Announcing the "Anti-Universal Coverage Club"...

"Universal Coverage" sounds nice and fuzzy. How could anyone object to "Universal Coverage"? I object. I do not object to "Universal Coverage" if it occurs naturally -- if everyone in America decides that health insurance is a good idea, and decides to go out and buy it of their own accord, I don't have a problem with it. But it's not going to happen. Why not? Because many of us, myself included, do not need health insurance.

I don't need health insurance because the hospitals are required by law to treat me whether I am insured or not. They should not be, but they are. So long as they are required to treat me even if I don't pay, I see no reason to pay, so I don't. That makes me one of the however many "victims" that the government wants to "save" by instituting health care rationing. Sorry, not interested. How about this as an alternative: Stop forcing hospitals to treat me if I don't carry insurance, and I'll buy insurance. Seems fair to me. digg story


G.E. Smith said...

Let's say you're in a car accident and you're seriously injured. EMS picks you up on the side of the road. Should they have to check your wallet to find your health-insurance card before putting you in the ambulance? If not, and they do take you to the hospital, and the doctors do treat you, and come to find out, you don't have health insurance and cannot pay, then guess what: We all pay. This is just a fact.

I am BY NO MEANS an advocate of single-payer healthcare! I believe the path to universal care is LESS government, not more (of course)! But I think the Hippocratic Oath requires doctors to treat patients, and so long as they can pass the costs on the insured, they will -- and sleep a lot better at night than they would if they let a five-year-old die because Mommy spent her money on cigarettes instead of health insurance.

With that in mind, I think there can be POTENTIALLY some limited role for government to play. Anything that helps create a more vibrant marketplace for individual healthcare and health insurance consumption, preferably at the state level, could be a decrease in force, not an increase.

By the way: I added your blog to my blogroll. Thanks for posting at my blog.

cxx_guy said...

I'm not sure how that (rare) situation of being unconscious and in need of medical care would be handled in a free country. I will try to look into what was done here before the health care system was cartelized and nationalized. Suffice it to say, there are solutions. I suspect that most doctors/hospitals would treat the patient and attempt to collect afterward. A charity could pay for the care of those who were unable. Luckily, this is a pretty rare situation.

The most important thing we can do to ease this situation, of course, is to cut the cost of providing service in the first place. This is one of the most important reasons to deregulate. When medical care has been deregulated to the point where the average operation costs the average worker 2 weeks pay instead of 6 months pay, it becomes much easier to finesse situations like the above. Note that the cost of medical care did not start spiraling out of control until the federal government gave the AMA permission to cartelize the industry, which would not have worked without being backed by government coercion, and started poking it's fingers into the health insurance industry.

If doctors do treat patients who are unable to pay in a free market, they would be very limited in their ability to shift the burden of their decision onto customers. The reason is that if doctors are not forced to do it, some will choose not to. They will not be passing on any unpaid care, and their prices will be lower. People will tend to choose their services in order to reduce costs. This will tend to lower the market price for these services. Doctors, being human, would probably continue to do it out of charity, and would probably set up a private organization to help pay for it.

As for a government role, anything the government did would cripple the market. Government is a chainsaw. Medical problems require a scalpel.

Geek said...

cxx guy,

I like the chainsaw analogy. I've always viewed the government as a hammer seeing every possible problem as a nail, a blunt instrument if you will.

Like the blog.

Avram Mirsky said...


The only self-policing the market will do based on greed and avarice is between market organisms (corporations). The common good is an irrelevancy if it confounds stockholder obligations.

As Thomas Franks said in 2004, it's all about "socialize the risk, privatize the profits."

cxx_guy said...

Actually, since all market actors (creators and consumers, incorporated, unincorporated, or individual) effect the price levels of the market, and these prices become reflections of the true values of society, the common good is served as perfectly as humans possibly could. Certainly no five year plan of any socialist dictator has come closer than perfection, no matter how hard they tried.

ayoalex said...

mmhmm interesting

Todd Steinberg said...

So how do we go about getting the state to allow more medical schools?

cxx_guy said...

Remove it's authority to enforce the AMA cartel. When medical schools do not require AMA recognition to exist, and their students do not need AMA (or state) permission to practice, medical schools will pop up like weeds.

The AMA can continue to certify physicians, and those who prefer physicians certified by the AMA can use them exclusively. They can even get "med-alert" bracelets saying that they consent to treatment only from AMA certified physicians (or physicians certified by the competing organization of their choice, or even a list of certifying organizations).

Paul Marks said...

Most people who go to E.R.s are not dragged there from car crashes. They are people who have chosen to go there, knowing that that the hospital can not make them pay - or turn them away.

So Rich Paul is correct.

As for the points some people make about "greed" and other such, actually it was the nonprofit hospitals (the ones that are nothing to do with greed) that seem to have the most problem controlling costs.

Blue Cross and Blue Shield back in the 1950's (when insurance started to become a mainstream thing) were not for profit enterprises concerned with stock holders.

I have no problem with non profit hospitals (or anything else) and, contrary to what some people think, the distinction a libertarian makes is not "profit and and non profit" but "voluntary and non voluntary". But thinking has to be kept straight.

Of course there are many reasons for high health care costs. F.D.A. regulations, government backing of the A.M.A. union, the "knock on" costs of Medicare and Medicaid (which, like government aid to higher education, push up prices for other people)and so on.

But if people knew they could just walk to an E.R. and say "I have a pain in my ..... I may be dying, I demand treatment" health costs would be lower.

Free hospitals (religious and secular) would still exist, but they would only likely treat people who really were poor (i.e. who could not pay, not would not pay). So the general "knock on" costs would be less.

RevJim said...

Now that I have seen your blog, I am very gratified that you left a comment on my "Lift That Torch, Ring That Bell" blog. You have definitely studied well. I have been searching for other Libertarian blogs for a while, and I am glad you found me, and visa versa

John J. Kaiser said...

"How could anyone object to "Universal Coverage"? I object"

Me too!

Paul Marks said...

What has been scaring me recently is how many self described "pro freedom" people have been supporting this "universal coverage" (i.e. government mandated health care) idea. Although only two of the Republican candidates for President seem to support some version or other of the idea at either State or Federal level(Romney and Huckabee)

At least one of the normal Samizdata comment writers for example.

"No more than what I would expect from you pro war types" - perhaps, but it came as a shock to me.

By the way I have replied to what you said on the Samizadata quote of the day thread - the one on burning people.

Dr. T said...

There would be universal coverage if Medicare, Medicaide, and mandated health insurance of various forms hadn't driven the cost of health care so high. Once upon a time doctors asked people what they did for a living in order to know what to charge them. That was their way of helping the poor afford health care. Now 3rd party payment drives up the price of medical care because in no small part doctors have to charge much more than their services are worth just to get the third party to pay what their services are worth. But if you don't have a third party paying for you, then guess what? You end up paying the whole new high price.