The Freedom Bulletin

The Massachusetts Bureau of Health Care Safety and Quality recently approved a system that increases doctors’ ability to monitor people’s prescription history. Previously, the Department of Public Health monitored a database tracking prescriptions for only a few drugs, but doctors did not have the ability to view the database. Now, even more medications are included in the database, pharmacists are required to update it, and doctors have full access to it.

Needless to say, paternalistic and anti-liberty people fully support this attempt to fight “doctor shopping” – going to more than one doctor to get prescriptions for the same drug. But I see it as the government stamping out the last tiny, pathetic remnants of freedom that are left in the American medical system.

It is bad enough that people are required by law to have a doctor’s permission to have medications. To give doctors access to people’s prescription history, making it even harder to obtain medications, just violates people’s rights even more. As I recently explained, people have the right to control what happens to their own bodies. Doctors have no right to deny people medications that they want and are willing to pay for, and they have no right to know anything about our medical history unless we want to tell it to them.

Here’s a radical idea: Why not repeal the Durham-Humphrey Amendment and the paternalistic medical culture that goes with it? Why not have all medications available in stores and allow people (with or without a doctor’s advice) to decide for themselves what to purchase? Then we wouldn’t have to worry about “doctor shopping.” People would have no need to lie to doctors or beg for their permission for the medications that they want. We could independently and autonomously make our own decisions and would have the final say over what happens to our bodies.

People have the right to do anything, as long as it does not violate the rights of others. The fact that an action is risky or unhealthy does not change this. The new prescription monitoring system might improve people’s health, but more importantly, it decreases our liberty.

It just keeps getting better! Not only is Virginia suing against the federal requirement to have health insurance, but a man named Michael Merlina is suing the Massachusetts Health Connector Authority, the entity in charge of implementing the state’s health insurance mandate. He was fined $2000 for failing to have insurance, and the Connector denied his appeal.

It’s awesome that someone is challenging the state’s individual mandate in the court system, but even better that three of out the four gubernatorial candidates (at least to some extent) support Merlina and criticize the individual mandate.

Republican Charlie Baker isn’t explicitly anti-mandate, but he makes a good point about Massachusetts’s long list of benefits that all insurance plans must cover:

“The whole plan was for people to have more affordable options, and Gov. Patrick eliminated them. Michael Merlina is arguing that the price of health insurance has become unaffordable, and he’s right.”

Said Independent Tim Cahill (I’m pleasantly surprised to learn that he’s against the mandate):

“He’s not asking for a handout – he just wants to be left alone. I feel for him. I hope he wins, and throws the whole insurance mandate up in the air.”

And Green-Rainbow candidate Jill Stein is surprisingly anti-mandate as well:

“All health-care nonreform did was created a windfall for insurance and pharmaceutical companies that are in bed with Beacon Hill.”

Health-care nonreform…what a great name! I might have to start using it.

A couple of years ago, the individual mandate was considered a moderate measure, supported by Democrats and Republicans alike and only opposed by the “far right.” In the early stages of the federal health-care nonreform debate, the individual mandate was considered a given and was rarely mentioned. All of the debate focused on the public option, Medicare cuts, abortion funding, and other things that, although important, are not as important as the mandate from a pro-liberty point of view. Now almost every time federal health-care nonreform is mentioned in the news, the individual mandate is mentioned, and usually called unpopular and/or controversial. How awesome that three out of four gubernatorial candidates in Massachusetts, where the individual mandate was first enacted in 2006, disapprove of the mandate to some extent. People are finally realizing what freedom truly is and how severely the individual mandate violates it.

“Medical professionals must take to heart the edict that their responsibility is to the health of the patient, not the patient’s wishes.”

So proclaimed a recent Boston Globe editorial. This belief, which seems to be shared by the vast majority and was made law by the Durham-Humphrey Amendment, epitomizes what is wrong with the medical system.

Medical professionals have a moral obligation to respect their customers’ wishes, not to paternalistically take away their freedom in the name of their so-called best interest. People have the right to live their own lives however they wish, as long as they do not infringe upon the rights of anybody else. No freedom is more fundamental than the right to control what happens to your own body.

If someone wants a medicine or medical procedure, and they are willing to pay for it and absorb the costs of any side effects that might result, they have a right to have it. Doctors are highly trained so that they can perform medical procedures correctly and give people advice when asked, but they have no right to interfere with people’s medical decisions, and it is wrong that our laws and culture give them this power.

