the development of productive citizens and progressing human beings.

3) They resent government intrusions into personal liberty. They believe that growth of the government comes at the expense of personal liberties. Government programs hit pocketbooks and limit Americans' utilization of personal funds. Government programs often lead to regulations that limit personal choice. They believe that the preservation of liberty is more important than overall economic strength and that liberty should not be sacrificed for any other goal.

4) They recognize that governmental assistance to the needy does not result in the same spiritual or moral growth as personal assistance to the needy. They see no moral progression in being taxed to help the poor. They see little patriotism in having a pocket unwillingly picked. The funds that they might otherwise dedicate to the good of their fellowmen are taken from them. In addition, the substitution of government checks for loving service and assistance from neighbors and friends considerably blunts the moral growth that could take place in those on the recipient end of charitable action. Those who believe in this way believe that there is no institutional salvation for America without the individual salvation of American citizens.

For those who share this mindset and who cherish personal freedoms, might I suggest a potent means of combating the incoming wave of American socialism. Let's use our freedoms to decrease the need for increased social programs now.

What need can there be for liberal social programs if we use our still-present freedom to alleviate the suffering of our fellow Americans? What driving force would there be behind socializing health care if all Americans had adequate access to basic primary care?

As we look beyond ourselves, we will see solutions to the "health care crisis" that require the exercise, not the sacrifice of personal liberty. How striking it would be if we could demonstrate examples of entire communities where the utilization of innovation and personal freedom lead to a complete independence from federal funding for health care. What a statement we would make if without tax impositions we achieved a society where there is no poor among us.

All Americans, compassionate conservatives and bleeding-heart liberals alike, desire the good of their fellow Americans. As conservatives, and especially as physicians, let's use our own agency to benefit our fellow men. Let us show how our to exalt our liberties and what a great loss America will suffer if these liberties are taken away.

Rusty Scalpel

Reader Recommendation: The Four Ways Money is Spent

We very much appreciate the following recommendation by one of our readers:

I saw this on C4L so I thought I would pass it on...

Milton Friedman brilliantly described the four ways that money is spent.
  • The first and most common way in the private sector is people spending their own money on themselves. In this case, the buyer is interested in both quality (the best product or service that he can afford) and value (getting it at the best price) because he is both the producer of the wealth being spent and the consumer of the good or service being procured.

  • The second way is when people spend their own money on others (such as gifts). Here they are still concerned about value (it's their money), but less concerned about service quality as they are not the consumer.

  • The third way is spending other people's money on yourself. Think of the rich man's girlfriend who buys herself the nicest dresses in the store on his credit card without even looking at the tag. She wants quality, but value is irrelevant since she sacrifices nothing.

  • The fourth way is when people spend other people's money on other people. In this case, the buyer has no rational interest in either value or quality. Government always and necessarily spends money in this fourth way. This guarantees inefficient public spending because the spenders have no vested interest in efficiently allocating those funds.