The Freedom Bulletin

The biggest problem with the medical system in America is that people do not have the freedom to make their own decisions. This is the result both of laws passed by the government and deeply anti-liberty attitudes that are ingrained in doctors. This article exemplifies what is wrong with our health system. It’s about the “problem” that doctors often prescribe medications that their customers ask for. I find it a little ironic that an article about how patients shouldn’t be able to choose what medications they get is in the “Empowered Patient” section of CNN.com. Anyway, here are a couple of the best quotes from it:

“There’s constant pressure to say yes to things even when it’s not in the patient’s best interest,” said Dr. Joseph Weiner, chief of consultation psychiatry at North Shore University Hospital in Manhasset, New York. “It’s become an everyday dilemma.” For example, he said doctors sometimes say yes to demands for antibiotics even in cases of the common cold, or submit to demands for drugs advertised on television when that drug isn’t the best choice.

“In the current environment in which patients are supposed to be treated like customers, there is sometimes the expectation that the customer is always right and should get whatever is asked for,” said Dr. Danielle Ofri, assistant professor of medicine at New York University School of Medicine.

News flash, doctors: patients are customers, and your job is to give your customers what they ask for. If people want a medication and are willing to pay for it, then they have the right to that medication, and as someone they’re paying, you have an obligation to give them what they want.

America was founded on the principle that people have a basic right to pursue their own happiness, and therefore people have a right to take the medicines that they choose. Doctors have no right to deny people medicines. Every person has the right to be the judge of his or her own best interest, and to act on whatever judgments he or she may make (as long as those actions do not violate the rights of anyone else).

I should make it clear that doctors do legally have the right to deny medicines to people. This unfortunate fact is due to the Durham-Humphrey Amendment, which, in my opinion, is unjust and unconstitutional and should be abolished. But the passage of this unconstitutional law does not change the fact that doctors have no moral right to stop people from obtaining the medicines that they want.

Doctors never “submit” to their customers by allowing them to make their own decisions; they merely fulfill the obligation that they have in a supposedly free society. Unfortunately, in our society, the role of a doctor is to tell people what they can and cannot do about health-related matters. Instead, their role should be to perform procedures that people ask for (kinda like movers, electricians, plumbers, and hairdressers) and to give advice when asked for (like financial advisors and consultants). Doctors shouldn’t be involved in the decision about what medicines to take unless a customer asks their advice. Just as we aren’t legally required to obtain a stylist’s permission before buying clothes, a feng shui expert’s permission before moving our furniture, or a financial advisor’s permission before investing money, we shouldn’t need a doctor’s permission for medication. Until doctors’ roles change, the medical system will never have any hope of working right, and America will never be free.

Thank you Boston Globe! This great article shows that there is no reason to ban elderly people from driving or require age-discriminatory testing.

Laws should never be made based on statistics, but even statistically, old people do not deserve to lose their driving rights. Drivers age 75 or older are 7% of all drivers but are involved in only 3.6% of crashes. In 2008, they accounted for 18% fewer crashes than in 2004. And the number of car crash deaths among people 70 and up dropped by 21% between 1997 and 2006, even though the population of people in this age group increased by 10%.

So much for the media brouhaha over a few recent accidents. I really dislike how news reports (and state legislators) make a big deal of individual incidents as reasons to change the law, but they never give any statistics about the normal frequency of such incidents, so viewers have no way of knowing whether the current level is above average or not. Kudos to the Globe for providing such statistics to combat the ignorant, knee-jerk reaction of those who want to further shrink our liberty.

Health post coming tomorrow as promised!

The medical system in America is in crisis and needs reform. But the problem isn’t that 47 million people are uninsured, or that people don’t have access to health services. There are three main problems, listed below in order of importance:

1. People have no freedom. In today’s society, people do not have control over their health decisions; doctors do. People can’t get medications without a doctor’s prescription, thanks to the Durham-Humphrey Amendment. Doctors think it’s their job to take notes on people and tell people what procedures they should get, what they should eat, and how their should live their lives. The FDA bans many medications that would benefit people. Instead, a doctor’s job should be to serve customers and give advice when asked for, and the FDA’s job should be to protect the public from deception by drug companies.
2. Payment methods are too complicated. You never see signs in doctors’ offices listing how much each procedure costs. Instead we have a huge mess of insurance companies paying doctors for some procedures and not others, insurance companies paying for some medications at the pharmacy and not others, the government paying for some people’s insurance but not others, employers paying for some of your insurance, you paying for some of your insurance, you paying a co-pay or a deductible or co-insurance…the confusion never ends.  Plus, the insurance companies won’t tell you up front what’s covered and what’s not. They have the power to refuse to cover you altogether, to refuse to cover any procedure they say isn’t medically necessary, to require proof that you’re a student, to require all sorts of incomprehensible paperwork, et cetera. This system is disorderly, messy, ugly, and intuitively displeasing, and it rips people off and sometimes even kills people.
3. The government spends too much money on health services. It’s wrong for the government to take money from the rich and use it to pay for Medicaid, SCHIP, and other health programs for the poor. It’s also wrong for them to take from the young and give to the old, like they do with Medicare. The only things that tax money should pay for are the military, roads, and the legal system.

Unfortunately, all three of these things are deeply entrenched in our society, and anyone who questions them is considered a radical. In my next post, I’ll go more into detail about problem #1 and show some examples that I’ve noticed in the news recently that really epitomize what is wrong with our medical system.

