Islam Bans Health Insurance?

Where it prevails, Islamic law invades every aspect of life. Now, one Islamic group has declared health insurance forbidden. The Economic Times reports (via WeStandFirm):

Comparing the benefits of health insurance policy to gambling, key Islamic organisations have termed the policies as "illegal" and directed Muslims to keep away from them.

At a seminar to deliberate whether insuring health was permissible under Islamic law Shariat, the Islamic Fiqh Academy (India) decided that availing such policies was illegal. ...

Health insurance schemes have turned a noble service in to a business activity, hence under Islam it is not permitted, they said. ...

The Ulema suggested that the community could itself organise services to help in the treatment of poor.

There is one exception: if insurance is forced through "legal constraints" (like what?), then a person might be able to get away with having insurance, so long as one spends "the left-over amount... on some form of service to Allah." (Why would there be a "left-over amount?" Isn't health insurance supposed to cover health costs?)

This is the sort of thing that happens when religious dogmatists run things. Nevermind that their views are absurd. Insurance is not remotely like gambling; the point of it is to pool resources to cover the expenses of those who happen to suffer high-cost health problems. If that's gambling, then life is a gamble (but don't tell these Islamists!). Note the socialist presumptions of the Islamists, who define business activities as ignoble. The line about helping the poor is off point; health insurance enables the middle class to avoid poverty. But poverty must be a central concern of such Islamists, as they perpetuate it through their anti-reason, anti-liberty controls.

Schwartz on Health Mandates

Brian Schwartz wrote an article titled, "The Collective Punishment Model," for today's TCS Daily:

Politicians peddle compulsory insurance under the guise of "personal responsibility." The story is that the uninsured receive medical care without paying for it. Their freeloading passes costs onto the insured, which increases premium costs. Compulsory insurance, say its supporters, can remedy this problem by forcing both the insured and uninsured to purchase medical insurance - as defined by politicians.

Schwartz offers three basic replies to this rationale for mandated insurance. "First, freeloading from the uninsured does not significantly increase insurance premiums." However, the various proposals to impose more political controls on medicine would cost far more.

Second, holding people responsible would mean punishing freeloaders themselves and allowing providers to prevent customers from skipping out on the bill. This is the exact opposite of compulsory insurance, which forces the innocent to purchase insurance policies determined by political interests, rather than their own needs.

I would point out here that, in a voluntary system, such "freeloaders" often would receive charity, either from health-care providers or from independent donors.

"Third, government controls already punish the innocent - insured and uninsured alike - by making medical care and insurance prohibitively expensive."

The biggest reason that some people lack health insurance is that political controls have dramatically increased the costs of health insurance. Now, because of the harm caused by those political controls, some "reformers" wish to impose still more political controls.

"Cost Shifting" in Medicine

Why do we supposedly need to socialize medicine? Here's the answer, according to one Colorado "reformer:"

Health care reform could span years
Lawmakers will begin to lay out a plan based on five proposals from a state panel, but a major package is unlikely this year.
By Jennifer Brown
The Denver Post
Article Last Updated: 01/08/2008 12:38:14 AM MST

...Convincing voters to foot the bill for massive health care reform is a huge challenge.

For starters, 92 percent of voters are insured, said Rep. Anne McGihon, a Denver Democrat who chairs the House health committee.

Why would they support a tax increase to give poorer Coloradans health coverage? Lawmakers point to this statistic: Coloradans who have insurance spend an extra $950 each year to cover the costs of those who show up at the hospital without insurance. ...

The first reply to the reporter's claim is that her figures seem to be way off. As Brian Schwartz comments beneath the article:

TAX US $400 TO SAVE $100?

...This figure [of $950] conflicts with the "Baseline Coverage and Spending" report* at the 208 Commission's website, which shows this cost to be less than $100.

The Commission's proposed $1.1 billion annual tax increase would force everyone to buy politically-defined insurance. Since 2.8 million Coloradans have private insurance, the tax would cost each privately-insured Coloradan about $400 -- to save $100?

Out of the $1.4 billion annual medical spending for the uninsured, the uninsured themselves pay 45% out-of-pocket. Private philanthropy, workers compensation, and veterans benefits account for another 23%. Public programs, which taxpayers already are forced to fund, account for 15% of medical costs for the uninsured. Only the remaining 17% ($239 million) -- categorized as "free from provider" -- can directly contribute to higher premiums. That's less than $100 per insured Coloradan. ...

