It should be of no surprise that establishment Republicans in Congress are rearranging the deck chairs from ObamaCare to “ObamaCare Lite,” in their saving the Affordable Care Act (ACA) from being fully repealed.
But conservative opponents, such as Senators Rand Paul and Mike Lee, who want ObamaCare fully repealed, are still not going far enough.
The problem is that other government entitlement schemes are interconnected with ObamaCare, and avoiding the “pain” of change would require repealing the other schemes. After all, the reason why medical care has gotten so expensive is because of government interventions, which distort decision-making by medical care providers, drug makers and patients, and drives up the prices, as Hunter Lewis writes at the Mises Institute.
Lewis acknowledges that there will be difficulties after ACA is repealed. Some people may lose their health care plans inflicted by ObamaCare.
However, when ObamaCare became law many people lost their insurance plans and doctors, despite President Obama’s promises to the contrary. Many employers changed full-time jobs to part-time, and many doctors retired early because of the demands of ObamaCare.
As Rand Paul stated in a recent interview with Sean Hannity, rather than expanding subsidies or Medicaid he wants to “expand the economy.”
Expanding the economy requires the shrinkage of government controls. Bureaucratic intrusions cause economic distortions, and taxes take away from workers and producers what they otherwise would be spending or investing in the economy or on health care. Shrinking governmental controls and wealth confiscations thus effect in expanding the economy.
Prior to the past century of bureaucracy enforced at gunpoint, Americans were easily able to see a doctor or go to the hospital if they needed to. If they couldn’t afford it then most doctors and hospitals were able to treat those people for free. But because of Medicare and Medicaid, taxes and fees, many of today’s doctors have difficulty doing that, or perhaps don’t even consider it because Medicare and Medicaid have been an assumed part of everyday life for 50 years now.
Some other non-economic problems caused by government interventions also include an over-reliance on prescription drugs, and doctors ignoring the importance of nutrition to stay healthy to avoid illnesses in the first place.
The only way that full repeal of ObamaCare (and not replacing it with a “Ryan Plan,” or anything else) can in the long run be made easier is further repealing of all the other economic and social distortions that government bureaucracies have inflicted into the lives of the people. Those include programs such as Medicare, Medicaid, Social Security, and all the taxes and other forms of wealth confiscations by government to fund those schemes.
Besides repealing and dismantling all those bureaucracies and the taxes which fund them, also fully eliminate the compulsory demands by government for personal and financial information about one’s employment and salary status, one’s businesses, and especially one’s medical matters. If those matters are private and none of your neighbors’ business, then they are none of the government‘s business as well.
I know, a lot of people think that Medicare, Medicaid, and Social Security are here to stay and that’s the way it is. In a nutshell, what the government does to administer those programs is to tax the younger, less wealthy workers to redistribute their earnings to mainly more wealthy older people, as Walter Williams pointed out.
The truth is, Social Security (and the related program, Medicare) is not an “account,” into which you voluntarily put some of your earnings, to be received later in life. The money is taken from your earnings by the government without your consent. And the source of the payments that current Social Security recipients receive is not from any “account,” but from those currently employed, from their paychecks. Social Security and Medicare are mainly redistribution of wealth schemes. As Walter Williams noted, Americans have been “duped by Congressional lies” into thinking otherwise, for decades now.
In more recent decades, people are understandably reluctant to even consider the real alternative to the dysfunctional and bankrupted statist quo of government-controlled medical care, insurance and retirement schemes.
The better alternative is freedom. It is not a “Ryan Plan,” a “Rand Paul Plan,” or any government bureaucrat’s plan. It is your plan. Your choice and your control, and on a free and open market of voluntary exchange with services and providers, without the supervision, permission, or control of anyone in government.
With freedom, voluntary contracts between doctors and patients, between hospitals and patients, doctors and hospitals, insurers and patients, and so on, are not intruded upon by bureaucrats or any other third parties. The government doesn’t demand money from workers, from doctors, from medical device makers, insurers. In a truly free society, such acts of plunder would be considered just that: theft and plunder.
But economically, when voluntary association and private property rights are restored in all aspects of the freed society, in medicine the bureaucrats’ price distortions would cease, and prices of medical care would drop dramatically. There is evidence for that. When bureaucracy and central planning intrusions end, prices come down. And in medical care, ending the bureaucracy also ends the government “death panels” and other tyrannies. And I really believe that with freedom, medical and hospital errors will no longer be the third leading cause of death in America.
So not only would we be better off by repealing ObamaCare, Medicare, Medicaid, the entire Social Security Act of 1935, but also all income taxes, and giving the IRS the heave-ho. That way, when government stops stealing from the people, families can once again afford to see a doctor or go to a hospital. More charities will spring up and more people will be financially able to donate to them. And a change in cultural attitude would result in sickness no longer being subsidized.
After the people are freed, with income taxes and other thefts and intrusions gone, the bureaucracy in Washington will be forced to let go of its little fiefdoms, the compulsive warmongering will have to end, and some of the corporate military-security-complex such as Raytheon and Boeing will have to stick with producing products that are beneficial to humanity, not deadly.
The only issue for me is how to get there from here. The central planning-obsessed apparatchiks in Washington don’t want to leave the people alone in medical matters, and are afraid of alienating voters and losing elections. I get that. Selfishness and narcissism rule in Washington, I know.
Some people suggest gradual phasing out of subsidies and government controls over medical care and the phasing in of freedom, as the aforementioned Mises writer Hunter Lewis pointed out.
But, as economist Murray Rothbard suggested, it may be necessary that bureaucrats “be confined to setting their subjects free, as fast and as completely as it takes to unlock their shackles. After that, the proper role of government and its advisers is to get and keep out of the subjects’ way.” Rothbard explained that
Holding back, freeing only a few areas at a time, will only impose continuous distortions that will cripple the workings of the market and discredit it in the eyes of an already fearful and suspicious public. But there is also another vital point: the fact that you cannot plan markets applies also to planning for phasing them in. Much as they might delude themselves otherwise, governments and their economic advisers are not in a position of wise Olympians above the economic arena, carefully planning to install the market step by measured step, deciding what to do first, what second, etc. Economists and bureaucrats are no better at planning phase-ins than they are at dictating any other aspect of the market.
To conclude, the way to fix the health care problem is the same way that will fix problems in education and everything else: liberating the people.
Scott Lazarowitz is a libertarian writer and commentator. Please visit his blog.