SUFFERING SICKO: WHY MICHAEL MOORE IS WRONG ABOUT NATIONAL HEALTH CARE AND SOCIALIZED MEDICINE

i am afraid this film is going to have a DISASTROUS effect on the 2008 elections. people will forget about the incremental curtailing of our civil liberties, the onward march of centralized federal power and the social engineers in washington who would like every aspect of our lives to be the property of some "department" or other--just as long as they get more government cradling.

i'm sorry, it is NOT the american way to think more about "we" than "me." this is the soviet way. this is the bush way, telling us we must "sacrifice ourselves" to protect our freedoms. it people want to pay into a universal health care pool because they have concerns about the lack of coverage for poor americans, that is fine. it is a VOLUNTARY transaction, just like becoming a member of a union. but to coerce charity out of people through pay-roll deductions and progressive taxation is yet another example of the kind of government use of brute force through redistribution of private income that advocates of liberty are so much against.

further, how will the bureaucrats in washington know, in their divine wisdom, which drugs tax payer money should subsidize? do we have ANY say in the matter? will any of our money go to alternative, holistic health care programs? will they rely on the demand side (i.e. sick people), or the supply side (i.e. big pharma)? where will competition come from--if the national health care system isn't doing its job properly (i.e. the government run veteran hospitals)?

i am afraid, if we allow government to run our health care system (or, more than it does already, as ron paul argues in the article below that the government already *does* interfere in much of our health care system and that is why costs are so high), you will see something very much like the scenario spelled out in the article on "food totalitarianism" below.

giving the government a monopoly on the definition of health parameters may lead to disasters like our current mishandling of the HIV=AIDS hypothesis, which has been an undeniable boon for the medical-industrial complex (i.e. toxic chemotherapy drugs like AZT) and has led us further and further astray from a real cure because the politics have ruled out alternative "multi-factor" and behaviorial models (see my blog post on "aids dissidents"). not only that, considering how our definition of health has already been hijacked by big pharma and the suicidal ideologies of behaviorism and materialism that only see health as a kind of register of physical variables, i think the stage will be set for a massive social engineering program that will further the spiritual and psychological impoverishment of the american people and compel them to rely solely on drugs, etc. to solve all their problems. just look at our government-run schools: academic scores continue to decline since the federal government took over while campuses all over the u.s. have become nothing more than mass social engineering camps under the auspices of the department of education (see my blog post on "public schools dumbing us down").

it will be yet another step on the way to achieving that vegged out population that is the dream of totalitarians everywhere.

is there another path? yes, i believe so. i will let RON PAUL, who is himself a physician, and other libertarian theorists propose an alternative to the socialists' beloved national health care system in one of the many critical articles, lectures and videos in this post.

lastly, i would like to point out that MICHAEL MOORE is your typical "big government will take care of all our problems if only we had the best and brightest group of regulators in the best federal departments" socialist.

moore has already done the 9-11 truth movement a great disservice with his parody of the bush administration in his previous film, making it seem like bush and co. were simply too stupid to prevent the attacks (with the exception of the one hard-hitting section about the Bin Laden family being flown out of the country), when we now know full well that they got plenty of warning in advance and appeared to have total criminal negligence on their part (or even actively participated in the attacks).

michael moore is also responsible for fanning the anti-gun hysteria that may very well lead to the further disarming of the populace and the evisceration of the second amendment, leaving us defenseless not only against a possible declaration of martial law, but also against attacks on public property like the school shootings moore loves to exploit (if the students and other faculty had been armed, they would not have been shot down en masse because they were waiting for "big government" to save them).

so, in short, this film is NOT bi-partisan. don't give in to the rhetoric. state socialism is NOT the american way--neither is corporatist exploitation on behalf of the insurance companies, who are in bed with the legislators in washington. this is another example of how big government almost always gives in to the temptation to work in the interests of corporatism. we need to exact as much of a divide between economy and state as we have with church and state. free market enterprise and competition--the american way--are the exact opposite of corporatism and government regulation--the soviet way.

read on and you will see that michael moore is not only wrong about the details (i.e. his naive portrayals of the health care systems in Canada and Cuba) but also in the fundamental principles he espouses to treat the problem (i.e. just socialize it).

Do No Harm
“Sicko”
by David Denby July 2, 2007
NEW YORKER MAGAZINE

Michael Moore has teased and bullied his way to some brilliant highs in his career as a political entertainer, but he scrapes bottom in his new documentary, “Sicko.” The movie is an attack on the American health-care system, and it starts out strongly, with Moore interviewing families who have been betrayed or neglected by H.M.O.s and insurance companies. A man whose life might have been saved by a bone-marrow transplant died when he was refused “experimental” treatment. A feverish baby died when her mother, rather than taking her to a hospital run by her insurer, Kaiser Permanente, rushed her to the nearest emergency room, where they were turned away. Moore then zeroes in on the situation of three volunteer Ground Zero rescue workers, who have trouble breathing or who suffer from stress and can’t get assistance from the federal government. More baffled than angry, they soberly report on their conditions, and Moore comments that even national heroes aren’t given help by the nation. A bit later in the film, however, he presents congressional testimony suggesting that people the Administration has deemed to be national enemies—the detainees at Guantánamo Bay—are receiving good health care free. So Moore loads the Ground Zero volunteers, plus some other people who have serious health problems, into three boats in the Miami harbor. “Which way to Guantánamo Bay?” he calls out to a Coast Guard vessel, and the little flotilla sets off for Cuba. When the boats arrive outside the base, they are, of course, stonily denied entrance.

