Watching this fight over health care / insurance reform has made me sad. I feel like I am watching my house burn down, while the Democrats who have the water hose are maddeningly watering the lawn to put out the fire, while the Republicans are struggling to get the hose away from them. Unfortunately, I have low confidence that once the Replublicans get the hose they would indeed save the house. I wouldn't be supprised if they started spraying the fence.

A friend asked me the other night why I don't think poor people should have the same health care as rich people.

First, I think the question implies a false premise, which is that we can create a system that would in fact give poor people the same health care that rich people have. That is false. Rich people, and I would venture to say that in this case this is the majority of Americans, get fantastic health care because they can pay for the best and because the free market is incented to provide the best to make profits, i.e. a free-market system. True there are many flaws in the landscape of the free market in the health care world – in many ways it is not as free of a market as say retail goods are but let’s set that aside for a moment.

The brief answer to the question that would be more accurate is this. Of course I, like everyone, wish that all people had the best health care, and health insurance. I also wish that everyone had a fabulous house, car, food, friends, etc. However, I do not believe it is possible to provide everyone with all these wonderful things without sacrificing something else I hold more valuable, liberty. I believe that Liberty trumps Equality. I believe that the reason this country is great is not because we strive for economic equality but economic liberty. I believe that the government should not be the provider of goods and services; I believe that to be the role of individuals and free enterprise. I believe the government’s role is as regulator to ensure that the relationship between providers of goods and services and the consumers of goods and services does not become exploitive and abusive. To entrust one entity, i.e. the government with both roles of provider and regulator is a very bad idea. I believe Big Government is more dangerous than Big Business. I have no faith that the government who faces no penalties for not controlling quality, fraud, or budgets and have shown absolutely no historical record of doing so would by some miracle do so now. I do not believe they are being honest when, for example, they say that they will cut Medicare by hundreds of billions of dollars to help fund this new or expanded entitlement when they have passed similar mandates upon themselves before wherein they have decreed a Medicare budget cut and never once actually made the cut even though it meant budget and cost overruns in other programs.

I believe that many solutions proposed by politicians are most often poor for many reasons including: politicians are usually under educated in the problem area, they are fed highly biased information from lobbyists, also politicians are motivated not by a desire to provide the best product/service to the consumer in a cost effective manner – but to get re-elected and secure campaign financing. An example would be the idea of preventing insurance companies from denying those with pre-existing conditions. Sounds wonderful at first glance, it’s a terrible idea because no one would get insurance until they got sick, they would be a fool not to (imagine if you could get car insurance after the accident and they would have to pay for the repairs). The only way to fix this dilemma is with a national mandate to force everyone to buy health insurance. Unfortunately this is unconstitutional; the government doesn’t have the power to force everyone to purchase an item simply because they are alive, no matter how well meaning. The rights of the government are enumerated in the constitution and those who believe in un-enumerated rights are opening the door to a world of massive government control. Some say how they can mandate car insurance but not health insurance. Car insurance is based on regulation of an interstate commerce privilege of car ownership (covered under the interstate commerce clause). You can regulate privileges, you cannot regulate rights (with the exceptions of in the case of protecting the rights of others). Some argue that healthcare or health insurance is a right. This is absurd. They clearly do not understand the difference between a right and a privilege.

What people don’t appreciate today is that as government gets bigger the individual gets smaller. Every time the government makes a new rule they have taken a decision away from the individual. The more you restrict people’s agency the more you restrict their ability to learn and grow. No other nation has had Liberty (i.e. Agency) as so core to its being as America has, and as governments and entitlement programs grow we change more into a culture like Europe that does not value Liberty of the individual as core to its identity. Equality and fairness under the law is important, equality and fairness economically is a utopian dream that in order to obtain the liberties of the individual must be sacrificed in part or whole depending on how far the dream is to be pursued.

I, like almost everyone, agree that the current system is broken and needs fixing. The status quo is not acceptable. However, our nation needs documents that are built upon principals like our founding documents, our founding fathers formed the entire federal government with a handful of documents – 2,200 of health care pages that only lawyers can understand tells me they are creating a structure more like the Internal Revenue Tax Code. A document that in my opinion is not a document that enhances liberty and agency, but rather enlarges the government and empowers the faceless bureaucrat. Documents like this reduce, restrict, and strangle the individual rather than celebrating and empowering him.

