Health Care Bill Violates Individual Liberty

The US Congress has now passed a sweeping health care “reform” bill that, even when “fixed” in the Senate, will represent much more a violation of individual liberty than an improvement in American health care.

When we founded Cascade Policy Institute in 1991 our mission was, and still is, to promote public policy alternatives that foster individual liberty, personal responsibility and economic opportunity. This bill threatens to set us back in all three areas:

Individual liberty will be violated as the federal government takes away even more of our options regarding what insurance, if any, we choose to purchase and how we purchase it.

Personal responsibility will be decimated as the federal government tells us “don’t worry about taking care of yourself; we’ll do that collectively from now on.”

Economic opportunity will be stifled as the tax burden on individual workers, employers and investors go up, not down. Without meaningful cost controls, health care costs will spiral, leading to higher federal deficits and to even more government involvement in the economy.

When the bill’s supporters tell us that every other industrialized country has national health insurance, our response should be, “America is not every country; America is supposed to be the land of the free.”

If we aspire to remain the land of the free, we need to redouble our efforts to educate our fellow citizens about the costs of government intrusion into every aspect of our lives, and about the tremendous benefits of freedom. Here at Cascade Policy Institute, we are committed to do just that. Please join us, and together we can begin moving Oregon and America in the right direction again.


Steve Buckstein is founder and senior policy analyst at Cascade Policy Institute, Oregon’s free market public policy research center.

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Posted by at 06:33 | Posted in Measure 37 | 30 Comments |Email This Post Email This Post |Print This Post Print This Post
  • Anonymous

    Steve, I know you’ve heard it before, but you are delusional. Get a hold of yourself, man.

  • Tom Degan

    To paraphrase Winston Churchill, as far as health care in the USA is concerned, this is not the end. Nor is it the beginning of the end. But, perhaps, it is the end of the beginning. The commentators keep reminding us that Theodore Roosevelt was the first president who tried to bring universal health care to the American people. That’s not quite true. The idea didn’t really bear fruit while he was president. In 1912 Roosevelt had been out of office for four years when he attempted to seize the office from William Howard Taft, the man he had picked to succeed him. Once in office, Taft began to dismantle most of the progressive reforms that Teddy had put into place. When he sought the nomination once again, his campaign slogan was “a square deal for every man and every woman in the United States.” Part of the “Square Deal” was health care for all. He arrived at the convention that summer with all the delegates he needed (and then some) to seize the mantle of standard bearer. It was not to be. His party would betray the people by giving the nomination to Taft. They had had enough of Theodore Roosevelt and his progressive reforms. 1912 was the year that the progressive wing of the Republican party died. He was the last great Republican president – the very last.

    A generation later TR’s distant cousin Franklin attempted to pick up the torch of universal health care. In his 1944 State of the Union address, he told the American people that his major goal for the post war world was national health insurance. Unfortunately for you and I, FDR did not live to see the war’s end. A film of that speech can be viewed in Michael Moore’s film, Capitalism: A Love Story. It’s out on DVD. We’re talking essential viewing here.

    The new health care bill is not perfect – far from it – but as the old Chinese saying goes, “The journey of a thousand miles begins with the first step.” There will be improvements made on it down the years – there absolutely needs to be – but this is a fairly good first step. We’re on our way! The Conservatives will whine, but that’s what they do best. They’ll whine just as they whined when Lyndon signed into law the Voting Rights Act of 1965, or the Civil Rights Act of 1964. Just as they whined when Harry Truman desegregated the army in 1947, or when Franklin D. Roosevelt brought Social Security into being in 1935. They’ll whine just like they did when Woodrow Wilson tried to form the League of Nations in 1919 – or when Abraham Lincoln ended the institution of slavery in 1863! They whine a lot. Did you ever notice that?

    https://www.tomdegan.blogspot.com

    Tom Degan
    Goshen, NY

  • Bronch O’Humphrey

    Steve here must not know any small business owners. Which is something I’d expect from CPI.

    Go talk to that auto shop down the street, or the clothing store around the corner, or the high-volume restaurant at the end of your block. Find out what they pay for health insurance. Find out if they can afford paying what they pay now. Find out how many insurance companies would actually give them a quote.

    Then come back and let’s talk about what this bill does to the country.

