Monday, December 1, 2008

Hsieh OpEd: "Asking For Trouble In Health Care"

The November 22, 2008 edition of the Colorado Springs Gazette has published my OpEd on the bailout crisis and lessons for those advocating "universal health care":
Asking For Trouble in Health Care

Paul Hsieh, M.D., Guest Columnist

In the 1990s, politicians wanted to make home ownership as universal as possible. They used laws such as the Community Reinvestment Act to force banks to make unsustainable loans to millions of people. They also expanded quasi-government agencies such as Fannie Mae and Freddie Mac to guarantee these loans.

This scheme could last only a few years. In 2008, the housing bubble finally burst and economic reality caught up with the politicians. American taxpayers were stuck with the tab for these "toxic" mortgages. The result was the Wall Street Bailout of 2008 and the worst economic crisis since the Great Depression.

In 2008, politicians want to guarantee "universal health care" with new laws and new government programs. President-elect Barack Obama wants to require health insurers to sell policies whether or not those policies are economically sustainable (for instance by requiring them to issue policies regardless of pre-existing conditions). He has also proposed creating a massive new "National Health Insurance Exchange" to help ensure "universal coverage."

But no politician can evade the laws of economic reality. Massachusetts' program of "universal coverage" requires hundreds of millions of dollars of federal money a year to stay afloat, paid for by the taxpayers of the other 49 states. If the U.S .attempted this at a national level, there would be no one to bail us out.

When Obama's proposed national system inevitably collapses under the weight of market inefficiency and bureaucratic overhead, this will merely pave the way to fully socialized single-payer health care. Health care spending now comprises one-sixth of the U.S. economy. Forcing taxpayers to pay for everyone's medical expenses would make the $700 billion Wall Street bailout look like pocket change in comparison.

Even worse, under nationalized health care the government will eventually have to ration medical services to control costs. This is already commonplace in other countries. A Canadian woman who feels a lump in her breast oftens wait months before she receives the surgery and chemotherapy she needs. In contrast, an American woman can get the treatment she needs within days.

According to The Telegraph, Great Britain's National Health Service paid bonuses to primary care physicians who reduced the numbers of referrals to hospital specialists - thus forcing those doctors to choose between their oaths to their patients or the government which pays their salaries. Whenever government attempts to guarantee a "right" to health care, it must also control it. Bureaucrats then decide who gets what health care and when, not doctors and patients.

The fundamental problem with "universal health care" is the mistaken premise that health care is a "right." Rights are freedoms of actions (such as the right to free speech), not automatic claims on goods and services that must be produced by others.

Individuals are legitimately entitled to health care that they purchase with their own money, are promised by prior contractual agreements, or are given to them via voluntary charity.

Attempting to guarantee an alleged "right" to health care must necessarily violate someone's actual rights - the rights of those compelled to pay for it. The ultimate victims will again be the taxpayers, just as they were the ultimate victims of the Wall Street bailout.

Instead of universal health care, we need free market reforms that reduce costs, reward individual responsibility, and respect individual rights. Some examples include eliminating mandatory insurance benefits, repealing laws that forbid purchasing health insurance across state lines, and allowing individuals to use Health Savings Accounts for routine expenses and to purchase low cost, catastrophic-only insurance for major expenses. Such reforms could lower costs up to 50 percent, making health insurance available to millions who cannot currently afford it.

We can't go back in time and avoid the Wall Street Bailout of 2008. But we can still make the right decision with respect to health care. We must reject calls for "universal health care" or else we'll be faced with a massive "Health Care Bailout of 2018." The events of the past few months have taught us some important lessons about economic reality. The only question is whether we're willing to learn from them.

Hsieh, of Sedalia, is the co-founder of Freedom and Individual Rights in Medicine.