An absurdist of outrage, Moore has attacked corporations that destroy cities by closing down local plants (“Roger & Me”); a gun-happy culture that makes arms easily available (“Bowling for Columbine”); an Administration that begins a war without sufficient cause (“Fahrenheit 9/11”). He has stalked corporate officials and congressmen, planted his bulk before them and asked mock-naïve questions, and his provocations, at their best, have smoked out hypocrites and liars. But this confrontation is different. Hauling off seriously ill people to a military base where they won’t receive treatment is a dumb prank. And the insensitivity isn’t much relieved by the piece of whimsy that comes next: Moore and the rescue workers (the other sick voyagers having mysteriously disappeared) wander onto the streets of Havana and ask some guys playing dominoes if there’s a doctor nearby. They go to a pharmacy and then to a hospital, where the Americans are admitted and treated. Few people in Moore’s audience are likely to be displeased that they receive help from a Communist system. But what is the point of Moore’s fiction of a desperate, wandering quest for medicine on the streets, as if he hadn’t known in advance that Cuba has free health care? Why not tell us what really happened on the trip—for instance, what part Cuban officials played in receiving the American patients?

After the early tales of the system’s failure, “Sicko” becomes feeble, even inane. A recent poll shows that a majority of Americans not only favor a national health service but are willing to pay higher taxes for it. In that case, wouldn’t it have made sense for Moore to find out what features of universal care in other countries could be adapted to America? Instead of sorting through any of this, Moore and his crew go from place to place—to Canada, England, and France, as well as Cuba—and, at every stop, he pulls the same silly stunt of pretending to be astonished that health care is free. How much do people pay here in France? Nothing? You’ve got to be kidding. But isn’t everyone taxed to death to pay for health care? Well, here’s a nice, two-income French couple who have a great apartment and collect sand from the deserts of the world. Not only haven’t they been impoverished by taxation; they travel. And so on.

* from the issue
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In each country, Moore interviews doctors who speak proudly of how well their country’s system works. But the candor of these doctors is no more impressive than that of the corporate spokesmen Moore has confronted in the past. No one mentions the delays or the instances of less than first-rate care. We find out that a doctor in Great Britain makes a good income (about two hundred thousand dollars), but not how medical care in, say, Toronto might differ from that in a distant rural area, or how shortages may have affected the quality of Cuban health care. Moore winds up treating the audience the same way that, he says, powerful people treat the weak in America—as dopes easily satisfied with fairy tales and bland reassurances. And since he doesn’t interview any of the countless Americans who have been mulling over ways to reform our system, we’re supposed to come away from “Sicko” believing that sane thinking on these issues is unknown here. In the actual political world, the major Democratic Presidential candidates have already offered, or will soon offer, plans for reform. A shift to the left, or, at least, to the center, has overtaken Michael Moore, yielding an irony more striking than any he turns up: the changes in political consciousness that Moore himself has helped produce have rendered his latest film almost superfluous.

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FROM WIKIPEDIA:
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Description of Cuban health-care system

Kyle Smith, a New York Post film critic, wrote that Moore asserts he asked Cuban officials to give his group exactly the same care that a Cuban would receive, "and that’s exactly what they got". Smith writes that Moore treats the Cuban health-care system with kid gloves, although he's capable of taking a hard look at American officials: "You can’t film anywhere in Castro’s Alcatraz without government say-so, meaning the whole scene was as phony as what happens when [New York Times restaurant critic] Frank Bruni walks into a four-star restaurant, [...] Moore solemnly reports Cuba’s official health statistics, which are of course a fiction [...] Moore's motto is to trust no authority figure from cringing corporate spokesman on up to Washington windbags. Except dictators. Dictators, he’ll take your word for it."[4]

Rich Lowry, editor of National Review wrote in his syndicated column that Moore whitewashes the health-care system in Cuba, describing it as better than that in the United States[5], although "According to a 2004 story in the Canadian National Post: 'Hospitals are falling apart, surgeons lack basic supplies and must reuse latex gloves. Patients must buy their sutures on the black market and provide bed sheets and food for extended hospital stays.'"[6]

The World Health Organisation which Moore states ranked the United States' health care system at 37th, ranked Cuba's health care system at 39th.[7]

In an interview with Time Magazine, Moore states "I’m not trumpeting Castro or his regime. I just want to say to fellow Americans, "C’mon, we’re the United States! If they can [provide care for all] we can do it."[8] Fidel Castro is also referred to as a "dictator" in the film.

A Boston Globe reporter wrote that in Moore's descriptions of other nations' health care systems, "Never is heard a discouraging word about any of them. Typical unbalanced Moore. That he may be promoting a Potemkin Village in Havana for Fidel Castro bothers Moore not a whit."[9]

Moore told the Globe reporter, "If we went to Columbia Presbyterian, they're going to roll out the best doctors, take us to the best floor. And if we went to Pfizer, they're going to show their best face, too. What's the difference between what Pfizer does and what Castro does? We get P.R.'d all the time."[9]

[edit] Description of other nations' health-care systems

Smith criticizes Moore for presenting health care systems in Canada, Britain and France with the same uncritical attitude the filmmaker took with Cuba, despite the fact that there are significant criticisms of those systems within their own countries.[4] According to Scott, Moore's descriptions of health care in other nations have "a bit of theatrical faux-naïveté", and "the utopian picture of France in Sicko may be overstated", but Scott dismisses the problem by saying a filmmaker praised in Cannes would naturally be pro-French.[10]