    • Steve Plunk

      This small business owner understands the cost of insurance but I also understand why it costs so much. Health care is expensive so insurance must necessarily be expensive. This new law does nothing to deal with those rising costs or the incentives to make care more expensive than needed.

      By avoiding cost containment strategies the government will now apply it’s proven ability to make things worse and more expensive at the same time. Inefficiency will be the standard from simple doctor visits to complex long term care. Not only will we be forced to pay more but we will be less satisfied.

      I knew we were dealing with lies when the Dem leadership talked of insuring pre-existing conditions. That not insurance it’s just socialized medicine. They can’t even call it what it is so what else might they be hiding? I feel sorry for my son who will inherit this mess and the debt that comes with it.

      • valley p

        “This new law does nothing to deal with those rising costs or the incentives to make care more expensive than needed.”

        That’s not accurate Steve. The law contains a number of cost control measures, and they were recognized by the CBO. The only reason we can (maybe) insure 32 million more people and save some money is because the ridiculous inflation level of medical care and insurance is now expected to abate.

        It would have been nice had “conservatives” sat at the table in good faith to put forward more and better cost controls in this bill. They chose to cast stones instead.

        “I knew we were dealing with lies when the Dem leadership talked of insuring pre-existing conditions. That not insurance it’s just socialized medicine.”

        Wrong. It expands access to affordable insurance. Socialized medicine is what the British, and only the British have. We are nowhere near that with this bill. The closest analogue may be the Netherlands, Germany, or Switzerland, and we are pretty far from what they have as well.

        • Steve Plunk

          You are wrong on all counts.

          Name one cost control feature. There are none and don’t count cutting medicare reimbursements as some sort of cost control, that’s rationing. The only way to pay for any of this is to force younger, healthier people into the pool to cover the sick. Costs will continue to rise and the system will consume more of our wealth.

          Conservative put forth plans but were not given a place at the table. Don’t misdirect on this one. The Dems did not allow anyone but leadership approved parties to formulate this reform.

          Covering preexisting conditions is like buying fire insurance while your house is in flames. Insurance is shared risk. Covering preexisting conditions is not shared risk. It is a charitable action financed by the government with funds from others. From each according to their abilities, to each according to their needs. Socialism.

          • valley p

            “Name one cost control feature.”

            Its amusing that free market advocates like yourself are disappointed that the bill does not include the sort of direct cost controls that single payers systems have. Nevertheless, the bill Obama signed has *not just 1 but 5* significant elements expected to reduce or hold down the cost of both health care and health insurance:

            1) The market exchanges will vastly increase competition and thus put a brake on prices
            2) The Independent Medicare Advisory Board has the power to implement cost saving measures, bypassing congressional approval (a key reason CBO estimated Medicare financial life just got extended by 9 years)
            3) The “Cadillac plan” tax
            4) Medicare “bundling” of payments to care givers is expected to reduce unnecessary procedures
            5) The Feds now have oversight over premium increases

            Cutting over payments to Medicare Advantage is not rationing. It is cutting waste, something conservatives used to be for. Medicare proper delivers the same service for 16% less, so why should taxpayers subsidize private insurers? We shouldn’t. Even if there were no Obamacare at all, this measure alone is a good idea that should have been implemented by Republicans years ago.

            “The only way to pay for any of this is to force younger, healthier people into the pool to cover the sick. ”

            Yes. That is a key part of the deal to be able to cover those who are less healthy. Like my friends daughter who has CF, an expensive to treat, uninsurable, fatal disease if left untreated. So the bill is also pro life.

            “Conservative put forth plans but were not given a place at the table.”

            Conservatives had 12 years to deal with this issue. They failed. Baucus gave them equal seats at the table and Grassly ended up parroting Palin’s lies about killing granny. No need to misdirect.

            “Covering preexisting conditions is like buying fire insurance while your house is in flames.”

            So if you have a kid born with a genetic condition that will require a lifetime of treatments, and no profit minded insurance company would ever insure her, what is your answer Steve? Tough luck? Go to charity? We tried that and it didn’t work.

            “From each according to their abilities, to each according to their needs. Socialism. ”

            Some would refer to it as being Christian. Mathew: Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, *I was sick and you looked after me* , I was in prison and you came to visit me.’

