Tag Archives: healthcare

The Culture of Entitlement in Medicine II: Your Invoice is Rejected

billI previously wrote about the culture of entitlement in medicine back in 2017. This is to be expected in an industry in which half of all gross revenue is tax revenue. That’s not to say doctors, nurses, etc. are bad people. Quite the contrary. But it’s human nature to overestimate the value of one’s own services – who doesn’t think he or she is underpaid?

The market provides discipline for this childish impulse. In a vibrant free market, we find out precisely what the goods or services we offer are worth to other people, because each customer decides precisely how much money they are willing to pay for our products, not to mention whether to buy them at all. Government regulations and subsidies have largely removed these market forces from the medical industry.

In addition to skyrocketing prices, this has fostered a culture of entitlement among medical providers. They feel entitled to an arbitrary amount of compensation for their goods or services, regardless of whether their customers are willing or able to pay.

This is reflected in their invoices. Rather than bill you for the amount both parties previously agreed to for a given service, as is customary in every other industry, they send you a bill for what they believe they “should” be paid and then represent the difference between that arbitrary amount and their contracted reimbursement (usually established via your health insurance provider) as an “adjustment.”

This passive-aggressive tactic attempts to portray  medical providers both as victims of “greedy” insurance companies (and moochers like you) and as altruists who have foregone most of what they believe owed to them out of the goodness of their hearts. It is important we disabuse them of these delusions.

I suggest we consumers, who not only pay for our own medical care but for the care of millions of strangers, process medical bills the way invoices are processed in any other industry. If you receive a bill priced any way other than what you and your provider have previously agreed to, simply reject the invoice with an explanation and invite the provider to resubmit. Repeat the process until you are billed accurately. Feel free to use the example below as a template:

Dear Accounts Receivable Manager,

Your invoice #XXXXX (copy enclosed) has been rejected for the following reasons:

*Pricing Errors

Your invoice contains five procedure codes for which you have a contracted rate with us through our health insurance provider. It is clear you are aware of this contract as you would not even agree to an appointment until eligibility with our health insurance provider was confirmed.

However, the billed charges on your invoice exceed the amount you agreed to in that contract. For example, your contract stipulates a charge of $38.14 for CPT code 99214. You have billed $175.00 for this service and then represented the difference as an “Adjustment” down to our contracted rate.

It is standard business practice for any going concern to bill its customers at the price(s) the customer agreed to pay via purchase order or contract, not the price the vendor wishes it could get paid.

In no other industry do vendors enter a contract to provide goods or services at one price and then bill for a higher one, representing the difference as an adjustment, as if the vendor were doing the client a favor. Rather, they bill for the agreed upon price and thank the customer for the business.

Please resubmit your invoice within 30 days with billed amounts matching our contracted rate for each service. We will waive the invoice rejection fee on this occasion as a courtesy. If you have any questions, please do not hesitate to contact me. Thank you.

Best regards,

Tom Mullen

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Society is in every state a blessing, but government…

DENVER, CO - JUNE 16: The TSA security lines in the main terminal are crowded with vacation travelers on June 16, 2013, in Denver, Colorado. Located 25 miles from downtown, Denver International Airport is the largest airport in the United States. (Photo by George Rose/Getty Images)

DENVER, CO – JUNE 16: The TSA security lines in the main terminal are crowded with vacation travelers on June 16, 2013, in Denver, Colorado. Located 25 miles from downtown, Denver International Airport is the largest airport in the United States. (Photo by George Rose/Getty Images)

This thing we call “society,” which Thomas Paine correctly observed is separate and distinct from government, is basically an economic arrangement. The basis of and primary reason for society is people exchanging their various goods and services with each other.

I wonder how many hundreds or thousands of years more it will take for people to realize what should be blatantly obvious: that every set of exchanges in which government is heavily involved, by either subsidizing, regulating (aka “protecting established firms from new competition”), or downright monopolizing it, is painful. All these sectors (education, health care, air travel, etc) share the same characteristics: poor service, no accountability, high prices, incredibly outdated, bureaucratic procedures (paper forms, long lines, etc), and lack of choices or options, just to name a few.

Conversely, every industry in which government has low or zero involvement has precisely the opposite characteristics: constantly lower prices, better and always improving service, absolute accountability (you go to a competitor if you’re not happy), cutting edge technology (phone apps, automated texts, etc) and constantly improving ease of use and convenience.

Anyone not completely blinded by their emotions (mostly envy) can see glaringly obvious cause/effect relationships that lead inevitably to one conclusion:

All advancement in human happiness results from markets and other voluntary cooperation and virtually all human misery is rooted in government.

One would think a light bulb would go on sooner or later for most people and government would be banished from most or all human interaction.