208 Commission report at: www.tinyurl.com/yuqkk8

Brian Schwartz, www.wakalix.com

Posted by Brian Schwartz (aka wakalix)
at 10:14 PM on Tuesday Jan 8

In other words, the socializers' "solution" to "cost shifting" is to massively expand cost shifting.

But the fundamental question is, why are hospitals forced to give people "free" care? After all, people who need food or clothes can't show up at the grocery store or the mall and demand free stuff. Lin Zinser and Paul Hsieh, MD, explain the history in their article, "Moral Health Care vs. 'Universal Health Care':"

One reason for the overcrowding and overuse of ERs is the Emergency Medical Treatment and Labor Act of 1985 (EMTALA). This law requires that hospitals that accept Medicare patients diagnose and treat anyone who comes within two hundred feet of an emergency room, regardless of whether the person can pay for the treatment. The effect of this law is that anyone can walk into an emergency room at any time and receive treatment -- without concern for payment.

That law should be repealed. Those who need medical care and cannot afford it should rely on payment plans or voluntary charity, whether provided by treatment centers or individual donors.

However, the "cost shifting" resulting from forced care is only a minor part of the problem; socializers use it as a pretext to deflect the debate away from the broader issues. A larger problem is the "cost shifting" that results from underpayments by Medicare and Medicaid. But the biggest problem is not "cost shifting" at all -- it is the transformation of insurance to pre-paid, tax-favored medical care, which results in more use without regard for cost and thus ever-higher costs. And that is precisely the problem that any of the schemes to expand political power over medicine would exacerbate -- to then be "solved" through political price-fixing and rationing.

Yaron Brook on Health Policy

Yaron Brook of the Ayn Rand Institute wrote an outstanding article for yesterday's Forbes.com on health policy. One of the points he makes is that Republicans too have promoted political control of medicine:

...Republicans have been responsible for major expansions of government health care programs: As governor of Massachusetts, Mitt Romney oversaw the enactment of the nation's first "universal coverage" plan, initially estimated at $1.5 billion per year but already overrunning cost projections. Arnold Schwarzenegger, who pledged not to raise any new taxes, has just pushed through his own "universal coverage" measure, projected to cost Californians more than $14 billion. And President Bush's colossal prescription drug entitlement--expected to cost taxpayers more than $1.2 trillion over the next decade--was the largest expansion of government control over health care in 40 years.

Brook briefly reviews the rise of political controls of medicine that have created today's problems, then he outlines the proper approach rooted in individual rights.

Drugs, Health, and Rights

From The Colorado Freedom Report:

Drugs, Health, and Rights: An Exchange

The following exchange consists of e-mails sent yesterday by "Rafaela" of Brazil and me regarding drug prohibition, individual rights, and health policy. --Ari Armstrong, January 7, 2008

Hi Mr Armstrong,

I've recently read an old article of yours, about Dr. Jeffrey Schaler's book "Addiction is a Choice," ...and found many interesting points of view regarding drug use and the prohibition of it, but on a few portions of the article raised some doubts for me.

From what I understood, ultimately you are against drug prohibition, as it is an individual choice from the individual that does not affect others, and even compare today's drug war to an Inquisition of sorts, where people who defend prohibition are mostly driven by a misguided sense of morality.

Now, I don't really have a completely formed opinion on whether drugs should be legalized or not (which is one of the reasons why I enjoyed the opinions in your article). I'm a doctor from Brazil, and the main problem i had with this line of thought is that in my opinion, this is a choice that does affect others. I don't know much about the US medical system, but in Brazil, we have two types of systems: Health Plans (which work exactly like in your country, i'm sure), and the Unified Health System, financiated by the federal and local governments, which provides assistance to the less privileged in all complexities, to simple consults to complex surgeries. Now, wouldn't the increase of substance use bring on a variety of health problems (such as an increase in the incidence of Hep C, HIV and other illnessess not directly related to the use of IV drugs) on these individuals that would ultimately affect the collective health system? I strongly believe in the individual choice, but sometimes the State does interfere in matters of public health in ways that i don't find completely wrong (for example, there's a tropical disease transmitted trough mosquito bites, those were attracted to still waters, there was a strong State campain against reservatoires of stillwater in individuals homes).

Forgive me if I haven't made a lot of sense while writing this, or misunderstood your point, but English isn't my first language, and such mistakes often happen. And I'm also sorry for the length of this.