          • Steve Plunk

            Item one is speculation. Item two is rationing not savings. Item three is tax not savings. Item four is speculation. Item five has to do with insurance not medical costs. I see five fails.

            You can hide behind Christian charity as an excuse for a socialist scheme but honest hard working people know this is nonsense. This is closer to Marx than Christ.

          • valley p

            Item 1 is introducing competition into otherwise non competitive markets. It is not “speculation.” The CBO does not do speculation. Item 2 is not ‘rationing.” It is improving decision making about what procedures work and what do not. It is common sense. Item 3 puts a downward pressure on over priced premiums. It is both a tax and a cost control measure. Item 4 was modeled by the CBO, therefore it is not speculation. Item 5, along with a requirement that insurance companies have to spend 80-85% of their premiums on actual health care, provides cost savings in the rates we all pay for insurance. You are correct it does not reduce the cost of health care delivery. But it reduces EVERYONE’S costs of getting that health care.

          • David Appell

            > Name one cost control feature.

            One of the biggest cost control features is simply that the bill requires everyone to have health insurance. This should end the spirals of premiums (as now) as healthy people opt against purchasing insurance, leaving those who need it in a death-spiraling pool that is ever riskier and thus ever more expensive.

          • Steve Plunk

            Obviously my liberal friends are not familiar with the term ‘costs’. Adding younger and generally healthier people into the insurance pool may lower premiums for those already in the pool but it does nothing to lower health care costs. It lowers some people’s insurance rates while raising others. The delivery cost for specific procedures or tests is likely to go higher rather than lower since there are no feature to lower those costs. Quit mixing up insurance for health care and health care itself.

          • valley p

            Sorry Steve, but your protest rings hollow. Like I said before, its ironic for any free market conservative to argue that this bill fails to “control” health care delivery costs. Short of a single payer (French) or fully socialized (British) system that sets rates (like in Medicare and Medicaid) that doctors can take or leave, the government has few tools available to directly keep costs low. What it can and did do, is use nearly every indirect method at is disposal. I listed those, you don’t like them…so be it.

            The bill enacted, if it does what is proponents claim (and only time will tell,) will expand access, reduce the cost of insurance for individuals and small businesses, initiate a number of experimental payment mechanisms that MAY reduce the cost of medical care by expanding the Mayo Clinic model, AND will reduce the federal budget deficit.

            If that is not enough for you, I make no apologies. Your party had their chance to get something done and they blew it. All they left behind were more uninsured people, skyrocketing insurance AND health care costs, and a huge budget deficit. When it came time for reform they stood aside and threw rocks. Now those rocks are going to start bouncing back to their source.

          • David Appell

            > Obviously my liberal friends are not familiar with the term ‘costs’. Adding younger
            > and generally healthier people into the insurance pool may lower premiums for
            > those already in the pool but it does nothing to lower health care costs

            It certainly does. Proof: Every industrialized country in the world, who all have national health care, all have lower costs/person than does the US — and, as has been pointed out time and again, with better results. Those countries all spend ~10% of their GDP on health care; the US spends ~16% of GDP, with results that are definitely no better and seemingly significantly worse.

  • Bob Clark

    The federal government can’t actually afford this new entitlement, nor the last program addition (Medicare

    Advantage), and so, ultimately financial crisis will probably effectively trump this new health care

    program, leading the country’s health care provision into an era of even greater bureaucratic

    morass. California has had to dramatically cut back on its myriad of state assistance programs, and with

    Obuma and the Dems the federal government is on a similar track. I also hear the Massachuttes public

    healthcare approach is a dismal failure, noting the election of Scott Brown a Republican to replace

    long time lib Ted Kennedy. (Note Abraham Lincoln was a Republican, and the Dems actually were for

    slavery.)

    Well the Dems tend to over regulate, leading to morass and economic mediocrity (think Carter), that is

    eventually undone by a Ronald Reagan type, leading to a period of economic renaissance. One can only

    hope the Dems will soon lose power so this healthcare blob can be dissolved before its crippling effects

    are realized.

  • skippy

    Before this bill passed there were no cost controls at all. Now there are some cost control cops on their new beat. Several articles and columns have been written citing cost control management.

