Healthcare: Libertarian Style
BY SAM FIELDS
The other night I had an epiphany about healthcare costs. The Libertarian Right is right.
I was watching The Daily Show. I was listening to Alice Rosenbaum [aka Ayn Rand] acolyte Senator Rand Paul explain why the free market is the best and only way to deal with rising healthcare costs.
Using examples from his profession as an ophthalmologist, Paul cited how the lack of government regulation, combined with customer free choice, had driven down the cost of Lasik surgery from $2000 to $500. The free market had made him sell contact lenses with profits measurable in pennies.
It made me think back to April 2012 when I had a heart attack [Imagine a lawyer with a heart.].
I’m on Medicare, the big government program. I had no choices.
The government-operated EMS ambulance required me to go to the nearest hospital. Damn you Plantation EMS!
The hospital gave me no choices about cardiologist, anesthesiologist, nurse, room, etc.
And I didn’t care. After all, government was paying for it all.
If I had to pay for this I am sure that I would have handled it differently.
First and foremost I would have priced out everything
I am sure a cab would have been cheaper than EMS.
I would have gone on the Web to compare hospital room rates in the same way someone needing contact lenses shops around. I’m sure “Hialeah Memorial Hospital and Discount Storm Door Company” would have done a fine job.
Now let’s be honest…you’ve seen one cardiologist you’ve seen them all. It’s like gasoline…it all comes out of the same Port Everglades tank. I would have price shopped to get the best bargain. Who’s to say that a doctor from an overpriced brick and mortar medical school is any better than one from a low-cost, online school? (I hope Jeb Bush is paying attention.)
The government monopoly on licensing doctors has got to end!
Did I really need expensive anesthesia? Biting down a piece of leather was good enough for my great grandfather. In any case that should be my choice and not Medicare’s.
Ever notice that Medicare and Marxism both begin with “M”? I’m sure Paul did.
Then, of course, there is the circumstance of being a prisoner in the hospital for three days. If I decided to walkout early I risked having to pay all the inflated bills for doing nothing more than demanding “free choice”.
In the future I intend to bring free market principles to my healthcare needs.
United Healthcare can pound salt if they think I’m going to pay retail for my supplemental coverage. When they send the contract, I will reply with counter offer.
The same with Medicare. My family has no history of kidney problems, brain tumors, pancreatic cancer and a host of other diseases. The chances of me getting Ewing’s Sarcoma are a million to one. With those odds, why should I have to pay insurance coverage on that disease?
I want choice!
So I am going to give up coverage for those things in exchange for reduced rates. I am sure that if I call the Secretary of HRS we can work it out.
I am equally certain that should I have another heart attack I will handle it differently.
Big Government is not going to push me around.
Before going to a hospital, I will go on the Internet and check out the prices and services.
Now if I can only get my blocked artery to go along with my new Libertarian principles.
August 18th, 2013 at 8:19 pm
Sam,
Don’t know where you go, but my wife had Lasik last year and it was around $4000. Love to hear where you get it at $500 let alone $2000.
Also, don’t know where you go for medical care, but when anyone I know, including my family, goes to a hospital, we can call in our own doctors, and do.
Of course if you don’t know any, well that may explain what happened. And it may explain that while you have choice, you don’t know what to choose so they choose for you.
BTW, as bad a situation you claim happened, it appeared that they were successful on whatever they did and you are still alive today. Maybe you should thank someone.
August 18th, 2013 at 9:34 pm
As the saying goes, many a true word are said in jest. What if Sam had been able to pre-dictate his choice of healthcare providers? Perhaps he would have gotten an equal or better outcome at less cost to our collective wallets?
The bigger question is why is Sam getting his news from the Daily show whose demographics skew to uninformed youths.
I would have thought Sam would look to the Huffington Post, MSNBC, or the Daily Beast.
August 19th, 2013 at 7:33 am
I have tried very hard to understand libertarian thought. After all, their champion Rand Paul has been in Congress a very long time. He is a physician. He has run for president, he obviously has had a very long time to think about things. Clearly he is an intellectual.
Yet I keep asking myself whether, at the end of the day, were we to go down the path he espouses, which would drastically change this country in nearly every respect, would we be better off than we are today? Lots of people ask that question.
