The Libertarian Democrat: Healthcare

This week’s topic: Healthcare and what needs to be done in the interim before huge changes can be made.

Having recently returned home from a two-week stint in the hospital, which included a major intestinal surgery (this being my fifteenth such surgery), I have decided to rev everyone up and discuss my perhaps unpopular stance on, and questions about, current health care in the US.

To illustrate my views, I’ll present a conversation a friend and I engage in often. While the libertarian side of me agrees with his views, libertarians often fail to provide short-term solutions.  I can’t disregard the needs of those dependent upon government-run programs, such as myself. We go around in circles about means to reduce health care costs, both by free-market competition and by ending monetary inflation (which results in price inflation), but . . . “What do people like me do today, before all this can happen?” The conversation (or should I say argument?) goes something like the following:

Friend: Obamacare is horrible. It’s just going to make healthcare more expensive for everyone. Government has no authority for such intervention, and it’s unconstitutional.

LD: I agree with you, in that the government shouldn’t have a say in citizens’ lives on most things, but on this issue the government needs to intervene in some capacity. Who is going to help people like me? I was perfectly healthy. Then, suddenly, I experienced major health problems and needed millions of dollars worth of surgery. Although I worked at very professional jobs, none of them offered health insurance. Nor did I qualify for self-purchase plans, insurers deeming my health as a “pre-existing condition,” even though I had never had prior health issues. Now, I am forced to stay on Social Security Disability to pay for my surgeries and thousands of dollars in medicine each month to keep me alive.

Friend: First, you are trying to use government to solve a problem that government created. You actually defined a problem with government regulation of health care, in that  health insurance is tied to employment. That raised prices, eliminating free market competition, because the consumer—you and I—no longer care about prices. Second, the “pre-existing condition” issue is a side effect of high prices. If government regulation were repealed, insurers would revert back to the market, driving prices down as a result of competition, even becoming a secondary means of payment behind out-of-pocket. This dynamic would place even more downward pressure on medical pricing.

LD: I agree with almost all of what you just explained, but what are we going to do with those who need these services now? Many people—myself included—simply cannot afford the cost of health care or health insurance.

Well, that’s how it goes, and goes—in circles. Now, I do not need young, healthy libertarians who have never dealt with innumerable doctor visits, years of life-saving hospitalization, or several thousand dollars per month in prescription medicine simply telling me that Obamacare “sucks.”  What we need are real-world solutions that work, yet still address the needs of the ill.

That said, Obamacare, meant to address access to health care, doesn’t actually focus on the root cause of rising prices. Instead, it’s at best a short-term solution masking the core issue of rising prices, and unintentionally causing prices to escalate even further. In California alone, according to an article published by Forbes, premiums are increasing by as much as 150 percent, and those are just initial estimates. The Wall Street Journal has reported that IBM, citing costs, is removing over 100,000 retirees from their health insurance coverages.

Moreover, the economy is trying to cope with the new rising prices by transitioning full-time employees to part-time. This is the case with Darden, owner of restaurant chains such as Olive Garden and Red Lobster. Not only does this result in fewer Americans having access to health care, it is reducing their income in an already tough economy. My initial thinking was, “Let’s pass a law forcing employers to provide all workers, regardless of hours worked, health insurance,” but that would be another short-term solution which would result in many part-time workers being laid off completely. It’s a vicious cycle.

As you can see, as enticing as they seem, short-term government programs usually just end up compounding  the problem in the end. Don’t take my word for it, though. Just look at what happened in Oklahoma with the Surgery Center of Oklahoma. Below is an excerpt from an article published earlier this year:

Dr. Keith Smith and Dr. Steven Lantier launched Surgery Center of Oklahoma 15 years ago, founded on the simple principle of price honesty.

“What we’ve discovered is health care really doesn’t cost that much,” Dr. Smith said. “What people are being charged for is another matter altogether.”

Surgery Center of Oklahoma started posting their prices online about four years ago.The prices are all-inclusive quotes and they are guaranteed.

“When we first started we thought we were about half the price of the hospitals,” Dr. Lantier remembers. “Then we found out we’re less than half price. Then we find out we’re a sixth to an eighth of what their prices are. I can’t believe the average person can afford health care at these prices.”

Their goal was to start a price war and they did.

The result was a drastic reduction of provider costs, resulting in individuals’ paying a fraction of the original price for surgeries.  This is a great example of free-market capitalism lowering health care prices for the public, and yielding government intervention. However, although I feel this is an excellent start for things like short ER visits (broken bones, etc…) that would be extremely cheap if prices were lowered significantly, it’s not a good solution for most surgeries or hospitalization, as bringing costs of hundreds of thousands down to merely thousands, or even several hundred, is still unaffordable for the average American today.

This is a call to all Libertarians to rally and provide new ideas, perhaps in line with the free-market and volunteerism, or approaches not previously considered. These new ideas must address the needs of those with both poor health and limited income. It may not be YOUR health that’s in jeopardy now, but someday it may, and you’ll need the same solutions as others. It’s not about compassion, it’s about being realistic, a cornerstone of libertarianism. Libertarians can be so used to looking into the future at the long-term changes they hope to enact, that they can become short-sighted to problems that need libertarian-minded short-term solutions in the now, not the same short-term solutions that national government has been feeding to us and messing the system up with for decades, but ones that are more enlightened and make real sense. Libertarians’ time and power is not just in the future, it is in the now, too, let’s not forget. The real challenge is finding elected officials who truly want to solve problems, and it’s up to the voters to elect those who are intellectually honest and forward-thinking, regardless of their party affiliation.

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