Instead, it’s “Thank you sir, may I have another!” ad infinitum.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

 

Why a free market would work for health care

Doctor_655362410569_AP-676x450 (640x426) (2)TAMPA, October 26, 2013 – Conservatives are confused again, rejoicing in Obamacare’s early operational struggles. One would think that their only objection to the legislation has been that the Democrats wouldn’t run it efficiently. Maybe it was. After all, the Republicans ran a candidate against Obama that had implemented virtually the same program in Massachusetts, promising only to “repeal and replace.”

Replace?

Jon Stewart took the opportunity to join conservatives in criticizing the government’s performance during his interview with Kathleen Sebelius because he knew it wasn’t a principled argument. That the government didn’t have its website ready to handle the volume doesn’t address the principle of Obamacare.

This wrongheaded criticism by conservatives allowed Stewart to join in and appear to viewers as if he were being objective, while at the same time delivering the message that Democrats ultimately want Americans to accept: that “a market-based solution doesn’t work for health care.”

First, it is important to define “free market.” When attempting to do so, both conservatives and liberals tend to focus on competition, private ownership of the means of production and the profit motive. These are actually results of the free market, not defining characteristics.

The free market has only one defining characteristic: that all exchanges of property occur by mutual, voluntary consent. Period.

That the means of production are privately owned is a result of this, as no government acquisition of anything occurs by voluntary consent. Competition, too, occurs because customers are free to choose which products they buy or whether they buy at all. This motivates producers to make their products more attractive in quality, price or both. They are also motivated to operate at a profit, both for their own enrichment and in order to survive. Losing money eventually results in the dissolution of the firm.

Applying the definition, a free market in healthcare means simply that all exchanges of property, including the labor of doctors, occurs by mutual, voluntary consent. There is only one alternative to this: coercion. If all participants are not acting by voluntary consent, then some or all are being forced to make exchanges under the threat of violence if they don’t.

Anyone who doubts this should simply withhold the Medicare portion of his tax payments and see what happens next.

Stewart made a familiar argument that is compelling on its face. The free market doesn’t work for health care because patients in need of treatment are often not in a position to make choices the way they do when buying shoes or automobiles. Patients may be picked up in an ambulance delirious or even unconscious. It is unreasonable to assume those patients can make rational decisions about which hospitals they are taken to, which providers treat them or what treatments are administered to them.

Granted, but here’s the rub. Their situation is worthy of compassion, but it does not give them the right to force others to do their bidding. They have every right to ask for help, but not demand it. Their misfortune may not be their fault, but bad luck does not grant them a legal claim on the property of others. Nor does it give them the right to dictate the terms under which an exchange of property is to take place. That exchange either happens by mutual, voluntary consent or freedom is annihilated.

The same argument applies to those who simply cannot afford to purchase health care. Again, many find themselves in this position through no fault of their own. That doesn’t give them the right to use force on innocent third parties.

American governments were once constituted with the assumption that the government’s role was to ensure a free market. As John Locke said in his famous treatise, “The great and chief end, therefore, of men’s uniting into commonwealths, and putting themselves under government, is the preservation of their property.”

It is no accident that Thomas Jefferson had a resolution passed in Virginia declaring that Locke’s treatise was the basis for American liberty.

However, the argument against Obamacare is not just a moral but a utilitarian one. There are cause and effect relationships between the manner in which exchanges are made and the affordability of products. When all exchanges are voluntary, supply expands, prices fall, and wealth is distributed widely. That’s why real wages rose so dramatically during the 19th century, contrary to leftist myths.

When exchanges are involuntary, these cause and effect relationships are disrupted. It is no accident that the most heavily regulated and subsidized industries, like education and health care, are the most disproportionately expensive. Heavy regulation artificially limits supply. Forced subsidies artificially expand demand. Both interventions make prices go up. It’s simple economics.

The health care market suffered from both interventions long before Obamacare. Medicare and Medicaid alone make up about a third of all health care spending. Regulation regarding who can dispense care makes medieval guilds look liberal. It’s no mystery why the price of health care is outrageously high.

If the Republican Party is to remain relevant at all, it has to stand for something other than myopic cheap shots over inconsequential issues like the Obamacare website. It has to stand for freedom. If not, it’s time for it to step aside, as its forbears the Whig and Federalist parties did. There just might be a party waiting in the wings that more faithfully represents voters who truly want a more limited government.

Tom Mullen is the author of A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

 

Elysium: One freedom thumbs up, one down

TAMPA, August 25, 2013 – It is 2154. A small, wealthy elite live on Elysium, a floating paradise orbiting the earth with stately mansions, majestic landscapes, clean air and perpetual sunshine. The rest of humanity lives on overpopulated, diseased and polluted earth.

The wealthy enjoy 22nd century medicine that can instantly cure any disease or injury, no matter how severe. The earth dwellers have overcrowded hospitals where care is backwards and rationed.