Some Canadian critics did not like Michael Moore's glamorizing the Canadian health care system.[11] Peter Howell, in The Toronto Star, wrote: "Sicko makes it seem as if Canada's socialized medicine is flawless and that Canadians are satisfied with the status quo." Howell wrote that he and other Canadian journalists criticized Moore for inaccurately contending that Canadians only had to wait for minutes for health care, rather than much longer waiting periods. [12]

Michael C. Moynihan, an editor at the libertarian Reason magazine, writes that while Moore presents other nations' health-care systems as close to perfect, they and other systems have many of the same problems as in the United States. He cites anecdotal examples that he says rival and parallel the examples presented by Moore: a Swedish parent whose government-run health-care system refused to put cochlear implants in both ears of her child, a German man[13] who couldn't get his national health-care system to approve surgery for a brain tumor — and if he hadn't paid for it himself instead of continuing to wait, his doctor says the man would have died. London's Hammersmith Hospital, featured in the movie, was pressured by health officials to limit the number of patients treated in order to cut costs, a problem that isn't anomalous in Britain, where the government has promised to cut down waiting periods — down to 18 weeks.[14] "Such examples suggest that Moore's depiction of European-style medicine as an easy panacea for America's problems is rather more complicated than presented. Massive queues and cash shortages have plagued all of the systems profiled—and celebrated—in Sicko."[15]

Jonathan Cohn, writing in The New Republic, agrees that Moore wrongly downplays the waiting lines that the British and Canadian systems "really do have", but he points out that the French not only don't have waiting lines, they have an insurance system that "allows free choice of doctor and offers highly advanced medical care to those who need it." Although the French pay a lot for their health-care system (paying more in taxes and less in private insurance than Americans do, overall), their national health-care costs are still ultimately less than those of the United States.[16]

Moore said the wait for service in Canada is, on average, a few weeks. "I'd be willing to wait a couple of weeks," he said during a stop in Colorado on a publicity tour for the movie. "Statistics Canada, which is the governmental statistics office in Ottawa will tell you the following: there is a four-week wait in Canada to see specialist. There's a three-week wait for diagnostic testing. And there's a four-week wait for elective surgery."[17]. [18]

THE PROBLEM OF GOVERNMENT SUBSIDIES



WHY ARE COSTS SO HIGH?



WHAT DOES THE SINGLE-PAYER HEALTH CARE SYSTEM HAVE IN COMMON WITH FAILED SOVIET-STYLE ECONOMIC POLICIES? ARE THERE CANADIAN CITIZENS WHO CROSS THE BORDER TO TREAT THEIR ILLNESSES IN THE UNITED STATES BECAUSE THE WAITING LISTS/RATIONING WOULD HAVE TAKEN THEIR LIVES? WATCH "THE LEMON" AND FIND OUT.



MICHAEL CANNON ON FREE MARKET HEALTH CARE: PART 1



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******Lowering the Cost of Health Care

by Ron Paul

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As a medical doctor, I’ve seen first-hand how bureaucratic red tape interferes with the doctor-patient relationship and drives costs higher. The current system of third-party payers takes decision-making away from doctors, leaving patients feeling rushed and worsening the quality of care. Yet health insurance premiums and drug costs keep rising. Clearly a new approach is needed. Congress needs to craft innovative legislation that makes health care more affordable without raising taxes or increasing the deficit. It also needs to repeal bad laws that keep health care costs higher than necessary.

We should remember that HMOs did not arise because of free-market demand, but rather because of government mandates. The HMO Act of 1973 requires all but the smallest employers to offer their employees HMO coverage, and the tax code allows businesses – but not individuals – to deduct the cost of health insurance premiums. The result is the illogical coupling of employment and health insurance, which often leaves the unemployed without needed catastrophic coverage.

While many in Congress are happy to criticize HMOs today, the public never hears how the present system was imposed upon the American people by federal law. As usual, government intervention in the private market failed to deliver the promised benefits and caused unintended consequences, but Congress never blames itself for the problems created by bad laws. Instead, we are told more government – in the form of “universal coverage” – is the answer. But government already is involved in roughly two-thirds of all health care spending, through Medicare, Medicaid, and other programs.

For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high-quality, affordable medical care, and thousands of private charities provided health services for the poor. Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.

The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone – doctors, hospitals, patients, and drug companies – to keep costs down. As long as “somebody else” is paying the bill, the bill will be too high.

The following are bills Congress should pass to reduce health care costs and leave more money in the pockets of families:

HR 3075 provides truly comprehensive health care reform by allowing families to claim a tax credit for the rising cost of health insurance premiums. With many families now spending close to $1000 or even more for their monthly premiums, they need real tax relief – including a dollar-for-dollar credit for every cent they spend on health care premiums – to make medical care more affordable.

HR 3076 is specifically designed to address the medical malpractice crisis that threatens to drive thousands of American doctors – especially obstetricians – out of business. The bill provides a dollar-for-dollar tax credit that permits consumers to purchase "negative outcomes" insurance prior to undergoing surgery or other serious medical treatments. Negative outcomes insurance is a novel approach that guarantees those harmed receive fair compensation, while reducing the burden of costly malpractice litigation on the health care system. Patients receive this insurance payout without having to endure lengthy lawsuits, and without having to give away a large portion of their award to a trial lawyer. This also drastically reduces the costs imposed on physicians and hospitals by malpractice litigation. Under HR 3076, individuals can purchase negative outcomes insurance at essentially no cost.