Thank you very much for your attention,
Rafaela

Ari Armstrong Replies

I'll start with the easiest, most empirical matter first. Would the re-legalization of drugs increase the use of infected needles, and thus increase the number of illnesses? My answer is no: the re-legalization of drugs (and clean needles) would reduce the use of infected needles in favor of clean needles. But there is a broader point: the prohibition of drugs has led to the use of more concentrated drugs, which are often smoked or injected. I believe that, with an end of prohibition, people who use drugs would tend to use them orally more often, which would reduce the number of needles used.

Now for the deeper political issues. It is NOT my view that drugs should be re-legalized because drug use "does not affect others." That is not the correct political standard. Plenty of things that impact others should be outlawed, such as assault, rape, and homicide. Then again, plenty of things that impact others should not be outlawed. For example, if a father eats a poor diet and refuses to exercise, that will impact his children, but diet and exercise should not be matters of law.

The proper political standard is individual rights. We have the right to control our own bodies and resources, provided that we respect the equal rights of others. Quite simply, there is nothing about drug use per se that violates rights. Now, some people who use drugs (including the legal drug alcohol) also commit criminal acts, but they should be punished for those criminal acts, not for the drug use. Obviously, drugs, just like many other objects, can be used responsibly or irresponsibly. The use of marijuana or opiates to ease physical pain can be quite morally proper. Any drug addiction, just like any sort of psychological addiction, is harmful. The proper purpose of government is to protect individual rights, not force people to otherwise behave as they should.

But don't irresponsible behaviors, such as drug abuse, cause more health problems? No doubt. But that is a political problem only under socialized medicine. If socialized medicine justifies drug prohibition (which, by the way, does not eliminate but increases related health problems), then it also justifies diet control, mandatory exercise, the violation of property rights (such as a ban on unhealthy restaurants), censorship, and compelled health education.

As Lin Zinser and Pual Hsieh, MD, write: "A final (and often unacknowledged) consequence of government interference in medicine is that it leads to violations of individual rights in other areas of life, such as violations of the right to free speech and mandates regarding what people may and may not eat. When the government pays our health care bills, in order to save money, it inevitably demands greater control in how we lead our daily lives."

The answer to the problems generated by socialized medicine is not to impose political controls on other parts of our lives, but rather to establish liberty in medicine (as Zinser and Hsieh eloquently argue).

Finally, I would like to address another example you offer in your e-mail. What about people who allow mosquito infestations on their property? As an aside, I am curious: I have often heard the claim that DDT bans have greatly exacerbated the problems of mosquito-born illnesses; do you know if this is the case in Brazil? But on to the example as it stands. A good argument could be made that allowing a mosquito infestation violates the rights of others by subjecting them to dangerous diseases, and thus government intervention of some sort is justified. But I fear that the problem requires the expertise of somebody who knows more about legal theory. Regardless of the legal issues, certainly a voluntary effort to eradicate mosquito infestations and educate people of their dangers would be appropriate. More broadly, what Brazil needs is economic freedom and secure property rights, so that its people can generate the wealth required to solve this and other life-threatening problems.

I hope that my response has been of some interest to you.

Regards,

Ari Armstrong

Voices for Liberty in Medicine

Wayne Laugesen, long a columnist for Boulder Weekly, now works for Colorado Springs's Gazette as "Editorial page editor." Congratulations, Wayne! Though Wayne comes at some issues (such as abortion) from a religious perspective, usually he's a dedicated "classical liberal" who cares first about individual rights. I'll be interested to track his work at The Gazette.

Not coincidentally, yesterday The Gazette ran a substantive editorial endorsing liberty in medicine:

...The Blue-Ribbon Commission on Health Care Reform, appointed by legislative leaders and the governor, will present its recommendations to the Legislature on Jan. 31. ...

“The majority of the commission favors a government-heavy proposal,” says Dr. Paul Hsieh, a Denver physician who has studied the new Massachusetts system. “They’re crafting it similar to the Massachusetts model.”

A year old, the Massachusetts system is resulting in rationing and shortages of care, and higher costs to taxpayers than originally expected. ...

Government intervention, in fact, explains the failures of our current system. The IRS code drives most Americans to buy health insurance through employers. That means insurers don’t have to compete for consumers, because for most Americans, shopping around for a better deal involves a career change. And because health insurance has been packaged as a “free” benefit from employers, patients have spent the past half-century consuming health care without challenging the price. ...

State legislators can’t change the morass of federal regulation that has led to a health care system unrestrained by the conventional market forces that control other services and goods. But legislators can improve access to health care by eliminating most of the state controls that prohibit affordable coverage. ...

Brian Schwartz... proposed to the Blue Ribbon Commission a market-based health care reform package that mostly involved deregulation. ...

