>(REPOST FROM Saturday, March 04, 2006)
Sheila Kuehl, Democratic California Senator out of Los Angeles, wants to outlaw the voluntary (often called “private”) provision of health insurance in the state, replacing it with a compulsory state scheme (often called “public”) for universal health coverage. She would create yet another state agency: The California Health Insurance Agency. What this ultimately is – have no doubt about it – is a gun to the head of peaceful exchange. This is her proposed bill, SB 840: http://democrats.sen.ca.gov/templates/SDCTemplate.asp?pg=senlegislation&cp=MemberPage&sln=Kuehl&sdn=23&zrn=.
California employees will forcibly have a sliver of their paycheck deducted in order to benefit everyone else. But of course “everyone else” is made up of individuals who will likewise have their paychecks dissected to benefit…everyone else. Thus, the so called benefits to “the public” are illusory, because “the public” is not a thing with feelings and volition that can be benefited, but simply an abstraction, a phrase often used to mask the reality of individuals with subjective desires moving and interacting en masse. But forget the philosophical morass, and let’s move on to consequences and empiricism.
This bill is inspired by the Canadian healthcare system, which also outlaws voluntary health care. At least the German system, to its credit, allows citizens to seek alternative medical services to that mandated by the government.
The Canadian system is rife with incredibly long wait times for relatively minor surgery; doctors attempting to leave the country because they dislike the detailed and relentless dictates from on high; and citizens that can possibly afford it (making due without, skimping) going south to the states for medical care.
There are multiple ways of approaching a critique of Kuehl’s bill. Economically speaking, a single payer system completely divorces true cost from the consumer, as in Canada. If all medical care is equally “free” from the viewpoint of the consumer, then the ability of price signals to reflect scarcity will be lost on them. If one is given equal access to a doctor, whether sprained ankle or bleeding ulcer, then their incentive to economize – weigh the benefits of the doctor’s scarce service with the cost of obtaining it (and perhaps free up that emergency room for the truly hard cases only) – will be lost.
Politically speaking, these state mandates create a hierarchy in which politicians and beauracrats impose standards and one-size-fits-all policies on the people. Democracy alleviates this to some degree, but pharmaceutical companies, doctors and state departments are also part of the democratic process, and they inevitably scheme to seek favors from the powers-that-be to benefit themselves. A completey free market would mean that the consumer was the only force to be reckoned with, their needs the ultimate priority. The employees compelled to fund the new system will have a portion of their check that otherwise would have been available for the purchase of private insurance of their choosing
instead directed to the state’s coffers.
As for the truly poor (who of course are the bulk of the paycheckers, suburban high school kids notwithstanding), the way to bring down costs for them is to radically DE-regulate. No more licensing regimes used by the medical establishment to prevent the appearance of enough doctors to meet the needs of the market. (Did you know you MUST speak English to practice medicine in California? As if a compound fracture required it. Besides, that’s what translators are for.) No more telling consumers of pills that they must first get a doctor’s permission before walking away from Longs Drugs with some Vicadin for their post-surgery needs. In that vein (no pun intended), why not abolish patents for pharmaceuticals, which only work to reduce the available amount of drugs and keep the price high?
I admire Kuehl’s wish to grant healthcare to the state’s poor, but I think her plans would result in a worse, and not better, situation.
Currently reading : Pharmacracy: Medicine and Politics in America By Thomas Stephen Szasz Release date: By November, 2003