The film doubles as allegory on the illegal immigration issue, with the earth dwellers representing Mexicans and Elysium the United States. Most people on earth appear to be bilingual in English and Spanish, while the elitists in Elysium speak English and French.

It sounds like a typical, leftist Hollywood narrative and in some ways it is. However, it also contains some of what used to be good about the left. Elysium is generally good on criticizing the police state and bad on economic freedom.

The plot revolves around Max, a former petty criminal who has gone straight. Early in the film, Max is harassed and assaulted on his way to work by robot police officers who ask him what is in his bag. Max must then discuss the encounter with his robot parole officer, who extends Max’s parole based upon the incident.

The central conflict is created when Max is ordered by his boss to enter a compartment where a mechanical door has jammed. When Max frees the door, it slams shut on him and the compartment floods with radiation, delivering a lethal dose to Max. His only hope to save his life is to get to Elysium.

When Max learns that his childhood friend has a daughter with terminal leukemia, his quest becomes one to save not only himself but the sick girl. In order to do so, he must make a deal with an outlaw revolutionary to obtain access codes that will open the door to Elysium to whomever possesses them.

The film succeeds in painting a dreary picture of a society that has allowed unchecked government police power to combine with technology. Max’s entire criminal history along with data gleaned from ubiquitous surveillance is instantly available to robot cops and parole officers, who use that data against him despite his being innocent of the current charge. The film also succeeds in conveying the hopelessness that accompanies a society where upward mobility is actively suppressed by an entrenched elite.

The film fails from both an artistic and freedom perspective for several reasons. First, it leaves too many questions unanswered. How did those who build Elysium acquire their wealth? Was it through production and trade or some form of plunder? How do they maintain it? If the earth dwellers are uniformly poor, who does Elysium trade with? Why are the earth dwellers unable to build their own wealth? Why are they unable to develop the same miraculous healthcare technology? The viewer is left to speculate.

Based on the film’s conclusion, one can interpret the film as an indictment of private property itself. The earth dwellers cannot improve their condition because the elite own all of the natural resources and means of production. Their property rights are enforced by the brutal police state, which also suppresses any attempt by “undocumented” earth dwellers to enter Elysium. This leaves them no alternative but to toil away as “wage slaves” for the corporations.

Typical of Hollywood, the film makes no distinction between those who have acquired their wealth in exchange for enormous benefits bestowed on others and those who have acquired it through tax-funded government contracts or privileges. The only private company we are told anything about is Max’s employer, which ironically manufactures the robot policeman who assault Max at the beginning of the film.

That’s a government contract, funded by taxes, which are collected by force. But all government contracts ultimately rely on someone, somewhere creating real wealth, i.e. goods and services that actually improve the lives of consumers enough that they will voluntarily exchange their money for them. Where are these private companies? Where is the justice for them at the conclusion? The film is silent on these questions.

The healthcare issue is treated in an overly simplistic manner that even critics of private, for-profit medicine would be disappointed in. In short, the film removes all economics whatsoever from healthcare. The treatment machines used in Elysium are so miraculous that there is no discernible cost to curing people, outside of manufacturing the machines themselves. It cheapens the healthcare question by characterizing it as cartoonish elitists who simply refuse to allow the rest of society to access care out of contempt for their inferiority.

This allows the film to avoid confronting the real barriers to healthcare access. It doesn’t ask why the price of healthcare constantly rises while the prices of computers and cell phones fall. Perhaps the answers wouldn’t conform with the film’s narrative.

The idea of scarcity in general seems to be lost on the producers. They do not acknowledge that either healthcare or the other riches of Elysium are scarce or confront the way in which wealth is created and exchanged. The conclusion of the film suggests that if all of humanity were simply allowed to divide up society’s products equally among themselves, everyone would live happily ever after.

The immigration motif is equally unrealistic. Depicting Elysium as the United States and the earth as Mexico doesn’t work, because the Elysium and earth of the film together represent the real United States. That seems to be the whole point of the rest of the film. Simply opening the borders wouldn’t change anything. The immigrants would simply find themselves joining the lower class or forming a new, even lower one.

Ultimately, the film fails to face several realities. One is that all property is eventually private property. An apple cannot be owned “collectively” unless no one ever eats it. Once someone does, he has excluded every other human being from eating it. This is true of all goods and services. Even in Soviet Russia property was privately owned. What was different was how it was acquired. How would property be acquired more justly in Elysium? The film is again silent.

The film assumes that private property ownership is a purely artificial concept invented by “exploiters,” which persists only through violent oppression of the exploited. The police state is mischaracterized as an enforcer of property rights instead of a violator of them.

No consideration is given to whether producers have any right to keep the wealth they have produced or whether those who wish to acquire it from them have any obligation to obtain their consent. There is no explanation of why the “have nots” have any more legitimate claim to Elysium’s wealth than the “haves.”