HR 3077 makes it more affordable for parents to provide health care for their children. It creates a $500 per child tax credit for medical expenses and prescription drugs that are not reimbursed by insurance. It also creates a $3,000 tax credit for dependent children with terminal illnesses, cancer, or disabilities. Parents who are struggling to pay for their children's medical care, especially when those children have serious health problems or special needs, need every extra dollar.

HR 3078 is commonsense, compassionate legislation for those suffering from cancer or other terminal illnesses. The sad reality is that many patients battling serious illnesses will never collect Social Security benefits – yet they continue to pay into the Social Security system. When facing a medical crisis, those patients need every extra dollar to pay for medical care, travel, and family matters. HR 3078 waives the employee portion of Social Security payroll taxes (or self-employment taxes) for individuals with documented serious illnesses or cancer. It also suspends Social Security taxes for primary caregivers with a sick spouse or child. There is no justification or excuse for collecting Social Security taxes from sick individuals who literally are fighting for their lives.

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The Mises Institute monthly

Volume 23, Number 11
November 2003

Socialized Medicine in America
Timothy D. Terrell
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Thanks to the untiring efforts of Bill Clinton and George W. Bush, Americans have been faced with the greatest expansion of the government into medical care since the 1960s. When these moves are complete, the free market in American medicine will be practically gone. Interventionism will be in complete possession of the field of battle, and the task of the government will be to mop up the remaining opposition.

There are three major pieces of legislation that indicate that socialized medicine has essentially arrived in the United States. A high profile, imminent concern is the Medicare reform now under consideration. The competing Medicare prescription drug bills—a House version and a Senate version—both accept the premise that the government should control medical treatment. Either bill would satisfy the Clinton administration's Medicare administrator Nancy-Ann DeParle, who exulted that in signing the bill, Bush would "preside over the biggest expansion of government health benefits since the Great Society."

But there are other ways in which government is invading medical care. Earlier this year, the Health Insurance Portability and Privacy Act (HIPPA) took effect. This horribly misnamed bill actually destroys patient privacy by allowing government bureaucrats, insurance companies, and others to gain access to private medical records without the patient's consent. Potentially even more dangerous is the Model State Emergency Health Powers Act (MSEHPA), which would grant state governors immense powers in the event of a public health "emergency," a condition that exists when so determined by the governor, of course. We'll take each of these in turn.

Medicare Reform

The Medicare reform would continue a long-term trend in American medical care—the intrusion of federal subsidies and regulation into every aspect of medical care. Over a third of all medical care is administered under federal Medicare and Medicaid programs. The bureaucracy that follows this intervention has added immense complexity and expense to the practice of medicine. There are elaborate diagnostic and treatment codes that require doctors to follow bureaucratic rules for medical care. Where Medicare or Medicaid are involved, a free market does not exist.

The government regulates prices, and it is illegal for the doctor to ask for or receive anything different, even if the patient agrees. Anything less than absolute adherence to the rules, indeed even a paperwork error, can be regarded as a felony charge of defrauding the government. A close enough look at almost any physician's practice would probably turn up some offense—which means that anyone the government wants to prosecute, it can prosecute. In effect, regulatory terrorism is being imposed upon the medical profession.

Medicare is a significant contributor to increased medical costs, by creating a large third party payer. In 1960, the government covered 21.4 percent of personal medical care expenditures. Americans covered 55.2 percent out-of-pocket. Most of the rest came from private medical insurance. In 2000, the government covered 43.3 percent of personal medical expenditures, through Medicare, Medicaid, SCHIP, and other government programs. Out-of-pocket spending accounted for only 17.2 percent of the total.

Over the same 40-year period, total personal medical spending increased by more than ten times, from an inflation-adjusted $111 billion in 1960 to $1130 billion in 2000. Some of this may be attributable to changing priorities, as Americans demanded relatively more medical care as other needs were satisfied in a growing economy. A large part, however, may be due to the incentives that appear whenever a third party is paying for medical care. In 1960, when Americans paid for the majority of their medical care out-of-pocket, they were more likely to watch for unnecessary expenditures. Today, with 83 percent of medical care being provided by a third party, we are naturally less vigilant.

In several ways, the government is responsible for the increase in third-party payment from private insurers as well. Government medical licensing created artificial shortages of medical practitioners, driving costs up so that illness or injury was more likely to produce financial catastrophe without insurance. Subsequently, as Gene Callahan noted in his textbook Economics for Real People, wage controls led employers to offer medical insurance instead of cash payments in their compensation packages. Increasing tax rates have had the same effect.

Employer-paid health insurance premiums are pre-tax while out-of-pocket expenditures are not. Finally, medical costs are bound to spiral upward when medical insurers are forced by law to create cross-subsidies from the healthy to the sick. This merely exacerbates the third-party payer problem, as the relatively healthy are given incentives to make greater use of medical services. (This last sort of attack on the market has come from both sides of the political aisle, as Jeffrey Herbener pointed out in a 1996 article).

HIPPA

On April 14 of this year, the Health Insurance Portability and Privacy Act's so-called "privacy" regulations took effect. This has to be one of the most egregiously misnamed laws to be passed in the last century (right up there with the "Banking Secrecy Act"). HIPPA created a "standard unique health care identifier" for all Americans, which destroys privacy rather than protecting it.