For reasons based in human nature I conclude that the answer would be no.
There would be a lot more unmet misery in our country and yes, I believe we are a stronger not weaker nation for having less misery among our people.
Does that mean that I do not stand for personal, individual responsibility. Of course not.
But you can’t preach personal responsibility to a mentally ill person. Or a quad case forced to blow through a straw to operate their wheelchair. Or to an orphan. Or a senior citizen — and there will be many times more of those in just a few years because of advances in medical science — coping with trying to live even as their bodies refrain them from doing the things their brains would want them to do.
I conclude that Rand Paul is not a bad person, actually the opposite. He is so kind that he would voluntarily help those in greater need through charity. So he doesn’t feel the need to be taxed for it.
Thing about Paul is he thinks all of society will react because of how he feels. They won’t and most can’t. That is where Rand Paul misses the boat. He has no plan B.
We cannot examine society through the lens of our own souls and arrive at workable answers. There are too many different kinds of souls out there, always were, and that fact is not subject to change. For systems or policies to work, they first have to meet that test — will this work within our society? Paul’s analysis never goes that far. It’s all theory.
It does not occur to Paul to look at the world as we truly exist. I say that not as a knock on the guy, oddly enough it’s a compliment.
Nonetheless, the truth is a third of us are truly special in most every ways. Another third are average and the last third are not particularly special. Rand Paul falls into that first category and his dogma arises from his personal perspective. On that plane what he says makes perfect sense.
Problem is he doesn’t test his dogma within the 2/3rds of the world that is unlike him. This point has been mentioned to him before. He may never realize that.
This is why libertarianism has never quite caught on. It’s not that these are bad people. They are not. It’s not that their ideas fail to make any sense, indeed we can agree or disagree but there is a clear logic to what they say.
The problem is their construct fails to embrace human nature as it truly exists. They are therefore at odds with the world and that’s a shame because with minor adjustments their approaches could be very useful, but they have one added element that makes this difficult. They generally dislike compromise and there too they miss the boat of human nature.
Peace,
Angelo
FROM BUDDY:
Your points are well made on the Libertarian philosophy held by both Ron Paul and Rand Paul, his son.
At the beginning, you are confusing Rand Paul with Ron Paul. Rand is in his first term and has never run for president.
August 19th, 2013 at 9:47 am
Sorry to hear about your heart attack. Happens to us old Medicare recipients.
You seem to have fallen into the Medicare Advantage trap. You might see if you can get straight Medicare, but it will probably be cost prohibitive to switch back, but you should check. President Obama tried to get rid of Advantage plans, but clearly the Inurance companies had apoplexy.
In return for free cheap glasses, Advantage takes away all your choices. The decide what foreign medical graduate you get and you get a semi-private room. “Semi-private equates with partially pregnant.”
Oh well, you got Advantage and I fear you are stuck with it. In the past my efforts to get folks out of Advantage puts new meaning to an irrevocable trust.
August 19th, 2013 at 12:40 pm
Did Senator Paul happen to mention that under Obamacare, the 85 year old patient with terminal cancer is not going to be getting that hip replacement?
At what point in our history did Americans need to start having insurance in order to be able to afford health care?
The medical profession is a greed driven industry. The best way to lower the cost of anything is to have competition. As soon as medical schools start turning out graduates at the same rate as law schools,then we’ll see prices start to really drop at the same rate they have in the legal profession. Some of us are old enough to remember when there was no such thing as a free consultation. Of course that was before we had 10,000 lawyers in Broward County.
August 19th, 2013 at 4:53 pm
Sam,
You’re a smart guy and I understand your sarcasm, but you really should have a group of doctors you have selected who know your history. This particular column is so off mark. You should be thankful you are alive and you should be thankful your heart attack didn’t occur right after July 1 (new residents day). If that had happened, with your health care, your writing days likely would have ended.