On a more practical level, the film also ignores the question begged by resolution. After the wealth of society is divided up equally among everyone, who will produce what is needed tomorrow to sustain even bare subsistence? What will motivate them to produce it?

The Soviet Union and 20th century China couldn’t answer those questions. Elysium doesn’t even try.

Elysium gets one freedom thumbs up for its ominous depiction of the police state. It gets one freedom thumbs down for its attack on private property and an additional freedom thumbs down for its oversimplification of complex economic problems, even by leftist standards.

Tom Mullen is the author of A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

More anti-libertarian nonsense: Libertarians are heartless

TAMPA, March 28, 2013 – This week’s anti-libertarian nonsense is “libertarians are heartless.”

There are many variations on this theme. Libertarians oppose government-run education so they must not want poor people to get an education. They oppose government-run healthcare so they must want poor, sick people to die. They oppose government-subsidized housing so they must want poor people to be homeless, too (if they aren’t already). Libertarians are selfish, amoral…You get it.

Libertarians also oppose state religions, but no one claims libertarians are against religion. I wonder why? It seems to follow.

The people who make these claims don’t understand what libertarianism is and don’t really understand the nature of government or their relationship to it, either.

Libertarians do not object to you helping the poor. They merely object to you forcing someone else to help the poor.

Libertarianism answers only one question: When is violence or threatening violence justified? The libertarian answer is only in self-defense. That includes defending your life from an immediate attack upon it or defending yourself against a previous theft of property or other crime.

This is where libertarians face reality and their opponents don’t. Libertarians understand all government action is violent action. That’s not because people in the government aren’t doing it right. It’s because that is what government is designed to be. Violence is its raison d’etre.

The philosophical justification for government in a free society is security. Because humans will sometimes invade the life, liberty or property of their neighbors (whether next door or in another country), there has to be some adequate means to force the perpetrator to cease his criminal activity and make restitution to his victim.

Government is supposedly the answer. Government is the pooled capacity for violence of everyone in the community. That’s all it is. That’s why Thomas Paine based his entire treatise Common Sense on one fundamental assumption:

“Society in every state is a blessing but government even in its best state is but a necessary evil; in its worst state an intolerable one;”

Why an evil? Because it is an institution of violence, nothing more. This is a foundational American idea. It is the reason for the entire Bill of Rights. Government must not be allowed to suppress speech because offensive speech does not justify violence. Government may not prohibit the keeping and bearing of arms because merely possessing arms does not justify violence against the possessor.

When intolerable? When it is used to initiate force, rather than respond to it. If one individual steals from another, the victim has a natural right to point a gun at the thief and demand his property back. In society, the individual supposedly delegates this power and the government points the gun at the thief for him. Almost no one would consider this unjust.

But what if no crime has been committed? Suppose I knocked on your door and demanded money from you at gunpoint. Would you drop the charges against me if you found out I had taken your money and paid some anonymous stranger’s medical bills? Do you believe that is the best way for human beings to solve the problem that the stranger can’t afford to pay them?

Almost no one would answer either of those questions “yes.” Yet, there is absolutely no substantive difference between that scenario and a government-run healthcare program (or education, or housing…). The only superficial difference is a government official is holding the gun. But most Americans can’t see it and will actually argue with you that it isn’t there.

There is an easy way to find out. Simply refuse to cooperate. Deduct the amount you owe for Medicare from your tax return next month and include a note waiving any benefits from the program. Or deduct the amount of your property taxes that underwrite public education and Medicaid (which is most of the bill) and indicate you waive the right to utilize either.

What will happen next? You will get some “reminders” about the oversight in the mail, followed by increasingly threatening letters. Sooner or later, someone in a black robe will write on a piece of paper. Then, men with guns will show up at your door. Don’t believe me? Test my theory.

So what do libertarians really say that is supposedly selfish or amoral? That initiating force against people is wrong. Period. You are free to help other people who need it, but you cannot force your neighbors to do so under a threat of violence if they don’t. You may build schools and hospitals for the poor and ask for contributions for anyone you wish. You just can’t pull out a gun if they decline to participate.

At one time, Americans believed so strongly in this principle that they seceded from their country and formed a new one based upon it. Imagine if they reestablished it again.

Libertarianism anyone?

 

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Why is health care so expensive? (Washington Times Comm.)

TAMPA, Fl., March 29, 2012 — The nation waits with baited breath while the high priests of the federal government prepare to issue a pronouncement on the constitutionality of the Affordable Care Act, or Obamacare. The legislation purports to make health care more “affordable” by among other things, forcing every soul in the United States to purchase health insurance. It also mandates several other new government interventions into the health care market.