As Rep. Ron Paul has pointed out, this identifier "would allow federal bureaucrats to track every citizen's medical history from cradle to grave." Law enforcement officials and other government agents could examine these records without a search warrant, and the government, rather than the patient, can determine who else should have access. As Ron Paul contended, "it is possible that every medical professional, hospital, and Health Maintenance Organization in the country would be able to access an individual citizen's record simply by entering the patient's identifier into a health care database."

MSEHPA

The Model State Emergency Health Powers Act[1] that circulated about state legislatures in the past year clearly indicates how the government could use a "public health emergency" to grab draconian powers. The legislation, which originated at the Centers for Disease Control, would give state governors broad powers to declare a health emergency, whereupon vast authority would be granted to state officials. The governor, public health officials, and other government agents could then detain people who had committed no criminal act, seize or destroy personal property, impose price controls, require individuals to receive a medical examination and/or be vaccinated (regardless of whether the person has conditions that could make vaccination harmful or even deadly), and assume other powers.

Civilian doctors, nurses, pharmacists, and other medically trained people could be conscripted into government service and required to conduct examinations or administer vaccinations. If they refuse, they could be stripped of their license. The military may even be brought in to back up the public health officials.

Many states rejected MSEHPA, but several have accepted significant parts of the legislation. Republican-controlled Florida is one of the worst—in that state the public health department may declare a health emergency with or without the governor's cooperation. Law enforcement would then be at the public health officials' disposal.

MSEHPA is a classic example of the government using emergencies to expand their power. In an atmosphere of general fear and panic, people are less likely to protest. Robert Higgs has pointed out that, in national emergencies, the Constitution is likely to be read very differently, and the freedoms it protects are likely to be significantly curtailed. The "Crisis Constitution," as he puts it, takes precedence as a fearful population grants immense powers to all branches of government. "The great danger," Higgs writes, "is that in an age of permanent emergency—the age we live in, the age we are likely to go on living in—the Crisis Constitution will simply swallow up the Normal Constitution, depriving us at all times of the very rights the original Constitution was created to protect at all times."

With the impending Medicare reform and recently-enacted legislation like HIPPA and MSEHPA, together with the vast structure of subsidies and regulation that has been around for decades, there is now little point in distinguishing between our current system and "socialized medicine." Aspects of a free market are still present, but they are so overwhelmed by government intervention as to be hopelessly crippled. We are not where Great Britain and Canada are now, with limited medical innovation and waiting lists of several years for life-saving, essential surgery. But the distinctions are now more a matter of degree than of principle. If Americans accept the basic idea that the government should control and provide medical care, it will only be a matter of time.


Timothy Terrell is assistant professor of economics at Wofford College and an adjunct scholar of the Ludwig von Mises Institute. He can be contacted at terrelltd@wofford.edu. See also Gene Callahan, Economics for Real People (Auburn: Ludwig von Mises Institute), 2002, pp. 180-182; Jeffrey Herbener, "Socialized Medicine, Take Two," The Free Market, vol. 14, no. 7 (July 1996);

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THE DEVIL IS IN THE PRINCIPLES:
MURRAY ROTHBARD ON CLINTONIAN "HEALTH REFORM"
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In the mid-1990s the Clinton administration proposed a major overhaul of the U.S. health care system. Libertarian scholar Murray N. Rothbard wrote this analysis:

The standard media cliche about the Clinton health plan is that God, or the Devil, depending on your point of view, “is in the details.” There is surprising agreement among both the supporters and all too many of the critics of the Clinton health “reform.” The supporters say that the general principles of the plan are wonderful, but that there are a few problems in the details: e.g., how much will it cost, how exactly will it be financed, will small business get a sufficient subsidy to offset its higher costs, and on into the night.

The alleged critics of the Clinton Plan also hasten to assure us that they too accept the general principles, but that there are lots of problems in the details. Often the critics will present their own alternative plans, only slightly less complex than the Clinton scheme, accompanied by assertions that their plans are less coercive, less costly, and less socialistic than the Clinton effort. And since health care constitutes about one-seventh of the American output, there are enough details and variants to keep a host of policy wonks going for the rest of the their lives.

But the details of the Clintonian plan, however diabolic, are merely petty demons compared to the general principles, where Lucifer really lurks. By accepting the principles, and fighting over the details, the Loyal Opposition only succeeds in giving away the store, and doing so before the debate over the details can even get under way. Lost in an eye-glazing thicket of minutiae, the conservative critics of Clintonian reform, by being “responsible” and working within the paradigm set by The Enemy, are performing a vital service for the Clintonians in snuffing out any clear-cut opposition to Clinton’s Great Leap Forward into health collectivism.

Let us examine some of the Mephistophelean general principles in the Clintonian reform, seconded by the conservative critics.

1.

Guaranteed universal access. There has been a lot of talk recently about “universal access” to this or that good or service. Many “libertarian” or “free-market” proponents of education “reform,” for example, advocate tax-supported voucher schemes to provide “access” to private schooling. But there is one simple entity, in any sort of free society, that provides “universal access” to every conceivable good or service, and not just to health or education or food. That entity is not a voucher or a Clintonian ID card; it’s called a “dollar.” Dollars not only provide universal access to all goods and services, they provide it to each dollar-holder for each product only to the extent that the dollar-holder desires. Every other artificial accessor, be it voucher or health card or food stamp, is despotic and coercive, mulcts the taxpayer, is inefficient and egalitarian.
2.