  • Brodhead For Congress

    Hillsboro Argus article:

    Rob Cornilles, a Tualatin businessman seeking the Republican nomination to challenge Wu this November, said he was disappointed in Sunday night’s vote.

    “When it comes to creating public policy, good intentions aren’t enough,” he said. “(Sunday) night, we saw the change of how one-sixth of our economy work.”

    In a Sunday night press release, Cornilles criticized the bill but stopped short of saying he’d seek its repeal. In an interview Monday, he said he’d support repealing “anything that’s wrong with this bill.”

    I have a hard time with his stating that he would not seek to repeal a bill that was passed through the use of reconcilliation!

    If this is the best he can do than I am glad I removed my endorsement………………….

  • Don

    I AM SO HAPPY OBAMACARE PASSED! YOU LOSE SUCKERS! SOCIALISM FOREVER!

  • Bob Tiernan

    *valley p:*

    Item 3 puts a downward pressure on over priced premiums.

    *Bob T:*

    The mandates on coverage has contributed to driving prices up. Removing
    mandates so that people could tailor their own policies would bring downward
    pressure on premiums, as would ending the ban on purchasing policies
    across state lines. But the government didn’t like those ideas because
    they would empower people.

    Most of you guys vastly overestimate the amount of basic economic
    understanding found in the heads of Obama abd others.

    Bob Tiernan
    Portland

    • valley p

      “But the government didn’t like those ideas because
      they would empower people.”

      The current government did not like those ideas because the result would be lousy policies that failed to cover basic care, had high deductables, and caps that would end up bankrupting the unlucky. People would be “free” to buy crap policies that were deceptively cheap on the surface but basically would have left the unlucky ones as wards of the state or whichever hospital they ended up in.

      Free market economics does not apply to every problem, particularly social insurance. Read your Hayak.

      • Steve Buckstein

        v person – if you’re referring to Nobel prize winning economist Friedrich von Hayek (not Hayak) yes, he did see a government role in social insurance. But if he were here today, I’m fairly confident that he’s wouldn’t even recognize his thoughts in the current federal combination of regulations, taxes and mandates. If you want to read his ideas in context, they’re set out in his classic 1944 book, “The Road to Serfdom.”

        • David Appell

          Of course, Hayek never envisioned the vast takeover of our economics and our culture by large global corporations. Pushback by the government is necessary to protect consumers and overcome this huge force.

        • valley p

          Thanks for the spelling correction Steve. Here is Hayek, from Road to Serfdom:

          “Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – *the case for the state’s helping to organize a comprehensive system of social insurance is very strong* … Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken,” – The Road To Serfdom (Chapter 9).

          What would he think if he were alive today? Based on the above he would be a Democrat and support Obamacare.

          • Steve Buckstein

            V person – You highlighted one portion of Hayek’s statement. I’ll highlight another:

            *”Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken.”*

            In the health care sense, I believe “disasters” are high cost, unpredictable events that some of us will experience, but we don’t know who those people are. To spread such risk is what true insurance is for; often called high-deductible or catastrophic policies. Most health care expenses are relatively affordable, and largely predictable. Paying for them through an insurance vehicle simply puts a middleman (or middlemen with Obamacare and the insurance companies in on the act) between patients and providers, and raises the cost accordingly.

            If Hayek were alive today, he’d realize that most Americans are fully capable of insuring themselves against “disasters.” He would also see that Obamacare is primarily about prepayment of routine medical care, and that it makes it more difficult for individuals to insure themselves against disasters. I don’t know what party he might join, but I’m confident that he would oppose Obamacare and make a case for returning health insurance to its true function.

          • valley p

            Steve, I defer to your deeper reading of Hayek. However, its hard to read your qualification against the statement I posted and conclude much about what Hayek would feel about today’s world, say comparing Northern European social democracies with the United States.

            Statistically, the Nordic social democracies are beating us in most economic categories, as well as in well being of their citizens. Yet those citizens are just as free as we are. They took a road to shared prosperity and managed to avoid serfdom.

            Maybe Hayek would ignore statistical evidence and stick with his beliefs, but I wonder.

          • Steve Buckstein

            valley p – Of course we’re both speculating on what Hayek might say today. I simply wanted to counter your selective emphasis of one of his thoughts as it relates to the current health care debate in the US. Glad to see, however, that you have read at least some of his work. That’s a good start…:-)

    • David Appell

      Bob T wrote:
      > The mandates on coverage has contributed to driving prices up.