While conservatives are arguing that this represents some enormous crossroads between socialism and freedom and progressives are replying that it’s nothing more than “Medicare for all,” everyone has become distracted from the most important questions. Why is health care so expensive? Why does the price continually rise?

The proponents of Obamacare say that it’s capitalism; allowing health care to be delivered in a free market results in “putting profits before people” and other snappy alliterative slogans. In a word, the problem is the age old progressive boogeyman: greed.

That begs several questions. If capitalism is the problem, then why does the price of computers and cell phones continually go down? Aren’t the producers of these products greedy? Does anyone seriously believe that technology corporations “put people before profits?”

Continue at The Washington Times Communities…

Extremism Is the New Race Card

There was a time in American politics when the “race card” was an effective Establishment strategy against arguments it could not refute logically. Regardless of how unrelated an issue may have been to race, the Establishment would try to make a connection in order to avoid confronting the troublesome argument. Alternatively, they might completely ignore the issue at hand and simply present evidence that the proponent himself was racist. So distasteful is racism to most Americans that the mere suggestion that a politician might be racist was enough to condemn any idea, policy, or position he might take, whatever its merits.

Today, that is no longer true. While hardcore liberals still try to use the race card to discredit anyone who opposes their policy positions, it is apparent that it no longer resonates with average Americans. It was always a strategy with a limited shelf life. Besides, it is only effective for one half of the Establishment. If the race card sounds hollow and timeworn coming out of the mouths of liberals, it sounds downright ridiculous when employed by conservatives.

Besides, the entire ruling Establishment is in trouble. Their welfare-warfare state is coming apart at the seams. While the blue team and the red team will continue to fight with each other, they both realize that average Americans are becoming more open to hearing from people who refuse to put on either jersey. Something must be done to stifle any reasonable consideration of these unapproved ideas. The ruling class needs a new pocket ad hominem, one that can be used by conservatives or liberals.

Extremism has filled the void. “Extremist” is a word that elicits an immediate emotional response. Thanks to the all-out propaganda campaign against extremism, average Americans immediately associate the word with images of bomb-laden Muslim terrorists or McVeigh-like “militia types,” both apocalyptic threats to all of humanity. The moment an argument is made that departs from the status quo, the tag of extremism is applied to its author in the attempt to deflect attention away from the argument itself.

The most discouraging aspect of this new slur tactic is its effectiveness.  Not only is it employed by both conservatives and liberals, but it is immediately given credence by both sides as well. Recall any discussion you’ve had on a political issue. If a position is taken that is outside of the Mitt Romney-Hillary Clinton continuum, it is inevitable that someone in the room will allege extremism. Heads will immediately nod in agreement, as if merely uttering the word makes the allegation true. It is also assumed without question that any “extremist” position must be wrong. The result? The discussion goes back to the continuum. So it goes in millions of households and hundreds of millions of minds.

But what does the word “extremism” mean? Merriam-Webster defines it (in the most relevant of several definitions) as “going to extreme lengths.” Often, extremism is characterized as “too much of a good thing.” For example, one might agree that too many carbohydrates in one’s diet is not healthy, but consider eating no carbohydrates at all as “extreme.”

However, what does the word mean when applied to politics? If politics is the pursuit of justice, can any position be accurately characterized as “extremist?” Can there ever be too much justice?

Read the rest at LewRockwell.com…

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

>A Familiar Strategy?

>Where the people fear the government you have tyranny. Where the government fears the people you have liberty. [1]

– John Basil Barnhill (1914)

Americans should be experiencing “déjà vu all over again” as Congress prepares for another weekend incursion into their rights via another two-thousand page bill that must be voted on before anyone has had a chance to read it. This time, it is H.R. 3962 “To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” The next law that should be passed is that legislators and bureaucrats shall not be allowed to work on weekends.

That working Americans will rise early on Monday to begin another week with less protections of their rights and more of their property stolen is not all that should seem familiar. If anyone can remember as far back as the Bush administration (this new regime has been so bad that I am afraid people have forgotten most of the outrages of the last), a very similar dynamic played out. The very first bailout – of the banking industry – met with resistance similar to that against the proposed government takeover of the health care industry. The first attempt to pass the TARP bill failed.

For those watching the statements made by their representatives while opposing that bill, one thing should have been obvious. Those representatives feared their constituents. It was in their eyes and in their voices as they explained their opposition. I do not mean that they feared violence. They feared for their jobs and they feared whatever other consequences there might have been if they deliberately defied the wishes of those thousands of voters who had angrily called their offices. For a moment, our government worked as it was designed to work. The people spoke and their representatives heeded their wishes, however reluctantly.