Coercive. “Guaranteed universal access” can only be provided by the robbery of taxation, and the essence of this extortion is not changed by calling these taxes “fees,” “premiums,” or “contributions.” A tax by any other named smells as rotten, and has similar consequences, even if only “employers” are forced to pay the higher “premiums.”

Furthermore, for anyone to be “guaranteed” access to anything, he has to be forced to participate, both in receiving its “benefits” and in paying for them. Hence, “guaranteed universal access” means coercing not only taxpayers, but everyone as participants and contributors. All the weeping and wailing about the 37 million “uninsured” glosses over the fact that most of these uninsured have a made a rational decision that they don’t want to be “insured,” that they are willing to take the chance of paying market prices should health care become necessary. But they will not be permitted to remain free of the “benefits” of insurance; their participation will become compulsory. We will all become health draftees.
3.

Egalitarian. Universal means egalitarian. For the dread egalitarian theme of “fairness” enters immediately into the equation. Once government becomes the boss of all health, under the Clinton plan or the Loyal Opposition, then it seems “unfair” for the rich to enjoy better medical care than the lowest bum. This “fairness” ploy is considered self-evident and never subject to criticism. Why is “the two-tier” health system (actually it has been multi-tier) any more “unfair” than the multi-tier system for clothing or food or transportation? So far at least, most people don’t consider it unfair that some people can afford to dine at The Four Seasons and vacation at Martha’s Vineyard, whereas others have to rest content with McDonald’s and staying home. Why is medical care any different?

And yet, one of the major thrusts of the Clinton Plan is to reduce us all to “one-tier,” egalitarian health care status.
4.

Collectivist. To insure equality for one and all, medical care will be collectivist, under close supervision of the federal Health Care Board, with health provision and insurance dragooned by government into regional collectives and alliances. The private practice of medicine will be essentially driven out, so that these collectives and HMOs will be the only option for the consumer. Even though the Clintonians try to assure Americans that they can still “choose their own doctor,” in practice this will be increasingly impossible.
5.

Price Controls. Since it is fairly well known that price controls have never worked, that they have always been a disaster, the Clinton Administration always keen on semantic trickery, have stoutly denied that any price controls are contemplated. But the network of severe price controls will be all too evident and painful, even if they wear the mask of “premium caps,” “cost caps,” or “spending control.” They will have to be there, for it is the promise of “cost control” that permits the Clintonians to make the outrageous claim that taxes will hardly go up at all. (Except, of course, on employers.) Tight spending control will be enforced by the government, not merely on its own, but particularly on private spending.

One of the most chilling aspects of the Clinton plan is that any attempt by us consumers to get around these price controls, e.g. to pay higher than controlled prices to doctors in private practice, will be criminalized. Thus, the Clinton Plan states that “A provider may not charge or collect from the patient a fee in excess of the fee schedule adopted by an alliance,” and criminal penalties will be imposed for “payment of bribes or gratuities” (i.e. “black market prices”) to “influence the delivery of health service.”

In arguing for their plan, by the way, the Clintonians have added insult to injury by employing absurd nonsense in the form of argument. Their main argument for the plan is that health care is “too costly,” and that thesis rests on the fact that health care spending, over recent years, has risen considerably as a percentage of the GDP. But a spending rise is scarcely the same as a cost increase; if it were, then I could easily argue that, since the percentage of GDP spent on computers has risen wildly in the past ten years, that “computer costs” are therefore excessive, and severe price controls, caps, and spending controls must be imposed promptly on consumer and business purchases of computers.
6.

Medical Rationing. Severe price and spending controls means, of course, that medical care will have to be strictly rationed, especially since these controls and caps come at the same time that universal and equal care is being “guaranteed.” Socialists, indeed, always love rationing, since it gives the bureaucrats power over the people and makes for coercive egalitarianism.

And so this means that the government, and its medical bureaucrats and underlings, will decide who gets what service. Medical totalitarianism, if not the rest of us, will be alive and well in America.
7.

The Annoying Consumer. We have to remember a crucial point about government as against business operations on the market. Businesses are always eager for consumers to buy their product or service. On the free market, the consumer is king or queen and the “providers” are always trying to make profits and gain customers by serving them well. But when government operates a service, the consumer is transmuted into a pain-in-the-neck, a “wasteful” user-up of scarce social resources. Whereas the free market is a peaceful cooperative place where everyone benefits and no one loses, when government supplies the product or service, every consumer is treated as using a resource only at the expense of his fellow-men. The “public service” arena, and not the free market, is the dog-eat-dog jungle.

So there we have the Clintonian health future: government as totalitarian rationer of health care, grudgingly doling out care on the lowest possible level equally to all, and treating each “client” as a wasteful pest. And if, God forbid, you have a serious health problem, or are elderly, or your treatment requires more scarce resources than the Health Care Board deems proper, well then Big Brother or Big Sister Rationer in Washington will decided, in the best interests of “society,” of course, to give you the Kevorkian treatment.
8.

The Great Leap Forward. There are many other ludicrous though almost universally accepted aspects of the Clinton Plan, from the gross perversion of the concept of “insurance” to the imbecilic view that an enormous expansion of government control will somehow eliminate the need for filling out health forms. But suffice it to stress the most vital point: the plan consists of one more Great Leap Forward into collectivism.

