Wednesday, January 20, 2010

Hennenfent's Reforms

Dr. Bradley Hennenfent offers his own suggestions on health care reforms that don't require a complete government takeover of medicine.

In general, I very much like his emphasis on allowing physicians and other practitioners to engage with patients using social media, without fear of legal repercussions. I know many physicians are reluctant even to use e-mail, precisely because of legal concerns.

Price transparency would also be a tremendous benefit if also coupled with genuine free-market reforms such as those proposed by John Mackey.

I would like to emphasize that in a free market, one would not need to mandate price transparency, as this would follow as a natural consequence of providers and patients each seeking their rational self-interest. Conversely, price transparency without a free market (for instance, in the type of heavily-regulated insurance market that Obama wants) would be meaningless.

As one small point of dissent, I think it's important not to conflate political power of governments with the economic power of corporations.

As Ayn Rand once noted:
A disastrous intellectual package-deal, put over on us by the theoreticians of statism, is the equation of economic power with political power. You have heard it expressed in such bromides as: "A hungry man is not free," or "It makes no difference to a worker whether he takes orders from a businessman or from a bureaucrat." Most people accept these equivocations—and yet they know that the poorest laborer in America is freer and more secure than the richest commissar in Soviet Russia. What is the basic, the essential, the crucial principle that differentiates freedom from slavery? It is the principle of voluntary action versus physical coercion or compulsion.

The difference between political power and any other kind of social "power," between a government and any private organization, is the fact that a government holds a legal monopoly on the use of physical force.
I fully support limiting the power of government to its proper function of protecting individual rights. Otherwise, Dr. Hennefent is correct -- we would end up with rationing and "death panels".

In contrast, any economic power of insurers in a free market would be controlled by the voluntary actions of patients and providers who would be free to deal with (or not deal with) insurers based on their own rational self-interest. The government should only intervene if the insurance companies are guilty of commiting fraud or initiating force.