Everyone is chanting, “STOP insurance companies from denying people with pre-existing conditions!” Here is a classic example of Stage One Thinking that is so common these days. We get an idea that sounds nice and start preaching it as the answer and never take the time to think through, what happens next? Well, if you are healthy and no insurance company can deny you coverage once you get sick, when are you going to get insurance? Obviously, you will get insurance when you get sick and need it. No one will get insurance when they are healthy, why would they. If you could get car insurance after your accident and the insurance would have to cover the cost of the repairs, what sane person would get car insurance before the crash? No one.

Some say the answer to that problem is a “National Mandate.” The government mandates that everyone must buy health insurance. There are problems with as well. The two main problems are first, it’s unconstitutional. The government does not have the authority to FORCE me to buy a product simply because I am alive. Wait, they make me buy car insurance how is that different? That is different because they are attaching that mandate to the privilege of driving a car on government provided streets. If you don’t want to drive a car then you don’t have to get insurance. With healthcare they are dictating that I must purchase something simply because I exist. That is unconstitutional, they have a lot of power, but not that much power. The second problem with this idea is that the government would have to ‘approve’ certain plans to indicate if they satisfy the mandate. If I want a plan that has a higher deductible, or doesn’t cover child immunizations, I don’t get that choice if the government says the plans have to be structured a specific way. And they will have to set minimum plan guidance.

The answer is to allow the free market to create a vast array of plans that individuals can chose from, some BMW plans and some Chevy plans. Get the employer based group discount systems out of the equation because they distort the market for the individual. If there is a wide assortment of insurance plan to pick from, and many are less expensive plans that only cover catastrophic health issues then most people will buy insurance. Those that don’t get insurance and there always will be some, will still go to the hospital and get help and we garnish their wages until they repay, but this I believe would be a small minority.

The most popular politician these days is “The Straw Man.” Why does it seem like the political parties are “talking past each other” like “ships in the night?” It is because of the Straw Man. The straw man argument is a logical fallacy used in verbal or written exchanges. To use the straw man you simply take your opponents argument, change it slightly so it loses its credibility and then you attack it and knock it down, just like you could if you were attacking a real straw man. Unfortunately, politicians are using this tactic almost exclusively. Watch the presidential debates and most of what takes place will be the genocide of populations of straw men, women, and children. Modern media format doesn’t help at all. Television has been bred for the laziest of attention spans. With only 60 seconds at your disposal, it is easy to feel that your only option is to prop up a straw man and show your constituents that you can beat the hell out of him. Dealing with the real issue on its real merits will always take longer than 60 seconds, and we just don’t have that much time these days.

An example is this: ‘republicans keep talking of death panels, and it’s simply not true, it’s not in the bill, they are using politics of fear!’  Simple, 60 seconds or less.

The reality is that there are numerous commissions and panels of this type and that type that are talked about in the healthcare bill. It is unclear what, exactly, many of these commissions or panels will be doing, and what power they will have. Combine that with the history of what we have seen in other countries like England and Canada, which is, that due to budget shortages they have to ration care because they simply cannot afford to give everyone every procedure they need right away, nor can they pay the doctors to service them all. So a panel decides to ration a procedure; someone waiting for that procedure dies because they can’t wait six or twelve months. That’s just the way the system works. If you have limited supply and high demand, rationing is the only reality. The panel didn’t decide that a given patient should die, but they did decide that a procedure would be limited because they are responsible for keeping the program within budget limits. Governments can’t (shouldn’t) bankrupt their nation. Therefore, they have to limit spending which results in limiting procedures. Limiting availability of procedures means patients have to wait and waiting patients die. Call it what you want but it may actually be in the bill. Unfortunately, that takes longer than 60 seconds to explain to someone.

We see this all the time when two politicians get on television news programs. They spend their precious time in front of a national audience setting fires to the anthropomorphicanthropomorphic
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The White House recently release this video. This is the type of communication we have been fed for years from politicians. The sad thing about that video is that there are NO FACTS presented in it, only intentions. The president states his intentions, if you like your insurance plan you get to keep it. Unfortunately intentions are not facts. What matters is what gets signed into law, that becomes fact. The bill is over 1,000 pages long and that is where the discussion must stay focused. It is a tragedy that politicians today believe is it morally justifiable to sign bills into law without reading them. This almost happened, and still might, with this healthcare bill and it did happen with the TARP and stimulus bills, doing that should be criminal.