The point was put very well, albeit admiringly, by David Lauter in the Los Angeles Times (September 23). Every once in a while, said Lauter, “the government collectively braces itself, takes a deep breath and leaps into a largely unknown future.” The first American leap was the New Deal in the 1930s, leaping into Social Security and extensive federal regulation of the economy. The second leap was the civil rights revolution of the 1960s. And now, writes Lauter, “another new President has proposed a sweeping plan” and we have been hearing again “the noises of a political system warming up once again for the big jump.”

The only important point Mr. Lauter omits is leaping into what? Wittingly or unwittingly, his “leap” metaphor rings true, for it recalls the Great Leap Forward of Mao’s worst surge into extreme Communism.

The Clinton health plan is not “reform” and it doesn’t meet a “crisis.” Cut through the fake semantics, and what we have is another Great Leap Forward into socialism. While Russia and the former Communist states are struggling to get out of socialism and the disaster of their “guaranteed universal health care” (check their vital statistics), Clinton and his bizarre Brain Trust of aging leftist grad students are proposing to wreck our economy, our freedom, and what has been, for all of the ills imposed by previous government intervention, the best medical system on earth.

That is why the Clinton health plan must be fought against root and branch, why Satan is in the general principles, and why the Ludwig von Mises Institute, instead of offering its own 500-page health plan, sticks to its principled “four-step” plan laid out by Mises Institute Senior Fellow Hans-Hermann Hoppe (The Free Market April 1993) of dismantling existing government intervention into health.

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The Mises Institute monthly

April 1993
Volume 11, Number 4

A Four-Step Health-Care Solution
by Hans-Hermann Hoppe
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It's true that the U.S. health care system is a mess, but this demonstrates not market but government failure. To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government controls.

It's time to get serious about health care reform. Tax credits, vouchers, and privatization will go a long way toward decentralizing the system and removmg unnecessary burdens from business. But four additional steps must also be taken:

1. Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health care services would appear on the market.

Competing voluntary accreditation agencies would take the place of compulsory government licensing--if health care providers believe that such accreditation would enhance their own reputation, and that their consumers care about reputation, and are willing to pay for it.

Because consumers would no longer be duped into believing that there is such a thing as a "national standard" of health care, they will increase their search costs and make more discriminating health care choices.

2. Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

Costs and prices would fall, and a wider variety of better products would reach the market sooner. The market would force consumers to act in accordance with their own--rather than the government's--risk assessment. And competing drug and device manufacturers and sellers, to safeguard against product liability suits as much as to attract customers, would provide increasingly better product descriptions and guarantees.

3. Deregulate the health insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.

Because a person's health, or lack of it, lies increasingly within his own control, many, if not most health risks, are actually uninsurable. "Insurance" against risks whose likelihood an individual can systematically influence falls within that person's own responsibility.

All insurance, moreover, involves the pooling of individual risks. It implies that insurers pay more to some and less to others. But no one knows in advance, and with certainty, who the "winners" and "losers" will be. "Winners" and "losers" are distributed randomly, and the resulting income redistribution is unsystematic. If "winners" or "losers" could be systematically predicted, "losers" would not want to pool their risk with "winners," but with other "losers," because this would lower their insurance costs. I would not want to pool my personal accident risks with those of professional football players, for instance, but exclusively with those of people in circumstances similar to my own, at lower costs.

Because of legal restrictions on the health insurers' right of refusal--to exclude any individual risk as uninsurable--the present health-insurance system is only partly concerned with insurance. The industry cannot discriminate freely among different groups' risks.

As a result, health insurers cover a multitude of uninnsurable risks, alongside, and pooled with, genuine insurance risks. They do not discriminate among various groups of people which pose significantly different insurance risks. The industry thus runs a system of income redistribution--benefiting irresponsible actors and high-risk groups at the expense of responsible individuals and low risk groups. Accordingly the industry's prices are high and ballooning.

To deregulate the industry means to restore it to unrestricted freedom of contract: to allow a health insurer to offer any contract whatsoever, to include or exclude any risk, and to discriminate among any groups of individuals. Uninsurable risks would lose coverage, the variety of insurance policies for the remaining coverage would increase, and price differentials would reflect genuine insurance risks. On average, prices would drastically fall. And the reform would restore individual responsibility in health care.

4. Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased breed illness and disease, and promote carelessness, indigence, and dependency. If we eliminate them, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid.

Only these four steps, although drastic, will restore a fully free market in medical provision. Until they are adopted, the industry will have serious problems, and so will we, its consumers.


Hans-Hermann Hoppe teaches economics at the University of Nevada, Las Vegas.

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When Totalitarianism Comes to America

It Will Come Wrapped in a Whole-Grain, Low-Sodium, Decaffeinated, Re-Usable, Non-Carbon-Footprint Wrapper

LewRockwell.com
by Karen De Coster

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The Centers for Disease Control and Prevention is sponsoring more food totalitarianism for the purpose of suitably herding the kiddies in their daily food round-ups in public schools. An Institute of Medicine committee - set up at the behest of congress - is proposing strict standards for all foods available in the government's daily internment camps.

Ayn Rand or George Orwell couldn't have fictionalized it any better. The Committee for Food Control, as we'll call it, is proposing that food and beverages be individually categorized into defined "tiers." The committee will collectively determine what food and beverages belong in either Tier 1 or Tier 2. Each tier of food and beverage items will come with varying availability according to the time of day and/or the child's grade level.