      This is far, far from obvious, and probably not even true. The European countries, which have more mandates than we do, have lower costs than we do. In fact, I believe this is true for *all* countries that have single payer health insurance. See Jon Palfreman’s film of about 2 yrs ago.

  • Bob Tiernan

    *Bob T:*

    The mandates on coverage has contributed to driving prices up.

    *David Appell:*

    This is far, far from obvious, and probably not even true. The European countries, which have more mandates than we do, have lower costs than we do. In fact, I believe this is true for all countries that have single payer health insurance.

    *Bob T:*

    You might be confusing something here.

    When the government (50 states, in these examples, soon to be one national government doing this) sets mandates on what health insurance policies must cover at a minimum, whether the purchaser wants it or not, such policies cost more and more. The result has been policies that cost a great deal per month and economically uneducated people think that this is the “free market”
    price for health insurance policies. Thtat is simply not true.

    You can’t support the government mandating coverage of a large number of things and then blame the insurance companies for charging what they do for such a policy. And the prices will go up when they have to pay for expensive treatments for people who buy a policy the day before and then drop the news on the company. That’s not what insurance is supposed to be.

    Bob Tiernan
    Portland

    • valley p

      So if the insurance companies are allowed to cover less, then they can charge less, but the medical care one gets will not cost less as a consequence. Its just a difference of out of pocket (or going without) versus pre-paying for services one may or may not ever use.

      Its probably true that in a completely free health care and insurance market the money spent on health care would come way down compared to what it is today because people would have more incentive to shop around, or they would simply go without a lot of procedures that may be nice to have if you don’t have to directly pay for them. “I’d like an MRI just to be sure. What? It will cost me $5000? Lets skip the MRI.” Its also probably true that the cost of police services would come way down if we had to pay a user fee every time we called 911. People might hesitate to call in that their neighbors house is being broken into if they will be charged for that call.

      The policy debate, which Republicans/Tea Partiers just lost, is whether medical insurance and care is a social good or a market product. Up until yesterday we had a split system that treated it as a social good for geezers, veterans, and some poor people, a market product for everyone else. Now we have taken a step towards making it a social good for everyone, albeit delivered largely by private companies at much greater cost than the government would charge directly (see France).

      “Repeal and Reform” can work if Republican/tea partiers can convince enough people that medical care and insurance really ought to be a free market good rather than a social good. But given the past and present market failures, that will be a tough sell. Tens of thousands of people dying in the streets from curable illnesses may be too high a price to pay for free market consistency.

  • Bob Tiernan

    *valley p:*

    So if the insurance companies are allowed to cover less, then they can charge less

    *Bob T:*

    Yes, for the same reason a restaurant charges you one price for a filet mignon and another for a hamburger. The problem is not insurance companies refusing to cover things like, for example, port wine stains even if you want this coverage or develop the condition, but that the coverage is often mandated whether or not the policy holder wants to be covered for that. Face it — they’ll be happy to cover it if you choose to be covered for it and pay for it, just as you pick coverage items for your auto insurance policy.

    *valley p:*

    but the medical care one gets will not cost less as a consequence.

    *Bob T:*

    The issue here is the cost of policies, not the medical care. Do you understand that? And without the widespread coverage of a zillion items, people will not overuse the supply of services. Overuse has been contributing to rising costs.

    And don’t confuse insurance with pre-paid medical care, which is what we have. People can pay for lots of things without pulling out the insurance care and paying a co-pay for a squirt of Bactine and a band-aid.

    Bob Tiernan
    Portland

    • valley p

      “The issue here is the cost of policies, not the medical care. Do you understand that? ”

      Well yes, but its not like there is no relationship between the two. Its like you did not read my post. Yes, if people had to pay full out of pocket costs for routine medical services they would use them less. And the poorer they are, they would use them less yet. Many would wait until they were quite sick or far gone to see a doctor, and then instead of early intervention they would get useless heroic care to prolong their lives by maybe months.

      The question I posed is, do we really want medical care AND insurance to be a free market service, or do we want it to be a primarily social service. I know you would come down on the free market side. I’m on the other side. Convince enough Americans you are right and you can have your repeal and reform.

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