Hsieh and Schwartz have become leaders in Colorado for liberty in medicine. Hsieh wrote an article with Lin Zinser, "Moral Health Care vs. 'Universal Health Care'," that explains the problems with health policy and how to fix them.

And yesterday Schwartz also had a letter published in Boulder's Daily Camera:

...[W]e don't have a free market in medical care or insurance. ...Tax-exempt employer-provided insurance coddles insurers by tying us to our employer's plans. Insurers are committed to satisfying customers, which are employers, not you. Hence, they can afford to be stingy and deceptive: they know that losing your premium dollars requires that you change jobs.

What "powerful and wealthy forces" oppose changing this? Labor unions. ...[T]he AFL-CIO supports "single payer health care": politically controlled medicine with government as a monopolistic insurer. This is even worse than buying it through your employer. If you don't like what the government "health barons" offer, it's not enough to change jobs, you must move out of state to change providers.

If you like "single payer," don't worry that the 208 Commission on Healthcare Reform has not recommended it. They recommend an "individual mandate," which makes it a crime not to purchase politician-approved "insurance." Such compulsory insurance is essentially single-payer in disguise. Strict regulations on legal insurance plans severely limit competition, so insurance companies are effectively government contractors for politically-defined insurance.

Colorado was supposed to be one of the national testing grounds for socialized medicine. Now, thanks to the work of people like Laugesen, Hsieh, Zinser, and Schwartz, the idea that we need more liberty in medicine, rather than more political controls, has become part of the public debate. While we still face a real and serious threat of more political interference in medicine, at least now liberty has a fighting chance.

Health-Care "Reform"

Yesterday John Goodman, president of the National Center for Policy Analysis, sent out an email pointing out some of the absurdities coming out of today's health-care "reform" movement:

Exhibit A: Critics who complain that the US health care system outspends every other country and gets nothing in return and then advocate...(can it be?)...more spending! For Sen. Obama, it's $60 billion more every year. For Sens. Clinton and Edwards, it's $120 billion - more than $1,000 per year for every household in America.

Exhibit B: Critics who complain that the error rate in US hospitals is way above anything that is tolerable in any other industry and then advocate more rules and regulations that would...(surprise!)...make it more difficult for hospitals to operate like other businesses.

Exhibit C: Critics who complain that poor people have inadequate access to health care and then advocate enrolling them in health plans where...(you guessed it)...they will have even less access than they have today.

Under ordinary circumstances this would all be laughable, but in health care - hey, they might get away with it.

Goodman points to his article, "Applying the 'Do No Harm' Principle to Health Policy," as well as to a health plan from his organization. However, for a clear account of the problems with American health care and a principled solution rooted in liberty, I suggest the article by Lin Zinser and Paul Hsieh, MD, "Moral Health Care vs. 'Universal Health Care'."

Moral Health Care

Colorado's own Lin Zinser and Paul Hsieh, MD, have written an article for The Objective Standard titled, "Moral Health Care vs. 'Universal Health Care'." The journal has made the article available at no cost to all comers.

Hsieh summarizes:

Lin Zinser and I have written an article on health care history and policy that will be appearing in the Winter 2007-2008 issue of The Objective Standard...

We argue that the current crisis in American health care is the result of decades of government interference and violations of individual rights in health insurance and medicine. Hence the solution to the problem is not more government controls but instead to gradually and systematically transition to a rights-respecting, fully free market in those industries.

Also, Yaron Brook and Keith Lockitch have written an article on the same theme for Modern Health Care. The article argues:

The notion that America has a private, free-market medical system is a widespread misconception. More than 45% of total spending on healthcare in 2004 was government spending. Our semisocialist blend of Medicare, Medicaid and government-controlled, employer-sponsored health plans-with its onerous system of regulations and controls on medical providers-is the opposite of a free market.

To date, I have not heard a single defender of politically-controlled medicine even attempt to counter the arguments of Zinser, Hsieh, Brook, Lockitch, and fellow travelers. Instead, those whining for more political interference in medicine simple ignore the fact that political interference is the cause of modern problems in American health care. Let us work to assure that the articles proving the point are widely read.

Health Care and Swallowing Flies

Here's my take on the old song, "There Was an Old Woman Who Swallowed a Fly."