As you might remember, alleged Craigslist killer Philip Markoff filed a motion a few weeks ago to inquire about media leaks that may have influenced grand jurors or compromised the secrecy of the grand jury process that led to an indictment in the case. Well, that motion was just denied by Judge Frank Gaziano.

Unlike jurors in a trial, grand jurors do not have to be completely shielded from media reports and do not have to be completely free of bias and prejudice. They are allowed to follow media reports to some degree and to have already formed opinions on the defendant’s guilt or innocence, as long as they don’t indict the defendant based on “hatred or malice.”

Additionally, Judge Gaziano ruled that the defense did not show that the secrecy of the grand jury proceedings had been compromised. While leaks about the evidence in the case had been provided to the news media by anonymous law enforcement officials, none of the leaks directly mentioned the grand jury proceedings.

Click here for a PDF of the decision, thanks to Jake Wark, the Suffolk D.A.’s press secretary!

Bad news - the Democrats’ health reform bill (or as I’d rather call it, their health socialism bill) passed a Senate committee, becoming just one little step closer to passing.

As I explained yesterday, I’m opposed to government-funded health services and extremely opposed to insurance mandates, but there’s another part of the Senate bill that a lot of conservatives don’t mind and that has received relatively little attention, but that I think is anti-liberty and should be fought: the policy of basing insurance prices on how people live their lives.

This Globe article mentions a few examples: EMC gives a 12% health insurancce discount to employees who take a “health risk assessment.” Safeway gives a discount to employees who quit smoking, lose weight, or engage in other healthy behaviors. Right now, companies are only allowed to give a 20% discount for such things, but under the Senate bill that would be increased to 30%, or maybe even 50%.

The article describes such policies as “a potential breakthrough on one of the most controversial elements of healthcare overhaul: how to get Americans to improve their well-being without turning government into a medical version of Big Brother.”

This sums up the crux of the debate between those who believe people need to be protected from themselves, and those who believe in liberty. In my opinion, there is no way to get people to improve their well-being without violating their liberty and becoming Big Brother. Attempting to control what people do is by necessity incompatible with freedom.

For employers to give discounts to people who do things that are considered healthy is equivalent to penalizing people who do things that are considered unhealthy. This is wrong. Employers should have no say over what people do in their private lives outside of work. All that your employer should care about is how you do your job. For this reason, it doesn’t make sense for employers to offer health insurance. Why should your employer care whether you have health insurance or not? Health insurance, if it exists at all, should be a product just like any other, and people should get to decide in the free market whether they want to buy it. Employers are really overstepping their bounds by using prices to control how much people weigh, whether they smoke, what they eat, and how they spend their leisure time. These things are simply none of their business!

In fact, having health insurance at all, even if it is purchased on the free market, creates incentives for people to control each other’s behavior. How you live your life can affect how many health services you need, which, if you have health insurance, affects how much the insurance company pays and therefore how much everybody else pays for their insurance. In this way, your insurance company and fellow customers have an inventive to control what you do, which violates your liberty.

Health insurance, whether paid for by the government, employers, or consumers, creates bad incentives. That’s why I think that ideally, there should be no insurance and people should just pay for each health service they receive. Price ceilings could be implemented to stop prices from being ridiculously high, as they are now. If insurance must exist, then there need to be strict laws that prevent companies from trying to influence people’s behavior, whether through price discrimination, literature, phone calls, or other types of propaganda.

I agree with Obama and the Democrats that the health system needs to be reformed, but I disagree completely about what types of reforms should be implemented. What Americans need is liberty – the ability to make our own decisions without others trying to control our lives.

I found two cool opinion articles today which I agree with, one in the Globe and one in the Metro:

• “Got a comment? Keep it to yourself” by Douglas Bailey, about how online comments devalue journalism
• “Leave my granny alone” by Thomas Keown, about how testing drivers based on age is “excessive and can’t be done with dignity.” That just about sums up how I feel about the issue. I am glad to see someone who agrees with me amid the hordes of people calling for increased testing.

The Democrats in the House have unveiled their proposal for a health care overhaul. In my humble opinion, this plan would decrease Americans’ liberty and move our country one step farther in the direction of socialism. Among the provisions of the proposed bill are the following (with my commentary):

• A government-funded insurance plan. I’m opposed to government-funded anything right now, since that would mean either higher taxes or more debt.
• Affordability credits available only to people who make up to $43,000. I think it’s unfair to charge different prices for the same thing based on income.
• Expansion of Medicaid. Again, this would require more government spending and would be giving people free things based on their income, which is unfair.
• An individual mandate to have health insurance, with penalties of 2.5% of one’s income if one does not obey. This is the worst part of the bill right here. The government simply does not have the right to tell people what they must buy. Having health insurance and not having health insurance are two equally good options, and people have a right to decide which is best for them.
• A mandate that businesses with payrolls of up to $250,000 either provide health insurance to employees or contribute 8% of their payroll. Businesses should not be required to provide employees with health insurance. In fact, I’d much rather employers not provide health insurance and instead raise their employees’ pay by the amount they would be spending on health insurance so that the employees can decide for themselves what to spend their money on.
• Insurance companies cannot deny people coverage for pre-existing conditions. I actually like this. Insurance should be made more like any other product – it should cost the same for everyone, and anyone who pays the price should be able to get it.

The Dems are calling their proposal America’s Affordable Health Choices Act. To me, it doesn’t seem too affordable, nor does it seem to give people choices, since one of the most important choices – whether or not to get health insurance - would be taken away from us. More government spending and more regulations on how we can live our lives are the last thing America needs.