Then, the uproar died down. President Bush emerged from his long, unnatural silence during the financial crisis and gave a speech designed to put that fear back into the hearts of the citizens, where our government prefers that it permanently reside. If the banking bailout wasn’t passed, Americans could lose their homes, their jobs, or their retirement savings. Financial Armageddon awaited if the bankers were not saved – for it is really the bankers that provide those things to everyone. Henry Paulson and Ben Bernanke joined the chorus to help paint the terrifying picture of unspeakable horrors that awaited us if we did not give almost $800 billion to the Treasury Secretary to be redistributed to his friends on Wall Street.

It is unclear if Americans really believed the government or if they just ran out of energy to protest. Either way, the bill passed the second time it came up for a vote. Those same representatives who only days before were too afraid to pass it were now somehow emboldened and it sailed through with barely a whimper from the victims. What was different the second time around?

Hopefully, Americans took notice of the fact that their representatives do not possess the courage to pass a bill that they actively oppose, even if that opposition amounts to nothing more than angry phone calls. It is difficult to ascertain what reassured those congressmen enough to vote for the bill the second time. Perhaps the calls to their offices changed after the government’s scare campaign intensified. Perhaps some of the people who had called before the first vote called back and told those congressmen that they had changed their minds.

However, there is another possibility that is infinitely more disturbing. Perhaps by the time of the second vote, the pressure had died down out of sheer inertia. After all, there is probably some limit to just how long Americans can make calls, march in protests, or write letters while trying to do their jobs, raise their families, and live their lives. If I were trying to develop a strategy to pass a bill that most Americans oppose, I would consciously plan for exactly what happened during the banking bailout bill in 2008. I would let them scream, let them march, let them carry signs and write letters, and even let the bill fail to pass. And once the citizenry was sufficiently exhausted or had turned their attention to something else, I would put it up for another vote.

Personally, I would be surprised if this were truly a conscious strategy by most of our representatives, although I am sure that the dynamic has not escaped the notice of the most devious of the professional political crowd. However, whether intentional or not, this is exactly what happened with the banking bailout and it is exactly what is about to happen with so-called “health care reform.” All summer long, Americans called their representatives, marched in the streets, and even showed up in the capitol city itself in numbers far too large to support the claim that it was some sort of Republican PR campaign. At one point, the idea of a government-run public option was all but pronounced dead on non-arrival by media outlets, whether conservative or liberal in their bias. It has found new life.

The American Revolutiony War was by no means encouraging for the Americans for the great majority of the time that it was being fought. The Americans lost almost every battle, constantly outclassed by the greatest military force in the history of the world at that time. However, there was one advantage that the Americans had over the British – they were relentless. No matter how many battles they lost (and they lost most of them), the American army would not go away. After being repeatedly schooled by superior British generals at New York, Brandywine, and elsewhere, Washington showed up at Monmouth and fought the British to a standstill. In the end, it was he and the Americans that emerged as the victors.

This weekend, the British are back. However, this time they are not wearing red coats but instead masquerading as representatives of the people. They are bringing with them the same tyranny that they did in the 18th century – unjust taxes, illegitimate government power, and violations of the rights of every individual American. It is imperative that Americans once again refuse to go away. Millions have sacrificed time, money that they could ill afford to spend, and days, weeks, and months of their lives to write, call, march, and shout with all of their might against the destruction of our liberty that this government has accelerated with increasing brazenness over the past few years (under presidents from both major parties). It all goes for naught if our representatives learn that they need only wait for us to exhaust our energy before ignoring our wishes and trampling upon our rights as they please.

There is a disturbing sound in the air – silence. There is a feeling that the outrage has subsided and that the coast is clear for another weekend theft of our liberty and property. Let us not let last summer’s tremendous demonstration of the American spirit go to waste. If you opposed this bill the first time, if you traveled to Washington, spent money you didn’t have, took time away from your job or family to be sure that your voice was heard, it will have all been for nothing if they pass this bill this weekend.

Now is the time for Americans to be relentless. Call your representatives and let them know that what happened in New Jersey and Virginia a few days ago has nothing to do with Republicans or Democrats – it is the fate of all incumbent politicians, from any party, that abandon their duty to protect the rights of the people. From now until Saturday evening, we must shout louder, march longer, and get angrier than we have ever been before. Do not underestimate the power that you wield and do not let this government monster outlast you. As we said over two hundred years ago to a government that had marched against our liberty, let us shout to our representatives as loudly and for as long as it takes – this far shall you go and no farther.

[1] Barnhill, John Basil (1914). “Indictment of Socialism No. 3” (PDF). Barnhill-Tichenor Debate on Socialism. Saint Louis, Missouri: National Rip-Saw Publishing. pp. p. 34. Retrieved on 2008-10-16.