There Were Politicians Who Made Prices Fly

There were politicians who made prices fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There were politicians who set wages tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There were politicians who made tax exempt
employer-payed health, showed for markets contempt.
They made health exempt because wages were tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There were politicians who raised a health tax.
So medical costs, they climbed to the max.
They raised a health tax and they made health exempt.
They made health exempt because wages were tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There were politicians who set more controls
on doctors and patients and insurance tolls.
They set more controls on top of the tax.
They raised a health tax and they made health exempt.
They made health exempt because wages were tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There were politicians who finally mandated
that people buy "coverage" at cost quite inflated.
They want a mandate because of controls.
They set more controls on top of the tax.
They raised a health tax and they made health exempt.
They made health exempt because wages were tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

There are politicians who want to take over;
they think bureaucrats can on health care deliver.
They want to take over and have it mandated.
They want a mandate because of controls.
They set more controls on top of the tax.
They raised a health tax and they made health exempt.
They made health exempt because wages were tighter.
Biz wiggled and jiggled and set health pay sweeter.
They set wages tighter for prices did fly.
They feared wages too, would travel sky high.
Perhaps we'll die.

Welfare for All

One might think that the welfare state started out soaking the rich in order to subsidize the poor. Yet the Social Security payroll tax, a regressive tax in its collection, has always redistributed wealth from the young to the elderly, regardless of income, though the distribution does favor the poor somewhat. Increasingly, the welfare state is about soaking the middle class in order to subsidize the middle class.

Ernest Istook of the Heritage Foundation provided some scary numbers in a recent editorial. He writes, "Today, almost half of America's children -- 45 percent -- have their health care paid for by taxpayers. The children's health bill (SCHIP) now before Congress would boost this to 55 percent." SCHIP stands for "State Children's Health Insurance Program," which is (obviously) mostly funded by federal tax dollars, Istook notes. Istook calls the jump from 45 to 55 percent "the tipping point." However, not only could SCHIP put most children in government-run health care, it could increase tax-funding of all health care from "almost half" to "the majority of all health care." Istook predicts, "Eventually, the whole country would be under Washington-run health care, using tax dollars to pay the bills."

The SCHIP bill claims to cover kids in families earning three times the level of poverty -- $62,000 for a family of four -- but it goes further, because states are free to disregard huge chunks of income to make more people eligible. This "free" health care for the middle class mostly substitutes government coverage for existing private insurance, because more than three-quarters (77 percent) of the kids who would be newly eligible are already covered by private policies.

Yes, SCHIP would redistribute wealth from from those with more money to those with less -- on average. However, SCHIP would also redistribute more money from people like my wife and me, who have put off having children because of our insane tax burden, to people who choose to have children but not financially support them. The main problem with the welfare state is not that it punishes productivity to reward poverty. Its problem is that it punishes the responsible in order to reward the irresponsible.

Let me say this. It is likely that, when my wife and I finally manage to crawl our way out of debt despite handing over many thousands of dollars every year in taxes, we will make less than $62,000 per year as a household, primarily because we've decided to raise our (potential) children ourselves, rather than let government employees raise them. All of you pathetic vote buyers and faux social do-gooders can keep your goddamn "socialism for the children." We want no part of it. We don't want the government to force other people to pay for the health care of our children. No self-respecting parent wants that. But, as the welfare state expands, our culture does not value self-respecting parents; it values political nannies.

We ask for only one thing. We ask for you to leave us the hell alone. If you'd just leave us alone -- leave us alone, for Christ's sake! -- we'd have no problem affording children or their health care.

Doctors Need Freedom

What's up with The Denver Post? At least in the Sunday edition of the paper that appeared on Saturday -- I haven't yet seen the paper as printed for Sunday -- the paper published another front page editorial. (It also published a front page editorial in favor of Referendum C.) I don't mean an editorial masquerading as a news story; I mean an editorial labeled as such, on the front page. A disclaimer appeared at the bottom: "The Denver Post's editorial board operates independently of the paper's news coverage." But who approved a front-page editorial? Wasn't it the same guy who manages the "paper's news coverage?" So the front page editorial is odd, but, hey, it's The Denver Post.

After calling Governor Bill Ritter "Jimmy Hoffa" for giving unions of state employees more power, the Post laments that Ritter's move might alienate "business". (Not particular businesses, just "business.") The Post fears:

Without business in his corner, we fear Ritter won't be able to effectively shepherd a comprehensive health care solution through the statehouse. And any plans he may have for a new revenue stream for higher education are dangling by a thread, too.

Perhaps more importantly, we're concerned he's lost whatever business support he had to reform Colorado's budget process. ... Ritter will be rudderless if he tries to convince voters to approve an extension of Referendum C.

So the Post (or at least its independently operated editorial board) is worried that, if Ritter favors unions too much, he won't be able to spend more tax dollars and impose new government controls on medicine. Wow. That's definitely worthy of the front page of The Denver Post. (I do agree that Ritter's favoritism toward unions was bad.)

