Wednesday, October 24, 2012

The Only Hope Is Repeal...

I. The HHS Mandate is back in the news again, thanks to the Obama campaign's designated squirrel* of the "War on Women" (despite paying their female staffers 18% less than male staffers, but I digress).

*For all the talk of the President "winning" the second debate last Tuesday, the 16th, it's remarkable that all of his surrogates chose to concentrate on the Romney "binders full of women" comment rather than talk up how, you know, the President actually WON the debate.

I have written about the HHS Mandate before at length (here, herehere, here, here, and here), but it bears repeating once again that in no uncertain terms this is a violation of freedom of religion - one of the core freedoms of the First Amendment to the U.S. Constitution.  What the Obama Administration is trying to do is tyranny, pure and simple.  It is an authoritarian attempt to bend people to his will and we must not stand for it.

II. The whole principle of the "Affordable Care Act" (aka "Obamacare") has been to slowly guide the American medical system to a European-style single-payer system.  It would have been more intellectually honest to say that, but there was no way in hell anyone would have voted for it (other than Bernie Sanders and John Kerry) and kept their jobs.  What we have, then, is a Trojan Horse that undermines the system in a fashion that causes people to cry out for more government intervention to the point where the government says "we just have to run it ourselves".

Before anyone accuses me of raging paranoia, just keep in mind that no one who actually has business experience (unlike a certain occupant of 1600 Pennsylvania Avenue) would be dumb enough to increase demand while stagnating or even decreasing supply and expect to lower costs.  And yet, that's precisely what the ACA does. And since we have the smartest man who has ever occupied the White House in office, he would never stoop to such an incompetent practice, right?

So we are left with the malicious intended effect of the ACA - to squeeze private insurance out of business by making them offer policies to people who can wait until they are sick to actually buy them and thus fundamentally alter the nature of insurance, which is now going to be mandated to have. I have addressed the nonsensical argument that the individual mandate of the ACA is equivalent to requiring car insurance.

III. We are always told about the so-called "good" things of the ACA...All TWO of them. It's amazing that in a 2,700 page bill, there are *two* "good" things. 1) All people with pre-existing conditions can get insurance at the same price as healthy people and 2) "kids" up to age 26 can stay on their parents' insurance.

Whoop-de-do.  The most recent link also talks about how "health insurance" is not insurance in any meaningful sense to begin with.  The whole point is to manage risk - if people are all treated as the same risk across the line, regardless of age, medical history, and behavior, then how can it be insurance?

There's a reason the age-26 portion is called a "slacker mandate" - and it is just another way of driving up demand without any requisite increase in supply.

So what about the bad things?  Lots of new taxes, decrease in caps of health savings accounts, and rises in premiums (How's that, you say?  Try Economics 101).

IV. I have read and heard it frequently from liberals who claim they have the monopoly on compassion, i.e. "we want access to affordable healthcare for all" or "the rich ought to pay their fair share" and "conservatives and libertarians want people on the streets to die and the rich to dance on their bodies".  I have yet to actually meet a conservative or libertarian that actually believes such a thing; nor have I read anything from any publication or think tank suggesting the same.

The point of debate has almost never been about ends, it's usually about means.  Centralizing the healthcare system is not the right means.  I have always agreed that the system needs some reforming - but there is a right way and a wrong way to pursue said reform.  The ACA is the wrong way.

The two things that would get health care costs under control almost immediately would be a) portability of insurance - to allow for purchasing across state lines (the ugly concept for a lot of leftists of choice and competition) and b) to get insurance OUT of routine medical care. That would make medical insurance cheaper off the top to start.

I have argued that store-style clinics should be rising up - it would be a cash model where you pay directly for services rendered, and any kind of non-life threatening injury can be treated.  Such a thing would lower costs because third parties would not be involved and it would also unclog emergency rooms.

Getting insurance out of routine medical care would restore insurance to its proper role of managing risk and preventing financial ruin against catastrophic events.  When these things happen, that's when we'll see...

a) The true value of medical care - which is skewed to the bejeezus due to third party payment and reimbursement procedures

b) Costs decrease - it's a proven maxim that the more someone else pays for something, the more you'll use it.  Medical care is no exception.  If you have to pay for it, it becomes a decision.


V. Now we are at the real issue, aren't we - the "right" to medical care.  The first thing that we need to make sure we are clear of is the separation between delivery of said care and payment of the same.  Too many people conflate the two.  They will say "health care", but what they really mean is who is footing the bill.

Here's the question - do you have the right to take away the fruit of another's labor?  When you truly slice down the question of health care reform - this is the most basic question - it's economic in nature.  Somebody has to pay for it.  It's clich├ęd as hell, but there. Is. No. Free. Lunch.  The hardcore advocates of health care reform (many who advocate single-payer) are trying to argue that there is, though, and that we have the right to the fruit of another's labor because of some misguided notion that we deserve it.  Where I come from, we call that stealing motivated by envy.

VI. The ACA was not ever about reforming the system - because if it were, it would have implemented common sense reforms.  Instead, it's about dictating our behavior and controlling us - menu calorie counts, forcing Catholic institutions to pay for contraception against their consciences, not allowing people to put money aside into flex-spending accounts, putting taxes on medical devices, implementing a board that will ration care, allow for insurance companies and the government to access your bank accounts, and on and on....

These are the people are supposed to care.  These are the compassionate ones.  

So where is the compassion?  Where is the care?

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