Politicians Talking Gibberish About Health Care

Joint_blog_close_PS-0774Every minute of every day, Americans are subjected to politicians and media pundits talking gibberish. There really is no other word for it, whether the particular subject is economics, foreign policy, or even climatology. However, the gibberish that is getting the most attention right now concerns health care “reform.” President Obama is leading the Democrats with the familiar socialist model that has failed in every industrialized nation in which it has been tried. The Republicans are answering with gibberish of their own. You have to especially admire the Republicans, because they are not only fomenting nonsense from a discredited, minority position, but are actually trying to suck up to voters by selling their version of government-run, loot-funded health care as a “free market solution.” Only the party of George W. Bush could be capable of gibberish like this.

To truly appreciate how bizarre the arguments are, let’s break down what our ruling class is really saying. Sometimes the music bed, the interruptions by the self-absorbed interviewer, or even the graphics leading into next segment can obscure the gibberishness of some of their assertions.

Let us start by examining the position of the Democrats. They assert that every human being has a right to health care, and that it is the government’s job to provide for those who cannot afford it. There are three key terms here: right, health care, and provide. Let’s define the first two.

Right: that which an individual is entitled to without the consent of or compensation to anyone else. For example, people have a right to life. That is, they do not need anyone’s permission, nor are they obligated to compensate anyone in order to live. It is appropriate for an individual to demand, rather than ask for, their right to life to be respected.

Health care: a service which primarily consists of the labor of health care providers. For example, a physician exerts his mind and body, utilizing his education and experience, to attempt to diagnose and treat a patient’s illness or injury. That physician’s labor is “health care.”

Let us now restate the argument made by the Democrats, using these definitions in place of the terms themselves.

“Every individual is entitled to the labor of health care providers without compensating them or obtaining their consent. It is appropriate for individuals to demand, rather than ask, that health care providers treat them for free.”

Gibberish.

To be fair, although the Democrats repeat their slogan about the “right to healthcare” ad infinitum, they do not actually propose that the government defend this “right” directly. Instead, they use their own peculiar definition of the third term previously cited, “provide.” Americans continue to be bewildered by this parlor trick, whether because they are easily confused or because it is more convenient to be fooled than not. In any case, “provide” to the government means that they will employ the method described by William Graham Sumner where A & B get together to pass a law requiring C to do something for X. So as not to miss the opportunity to describe this plainly, this really means that they are going to use the brute force of government to force some people to pay for health care for others. That is all it is, when you peel away the doubletalk, jingoism, and spin.

Moreover, it is not just your property that the government will take in order to run its program. It will also require another huge portion of your liberty as well. In a recent speech about his health care reform plans, President Obama suggested that “we” must begin encouraging healthier lifestyles, including getting our children away from computer games and back to playing outside. “We” means “the government.” Of course, when it is the government’s responsibility to pay for the health care of other people, the government now claims a right on behalf of taxpayers to see that those people keep themselves as healthy as they can in order to limit the cost. There are already government-imposed exercise programs in Japan. Americans should be aware that the same rules will apply here. One can almost hear the government “instructress” from Orwell’s 1984 screaming from the telescreen.

“Smith W.! Yes, you! Bend lower, please! You can do better than that. You’re not trying. Lower, please! That’s better, comrade.”[1]

Political gibberish often conceals rather horrifying ideas. Thankfully, we have an opposition party that is opposing these heinous proposals, correct? As the people from Hertz say, “Not exactly.”

It is true that Republicans oppose a government-run health care plan. As reported in the Wall Street Journal, the Republican summary of their “Patient’s Choice Act” argues that “ The government would run a health plan “with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina.”[2] All true, but of course the so-called party of individual liberty and free markets fails to argue the main point: the government – we the people – do not have the right to forcibly take money from one person and give it to another, not even for the purposes of paying for their health care. Nowhere in any report made public nor in any interview with a spokesperson for this “opposition party” will you hear this argument. There is a good reason for that.

Of course, the Republicans will argue that their plan works through the tax system and actually let’s families “keep more of their own money” to spend on health care, but a careful read of the WSJ article reveals that the same redistribution scheme is hidden within the stale “free market” rhetoric. First, the Republican plan would eliminate the tax exemption for employers when they provide health insurance benefits to their employees. This amounts to a tax increase on employers, whether they continue to provide the benefits or whether they eliminate them and merely pay taxes on the extra net income. What would the government do with this new revenue?

“Instead, it would give an annual tax credit of $2,300 to each individual and $5,700 to each family that they could use to offset the cost of their health insurance. Low-income families would get extra money to buy into private insurance plans.” [emphasis added]

So, in an effort to appear to be protecting the property rights of their more affluent base but at the same time buy the votes of those who cannot afford health care, the Republicans will simply tax those whom they think they can get away with taxing and call their own version of wealth redistribution a “tax cut,” much like George Bush’s “tax refunds” of the past decade. Of course, there is only one word for the suggestion that you can “cut” or “refund” taxes for people who are not paying taxes.

Gibberish.