For now, though, I want only to reflect on the Post's call for "a comprehensive health care solution." What does that mean? It means that state legislators would spend more of other people's money in order to expand the political control of medicine. Leading plans call for an expansion of health welfare and for health-insurance mandates. Who will decide how these welfare dollars are spent? Who will decide what the mandated insurance must cover? Some combination of politicians and bureaucrats, no doubt with plenty of input from special interests.

"A comprehensive health care solution" would further erode the ability of patients and doctors to associate voluntarily. It would further replace the judgment of doctors with the whims of politicians and bureaucrats. It would expand the political controls that have created current problems in American medicine.

A recent release from the Ayn Rand Institute makes clear the fundamental importance of restoring liberty in medicine. The release quotes a doctor from Atlas Shrugged:

Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything -- except the desires of the doctors. Men considered only the "welfare" of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only "to serve." ... I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind -- yet what is it that they expect to depend on, when they lie on an operating table under my hands?

Hillman Opposes Health-Insurance Mandates

Recently I've mocked The Denver Post for its stance on Halloween, and I've criticized Republicans over health policy, tax spending, and investment controls.

But on October 26, The Denver Post published an outstanding op-ed by Republican Mark Hillman that criticizes health-insurance mandates. The article is part of the "Colorado Voices" series, which often produces duds, but on this occasion the Post has found somebody who writes very well and who has something interesting to say. (Note: the publication dates noted on the Post's web page sometimes precede the dates of print publication.)

Hillman writes, "Ironically, despite the abysmal record of lawmakers and bureaucrats to produce lower prices or create greater choice, the public still clamors for government to 'do something.' Perhaps the more logical outcry should be: 'undo something'."

Hillman offers the following main reasons to oppose health-insurance mandates:

* "[A]nother law won't produce universal coverage," because some people won't obey the mandate or will be exempted.

* Mandated insurance would be a bad deal for many consumers, because "special interests perennially lobby the legislature to require you to buy things you don't need, don't want or can't afford."

* Politicians tend to require insurance to pay for care that "you could more easily and less expensively pay for... yourself..."

Hillman summarizes, "The end result is that you and I are no longer allowed to choose the insurance coverage that best fits our needs, and insurance companies can't respond to what we want."

Hillman perfectly captures the state of today's health-care "reform" movement: "[L]awmakers and lobbyists control the health care market, as they have increasingly for the past 40 years; then they react in amazement when the product is something you and I either do not want or cannot afford."

Hillman's article demonstrates that both The Denver Post and Republicans can produce good work.

I do have one criticism of Hillman. I recognize that short newspaper articles cannot cover every aspect of the issue. Sometimes the moral argument is not the focus. But Republicans often seem to be allergic to pronouncements that hint of the morality of rights in property and income -- probably because most Republicans are so busy violating those rights. To date, and as far as I can remember, I have not heard any Republican other than my dad (who I'm pretty sure is a Republican) endorse the argument: "Insurance mandates are morally wrong because they violate the rights of individuals to control their own lives and resources."

"Plan Five" from the 208 Commission

The Rocky Mountain News is rightly skeptical about the "208" Healthcare Commission's plan to "reform" health care by expanding government control of it. The News writes in an October 28 editorial:

Is the Colorado Blue Ribbon Commission on Health Care Reform going to lay an egg in January, when by law it must offer its recommendations to the legislature?

It's too early to say, but prospects for the commission's success dimmed somewhat the other day when the price tag was announced for the panel's own proposal - we'll call it Plan Five because the commission will submit four others, too, written by outside groups.

Plan Five's cost: between $1.4 billion and $2.1 billion a year, according to the Virginia-based Lewin Group.

The News continues to explain why such a hefty tax hike is unlikely in Colorado.

I particularly like the title, "Plan Five." For some reason, it reminded me of Plan 9 from Outer Space. The comparison is doubly fitting, because the movie is about the goofy plans of extraterrestrials, and the movie is one of the worst ones ever made. But at least it's funny. Not so with "Plan Five" from the 208 Commission.