Tier 1 snacks contain no more than 200 calories per portion, and entrée items that could be sold à la carte do not exceed calorie limits on comparable school lunch program items. Tier 1 items have no more than 200 milligrams of sodium per snack portion or 480 milligrams per à la carte entrée item. They contain no more than 35 percent of total calories from fat; less than 10 percent of total calories from saturated fats; no trans fats; and no caffeine except in naturally occurring trace amounts. They also contain no more than 35 percent of calories from total sugars; exceptions to this guideline are flavored milk, which may contain up to 22 grams of sugars per 8-ounce serving, and yogurt, which should not exceed 30 grams of sugars per 8-ounce portion.

Got that? This means that yogurt with the inexcusable "fruit-on-the-bottom" will likely exceed the sugar limit and thus be tossed into the "less healthy" Tier 2. In fact, we're told that Tier 1 foods include stuff like carrot sticks, whole-grain, low-sugar cereals, whole fruit, skim or soy milk, and raisins. There would be a cap on juices because of their calorie-laden, sugary nature - 8 ounces for high school kids and 4 ounces for middle and elementary school students.

Tier 2 foods are the borderline sinful items - stuff like low-sodium whole-wheat crackers, caffeine-free diet soda, and seltzer water. These food items can only be made available after school hours and must conform to the U.S. Dietary Guidelines for Americans. Sports drinks, like Powerade or Gatorade, may only be ingested when the child has participated in "one or more hours of vigorous activity." That one ought to make for some great union jobs in providing for oversight and enforcement.

These standards will be applied to food and beverages sold on school grounds, including vending machines; à la carte cafeteria items; and "other foods and drinks that are available outside of - and therefore compete with - federally reimbursable school meals, which already must conform to some nutrition guidelines."

The criticism here is obvious. For starters, there is no room in a free society for lifestyle decrees of this nature - the government has overstepped its boundaries when it extends its coercive powers into the realm of the family and strives to regulate individual human eating habits. An unconstitutional action, yes. But even more so, it's preposterous to think that any group of people can be empowered to determine what kind of nutritional substance (or lack thereof) you can or can't put into your child's body. This proposed esophageal terrorism on the part of big government - under the pretext of making us all healthier - is indeed invasive and controlling enough to justify the term "food totalitarianism."

(Article Continues Below)

In reality, in order to enjoy good health and clean eating individuals do not need to categorize all foods as strictly "bad" or "good." They need to balance the healthy foods with the less healthy and moderate their overall diet so that, in total, their bodies are receiving a net advantage of solid, nutritional foods. Self-moderation on the part of the individual eventually brings on more knowledge, better decision-making, and cleaner eating habits. Taking the road from being a sloppy eater who subsists on fast food, sweet stuff, and highly-processed foods toward a life of clean eating is typically not a forced sprint; it is a voluntary walk along the path of knowledge when one strives for personal betterment through enhanced nutritional habits.

Another critique - that complements the comments above - is the government's "one-size-fits-all" proposal. The notion that what is good or bad for one person is necessarily the same for all others is collectivist in its foundation as well as scientifically unsound. Our bodies are so supremely individualistic that no group of us will achieve the same results from a given form of exercise or food program. As for children, there are many determining factors for diet type. A child's natural body type, growth pattern, metabolism, and level of activity will determine what he should be eating and when he should eat it. A centrally-planned food program with calorie ceilings, rigorously-defined good and bad foods, and shared time management techniques is both physically and mentally unhealthy. Envision the negativity that children would experience when eating becomes forced and authoritarian, and falls under yet another set of harsh rulemaking.

Furthermore, there is no totalitarian decree that can effectively centralize the health and food diets of millions of children via random commands from one gigantic central planning commission - made up of establishment doctors, government agencies, health special interests, busybody citizens, and corporatist food interests - headquartered in Washington D.C. In effect, the establishment of twinkie control and calorie constraints is oppressive and inhumane, and surely, it works against the very foundations of freedom that we should savor and preserve.

True, bad eating habits will lead to grim consequences later in life, if not in the here-and-now. However, one's body is one's own to take care of or not. When an obese person - or any individual for that matter - makes the choice to consume a Big Mac or deep-fried, processed corn dogs as opposed to non-fat yogurt and broccoli, they are choosing food consumption as the way to immediate happiness instead of thinking long-term and putting off instant gratification for future health benefits. Done continuously, it's a bad choice, but it is a choice. Poor choices like these are ripe for criticism and open to persuasion from onlookers, but they can never be taken away from individuals if we value self-ownership and the notion of negative liberty - the absence of physical interference with an individual's person and property - as espoused by classical liberal philosophers.

Looking through the proposal, I guess there's one thing for which we can be "grateful" concerning this latest episode of obesity scaremongering: "The standards apply only to competitive items sold or available on campuses, not to federal school meals or to bagged lunches or snacks that children bring to school."

Then again, before you consider this latest oppressive scheme for food control to be only a problem of food served in the public schools, consider the ramp-up in food totalitarianism that we have been witnessing all around us. One thing for certain is that government central planners are always predictable: given the opportunity, they will collectively assimilate all people everywhere into one big kettle and dole out equitable slices of compulsory recommendations that are backed up by the supremacy of law. This is so that we can all share in the same perceived benefits in the same equal amounts as identified by them - the chosen caretakers. Never mind that what may be beneficial to one man may be detrimental to another man.

Blessed be thy caretakers. They are spinning Orwell in his grave.