As usual, the American public is served up a carefully framed debate that attempts to appear to have two sides but doesn’t. In either case, we are getting “reform” of the health care system in the only way that any government can “provide” anything. They are going to forcibly take away the property (taxes) of one group of people and use it to provide property (health care) to another group. Lest anyone mistakes this brutal practice as “the wrong means to a compassionate end,” let us remember the only reason that politicians from either party suggest this: to buy the votes of those who believe that they will benefit from it. Since there are more who would receive benefits in the voting base of the Democratic Party, they are more open about what they are really doing. Since there are more of those who will be forced to pay in the base of the Republican Party, they try to spin their redistribution scheme as a “free market solution.” However, it is dressed up, it amounts to one thing; stealing.

In addition to ignoring the fundamental violation of rights that is part and parcel of any government provided service, both the Republicans and Democrats seem completely unaware of the root cause of the problem: health care is only so expensive because government already provides so much of it. This is the other elephant sitting in the corner whenever politicians from either party start talking about health care reform.

Last year, total health care spending in the United States amounted to roughly $2.4 trillion dollars. Medicare and Medicaid alone accounted for over $800 billion, or 33% of that. Add the Veteran’s Administration and other smaller government health care programs, and government is directly providing almost half of all health care delivered in this country. What does this have to do with the price? Any first-year economics student can tell you.

Price is determined by the intersection of supply and demand. Demand has two components: the desire to buy a good or service and the ability to buy that good or service. Let us assume that the desire for health care services is unlimited, as it is for many other goods or services. In that case, the only factor that can limit demand for health care services is ability to pay. This is the factor that most influences the price of every other good or service provided in the marketplace, including food, clothing, and shelter, which are even more vital to human life than health care. It is the finite amount of money that the buyers have to spend which keeps the price down and makes most goods affordable to those on limited budgets.

However, when government makes something an entitlement, demand suddenly becomes unlimited. Since the government now must provide the benefit and they have the option of taxing or printing what money they need to provide it, there is no longer anything holding down the price. This is the reason that we have seen health care prices skyrocket in recent decades. They will continue to rise until all resources are consumed trying to provide them.

State and local governments have already been experiencing this for years because of the exploding cost of their shares of the Medicaid programs (half of Medicaid benefits are paid by the states, some of which require their local governments to pay a percentage as well). They cannot print their own money, so they have instead cut their police forces and other legitimate functions of government in order to divert money to the insatiable Medicaid beast. In one local county in upstate New York, 100% of the property taxes collected in that county and $40 million dollars of sales tax revenue – the county’s only other revenue source – went to pay that county’s share of the Medicaid bill for their recipients. Now, it has been reported that the majority of the TARP funds that were supposed to go to “shovel-ready infrastructure projects” are instead being earmarked for “existing state social programs.” An audit of these payments would undoubtedly reveal that the bulk will go to Medicaid.

Economic laws are like the forces of nature. They can be held off, as a levy holds off a flood, but they will eventually overwhelm any attempt to violate them. The most fundamental economic law is this: you cannot consume more than you produce without taking the difference from someone else. Government produces nothing. Therefore, any health care benefit that government provides must be funded with money taken by force from someone else. There is no political theory, mathematical equation, or black magic incantation that can change this.

However, even if we are able to put aside the moral repugnancy of this practice, we cannot do so forever. Once voluntary exchange is abolished, market forces are suspended and the price of providing health care will rise until the government is no longer able even to steal enough to pay for it. That day was only a few decades away for the existing government health care programs before the economic crisis we find ourselves in now (which was similarly caused by government for all of the same reasons). If government attempts to provide everyone with health care, the end will come much sooner.

This sheds light on a fundamental misconception that underlies all of the societal problems that American society faces today: the belief that there is a conflict between individual rights and the “needs of society.” This conflict doesn’t exist. Protecting the rights of every individual serves the needs of society. Violating those rights, for whatever purpose, destroys society. In fact, it is by violating the individual rights of its constituents that government causes nearly every societal problem we face. The high price of health care is just one example.

There is only one moral and practical answer to the high cost of health care: we must get government out of the health care business entirely. That includes rejecting new programs proposed by either major party and figuring out a humane way to get our children out of the existing entitlement system without cutting off those presently dependent upon the benefits. The only lucid argument I’ve heard so far has been put forth by former presidential candidate, Congressman Ron Paul. He suggests that we dismantle our $1 trillion per year overseas military empire and use that money to pay Medicare and Social Security benefits while our children are allowed to enter the workforce without enrolling in the system themselves.

What do you know? A politician moved his lips and something besides gibberish came out.

[1] Orwell, George 1984 Part I Ch. 3

[2] Adamy, Janet “Republicans Offer Health-Care Plan” The Wall Street Journal May 21, 2009

 

Tom Mullen is the author of A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

 

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