FreeColorado.com Update -- Health Policy

Here's the latest from the Colorado Freedom Report:

Insurance mandates threaten your health
"Insurance mandates are morally wrong because they violate the rights of individuals to control their own lives and resources. The government has no more right to force us to buy health insurance than it does to force us to buy shoes, houses, hamburgers, or Bibles. ... Instead of trying to force people to buy health insurance, why doesn't Dr. Pramenko take a look at why health insurance is too expensive for some people to afford?" (by Linn and Ari Armstrong)

Restore Liberty in Health Care in Colorado
"The role of government in regard to health care should be to cease and desist. The proper role of government is not to force anyone to do anything. Government's proper role is to protect every person's right to liberty. But subsidies, tax distortions, insurance mandates, employer mandates and individual mandates violate this right and wreck the market." (by Richard Watts)

"Get the Hell Out of the Way"

In his October 12 article for The Daily Sentinel of Grand Junction, Mike Saccone writes:

Dr. Jim Schroeder warned four members of a statewide health reform commission that over-involving government in doctor-patient relations could push a large number of physicians to leave the business.

“The role of government should be to get the hell out of the way and let the doctors meet with the patients,” Schroeder said, his voice wavering with emotion.

Schroeder said any attempt from policymakers to expand existing government-managed health insurance programs or to create a single-payer, government-run health insurance program could allow the state to lower how much it pays physicians for their work.

"If you're not paid for what you’re doing... you're not going to stay in the field," the local pediatric cardiologist said.

Schroeder's comments came as part of a Thursday evening forum the Senate Bill 208 Commission hosted in Grand Junction to receive feedback on its five possible health care reform proposals.

These meetings all seem to go about the same way. Those who seek "concentrated benefits" of government wealth transfers show up in large numbers, while those on whom the costs are dispersed mostly stay away. Yet, as I noted previously, Brian Schwartz spoke eloquently at one of the meetings of the hazards of government-controlled medicine. I was heartened to read Dr. Schroeder's comments. And Richard Watts tells me that he advocated liberty in medicine at a hearing in Craig.

Of course, the issue of payment discussed in the article is only one of many problems with government-run medicine. Medicaid and Medicare already pay doctors less than what services cost to provide. The bureaucracy and political meddling also induce especially the best doctors to leave the field. Political controls harm doctors as well as their patients, as both groups look to influence politicians and bureaucrats, rather than enter into voluntary, mutually beneficial relationships with each other.

Unfortunately, many who work in related fields are drawn by the siren song. Saccone continues:

Kristy Schmidt, director of community and consumer relations for the Marillac Clinic, said requirements for individuals to have their own health insurance are a good idea.

“Having everyone pay into the system will decrease costs for all,” Schmidt said.

But Schmidt's statement is false. Forcing people to purchase health insurance violates their rights to control their own resources without addressing the underlying problems caused by existing political controls. Obviously, the point of the mandate is not to "decrease costs for all." The point is to force some people to subsidize others through insurance. Because politically-enforced insurance would act more like pre-paid medical care, it would encourage people to seek more care without regard for cost, thereby increasing average "costs for all," at least until price controls and rationing kicks in.

No, Dr. Schroeder offers the correct diagnosis and the correct remedy: "The role of government should be to get the hell out of the way and let the doctors meet with the patients."

How to Access Dental Care Without Insurance

Chris J. Wiant, M.P.H., Ph.D., wrote the following comments for the October 7 Rocky Mountain News:

While 770,000 Coloradans are without health insurance, twice that number of citizens do not have dental insurance and, therefore, lack access for preventive and restorative services. They must wait until their dental problem becomes a medical emergency before they are likely to get service. ...

Therefore, it is my hope that Colorado’s Blue Ribbon Commission on Health Care Reform takes seriously the need to include dental care as part of an overall strategy in fixing our health-care system in Colorado.

Wiant's assertion is false. It is simply not true that people who lack dental insurance therefore "lack access for preventive and restorative services." They have all kinds of access. Since Chris J. Wiant, M.P.H., Ph.D., is apparently ignorant of this fact, I'll describe how people may access dental care.

Step One: Locate a phone book.

Step Two: Look up "dentist" in the phone book. It's under "D."

Step Three: Using a telephone, call a dentist in the phone book.

Step Four: Make an appointment to see the dentist.

Step Five: Go to see the dentist at the appointed time.

Step Six: Pay the bill.

As an alternative to the first two steps, look on-line -- I found 2,080 dentists listed through DexKnows -- or ask friends for a referral (which is what my wife and I did).

My wife and I do not have dental insurance. Indeed, we have never used our high-deductible insurance to cover any medical cost. We pay all of our medical and dental costs out of pocket (or out of our Health Savings Account, which is an extension of our "pocket"). And we like it that way.