August 19th, 2013 at 6:56 pm
I agree with Angelo’s analysis. Further, Libertarianism is basically the worship of private property disguised as “freedom.” It would fall apart in practice since the “rational marketplace” does not take into account how actual humans operate. It’s based on unreal assumptions of how people will act, just like communism was. For example, Rand Paul believes the Civil Rights laws which require equal accommodation in public establishments like restaurants are not needed since the “market” would sort things out via the profit motive – if I operate a business that serves all, I will make more money, and this will result in discriminatory businesses eventually losing out. Does that sound like the real world? Libertarianism is just another system that would result in totalitarianism – the one or few families who eventually own all the Monopoly properties get to be dictator because we must respect and worship the “freedom” for one to do as they wish with “their” private property. Even if the “private property” is now controlled by the 3rd generation who had nothing to do with obtaining it in first place. Capitalism has been great for the USA, and some libertarian sentiments are very good, but there are common sense reasons for safeguards and checks to be in place.
August 19th, 2013 at 8:07 pm
Correct, Buddy. Ron. Not that Rand’s thoughts are much different but the correction is appropriate.
August 19th, 2013 at 8:58 pm
Commissar Angelo. I suggest you substitue the name Barack Obama for Ron Paul, think back to 2007, switch libertarian ideals to Obamanomic ideals, and you will be amazed at how prophetic you really are! Our country is in the crapper for following the socialist path that 2/3 of the world and Obama espouse. Give me either Paul anyday over Barry Obama. And please keep your comments in the future to one or two paragraphs like the rest of us do.
August 19th, 2013 at 9:45 pm
anybody in pines get locked up today?
August 20th, 2013 at 10:02 am
People like Sam Fields and Angelo just don’t understand Libertarianism, and never will. They would prefer the Obamacare version of healthcare where charitable hospitals are fined for giving health care to those who cannot afford it.
What Sam Fields and Angelo really want is control. Control over your health and body. Control over who you do business with. Control over what and to whom you give charity. Control of your finances. What they really want is control of your mind. And if you don’t like how they have ruined the United States of America, they fine you and confiscate your money if you try to move out.
BTW, West Davie is right Angelo. You are way too verbose in your comments. You suffer from diarrhea of the keyboard.
August 20th, 2013 at 10:13 am
Libertarians are the Luddites of modern times. We live in an increasingly complex and urbanized society — requiring people to have health insurance is no more a denial of freedom than prohibiting outhouses or burning your garbage in the backyard.
August 21st, 2013 at 7:24 am
Is Fields too stupid to realize that Medicare patients can shop around, especially for doctors? comparing prices would not occur in many emergencies. It obviously occurs in some traffic to the emergency room or why would hospitals advertise their ERs all over 595 and 95? Other procedures where this is time to plan there are even more competition. Obamacare would destroy this competition.
If you like the Post Office before Fedex existed, you’ll love Obamacare.
August 21st, 2013 at 12:16 pm
Dear Richard, et al.
Sorry if you did not get the joke. I will try to be less subtle in the future.
Also I do have a cardiologist but he is on the Eastside and I would not know if he even had privileges at Westside Regional which did a great job caring for my illness.
The artery that was blocked is known as “The Widowmaker”. There is no waiting involved since the blockage is depriving the heart muscle of fresh blood. Every minute is more heart damage. In a few hours you are dead. There is no time to shop around or implement some pre-planned choice.
From the time I felt the first pain until the cardiologist completed inserting a stent was 90 minutes. Dr. Robert Singal did a great job!
The point of the blog was that Rand Paul suggesting that free market Lasik and contact lenses offer a lesson for heart surgery and most medical procedures is idiotic.
Let me go a bit further. Few of us are qualified to judge the quality of medical care. In most cases we listen to the advice of our primary care physician who sends us to the specialist who tells us what service we should get. If he tells you that he needs to take out your gall bladder the most you can do is get a second opinion and check out the docs on the Internet. You’re not going to tell him who the anesthesiologist should be who that the rooms are cheaper at Broward General.
Medicine and insurance companies are big businesses who are going to fight out over fees.
Far and away the most important thing any of us can do to keep down costs is to stay healthy…don’t use tobacco, eat properly and exercise.
Libertarians [Otherwise known as Republicans who want to smoke pot.] live in this naïve world of economics. They have a few good ideas related to personal freedom, cutting back on the military-industrial complex and empire building.
Note to Ron Wright. I don’t have Advantage—whatever that is. Along with Medicare I pay a couple of hundred a month for AARP United supplement. So far I have no complaints. All my old doctors and new ones are covered.
Say hi to Judy.