Only when people have the liberty to make medical decisions for themselves will America truly be free.

The Milwaukee teachers’ union is suing for health insurance plans that cover Viagra. This is happening as the district is in the middle of a budget crisis and has laid off 482 teachers. Taxpayer-funded Viagra would cost $786,000 or enough for 12 teachers to keep their jobs.

The lawsuit claims that excluding Viagra from insurance coverage discriminates against men. According to MSNBC…

“In recent years, several lawsuits have claimed that employer health plans discriminate against women when they cover Viagra but not contraceptives or infertility treatment.

But the Milwaukee union says males are treated unfairly here. In one brief, its lawyers argued that vaginal cream, anti-bacterial medicine and estrogen replacement medication for female sexual dysfunction are covered. Other options such as penile pumps and implants included in the plans “are far less desirable than oral medication,” the filing said.

District spokesman Philip Harris said school officials won’t comment because “we just want to leave it alone.” But Miriam Horwitz, an attorney representing the board, argued in court filings the drugs weren’t necessary to treat life-threatening disease or have children.”

I have an idea – none of these things should be covered! The only things that should be covered by health insurance are things that people need in order to be healthy. This is especially true of plans that are taxpayer-funded.

You don’t need to have sex or have children to be healthy, so contrary to the opinion of the school board’s lawyer, neither Viagra nor infertility treatments (or maternity care, for that matter) should be covered. Whether to have sex or have children is a choice, and it is unfair for people who choose not to do these things to subsidize the decisions and preferences of those who do.

No Viagra, no infertility treatments, no penis pumps, no contraceptives, no maternity care, and no estrogen replacements. Discretionary procedures and medications should never be covered by health insurance, no matter what the person’s gender. Paying only for things that are medically necessary is the fairest policy for everyone.

I don’t usually go to sites like AmericanProgress.org, which probably isn’t surprising given my mostly libertarian / conservative political views. But I recently happened upon an article at that site by Ian Millhiser, claiming that “it is absolutely clear that the health reform bill survives constitutional scrutiny,” that it was “clearly erroneous” to allow Virginia Attorney General Ken Cuccinelli’s lawsuit against the law to proceed, that the lawsuit is “baseless” and “wholly without merit,” and that the decision “sadly allows him to continue to waste taxpayer dollars on this frivolous lawsuit.”

I disagree with these claims, to say the least. But there are two arguments in particular that Millhiser makes that I would like to respond to.

First of all, he quotes Justice Antonin Scalia, who once said, “Where Congress has the authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective.” According to Millhiser, everyone agrees that it’s constitutional to ban insurance companies from refusing coverage to people with pre-existing conditions. If this happened but there was no individual mandate requiring people to buy insurance, then only sick people would buy health insurance, and prices would rise. I’m sure everyone doesn’t agree that the pre-existing conditions law is constitutional, but I’ll give him these first two points.

I disagree with Millhiser and Scalia, however, that if Congress has the right to pass a law, it has the right to do whatever it takes to make that law effective. Congress has the right to defend America from foreign invaders, but it doesn’t have the right to institute a draft, in my opinion, even if a draft were necessary for a strong military. Congress has the right to ban the hijacking of airplanes, but in my opinion, it doesn’t have the right to force people to take their shoes off and go through strip search machines. Individual rights come first, and the government is never justified in taking away people’s freedom, even if that is necessary to make a law effective.

Second, Millhiser claims that the individual mandate is equivalent to prohibiting businesses from using racial discrimination against potential employees or customers, since these both involve requiring people to engage in economic activity. This comparison is completely off base.

Banning segregation affects people only if they choose to own or manage businesses, and it affects them only in their role as a business owner or manager, not as a private individual. Additionally, it does not require anyone to engage in economic activity. It simply says that if someone wants to run a business, they must accept all customers regardless of race, and not use race in hiring decisions. Everyone still has the option of not running a business.

The individual mandate, however, tells people that they must use their money to buy health insurance. It tells people what to do with their own, private money that they have earned, and it applies to everyone.

So anti-segregation laws and the individual mandate are vastly different. One applies only to people who choose to run businesses and applies only when they are acting in their professional capacity. The other applies to all people in their role as private citizens. It is completely reasonable to find the former constitutional but not the latter.