My wife and I have both been very proactive in seeking out (and purchasing) "preventive and restorative" dental services. For example, just within the last few weeks, I had my first cavity filled (which was tiny because I went in as soon as I noticed it), and my wife had a filling replaced. Months ago I had a cracked molar repaired. We both get regular check-ups and cleanings.

Our dentist does an outstanding job. He is worth every cent that we've ever paid him -- and much, much more. We get a spectacular value for our money with him, and I am proud to pay him for the services that he renders. Now that's "access."

We don't need Chris J. Wiant, M.P.H., Ph.D., to force us to purchase dental insurance that we neither want nor need. And that's really what he's saying here. It is now common knowledge that the 208 Commission has endorsed an "individual mandate" for Colorado, meaning that the Commission wants to force people to buy "insurance" that's approved by politicians and bureaucrats (as opposed to, say, removing the political impediments that make insurance too expensive for some people to purchase).

But Wiant is concerned with the fraction of people lacking dental insurance who have trouble with Step Six. But they don't need "insurance" (i.e., government-managed, pre-paid care that others are forced to fund) in order to have "access." Those without funds to pay for dental services can and should set up payment plans or turn to voluntary charity.

Wiant's article is indicative of what we can look for if the political takeover of medicine advances. Special interests will continually lobby to have their favored services included in the politically-enforced mix. As people "access" more of the "free" (or nearly free) services, the result will be price controls and rationing. Real "access" will be reduced.

By the way, "Chris J. Wiant, M.P.H., Ph.D., is president and CEO of the Caring for Colorado Foundation." And what manner of group is that? According to its web page:

In November of 1999, Anthem Insurance, a for-profit company, purchased Blue Cross Blue Shield of Colorado, which had non-profit status. This sale yielded proceeds of $155 million. As mandated by Colorado state law, the profit from the sale was dedicated to benefit the health of the people of Colorado. Caring for Colorado Foundation, a non-profit 501(c)(4), tax-exempt Foundation, was endowed to fulfill this responsibilty (sic).

Let us leave aside the absurdity of state laws stacked on federal tax codes micromanaging mergers. Chris J. Wiant, M.P.H., Ph.D., is, by advocating more political control of medicine, actively undermining " the health of the people of Colorado."

Schwartz Advocates Free Market in Medicine

Brian Schwartz continues to speak out as voice for liberty and free markets in medicine.

David Montero quotes Schwartz in an October 5 article for the Rocky Mountain News.The subject is a meeting of October 4 sponsored by the 208 Healthcare Commission.

Montero closes his article:

And at least one speaker, Brian Schwartz, proposed getting government out of health care entirely - calling Medicaid a "failure" and an example of why single-payer won't work. Instead, he advocated the free-market system.

"Should we have single-payer food and housing?" he asked. "Didn't we settle that with Soviet Russia and North Korea? Why is health care different?"

Congratulations to Brian! And thank you for speaking out at a meeting stacked with advocates of political force in medicine.

The Coalition to "Do Something"

Chris Barge's story for today's Rocky Mountain News states:

Calling itself "Partnership for a Healthy Colorado," the group emphasized that reform is needed because the cost of caring for the uninsured and underinsured is passed on to Colorado's insured majority.

The group acknowledged that it had not arrived at any agreement on a proposal for reform, or how to pay for it.

But there was agreement that something must be done. ...

"The members of this partnership are diverse and we don't always agree on everything," said Amy Fletcher, associate director of the Business Health Forum. "But we're here to say that, when it comes to health care, something must be done in Colorado."

Something, anything must be done -- except to actually figure out what's wrong with medical policy and fix it. Various members of the "new" coalition, including the Service Employees International Union, the Colorado State Association of Health Underwriters, and the Colorado Medical Society, have already advocated more political control of medicine.

Yet political controls of medicine -- tax distortions that entrench expensive, non-portable, employer-paid insurance, massive tax spending, and reams of federal and state mandates -- are what have caused prices to skyrocket and quality to suffer.

In addition, the claim that "the cost of caring for the uninsured and underinsured is passed on to Colorado's insured majority," when taken as a broad assertion, is simply a lie. When my wife and I were uninsured, we paid for all of our own medical expenses out of pocket. The article's claim insults those who pay their own way.

To the extent that the the statement is true, it is true only because politicians have mandated treatment, forced insurance companies to guarantee coverage, subsidized costs, and made insurance so expensive that many workers cannot afford it. But will the "new" coalition advocate the repeal of the political controls that have caused the problem? Obviously not. Instead, I predict, it will urge politicians to force people to buy insurance. Because, in the eyes of such reformers, the solution for failed political controls is more political controls.