A Conversation: Can Free Markets Save American Medicine?

A recent article from the Mises Institute. “Under Socialized Medicine, The State Owns You,” sparked a conversation between Mr. Bob Wells and IP4PI founder Dr. Craig M. Wax.

Bob

I appreciate your assessment of the solutions presented like VA, Medicare and Medicaid being awkward, too expensive, and failing in large demonstrable ways. We haven’t had true market based medicine since World War II. Prior to that, it was relatively inexpensive cash and Barter based services. I argue this is the most efficient as it cuts out insurance, pharmacy benefits managers, all levels of administration, and last but not least, all aspects of government regulation compliance and taxation.

In the last six years there have been at least 12 plans on the table to repeal Obamacare. And, there have been six in the last 12 months. There was no sparsity of plans, just no palpable consensus.

I assert that inexpensive primary care, labs, low-end studies, cheap generic medications, will allow for most needs to be met by most people. And expanded health savings account HSA would be used for each citizen to use pretax dollars to buy anything health related from gym memberships to over the counter medications to actual care necessities. Further, inexpensive catastrophic insurance for the big ticket items would be also affordable by most. There could be community, charity, and state programs to provide for the neediest, while keeping the federal government taxation hands to itself.

Unless the Congress and President act soon to repeal Obamacare, just rearranging the deck chairs, will not prevent its fate. Already 19 out of 23 taxpayer-funded co-ops have gone bankrupt taking billions of taxpayer dollars with it. And for the phony federal mandates state exchanges, many have only one high price insurer participating, while still others have none. Leave it to the government to mandate you buy something very expensive and then there’s no opportunity to even comply!

Best wishes for good health,
Craig M. Wax, DO

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Dr. Wax,

The deficiencies of state-sponsored health care are widely known. What is difficult to figure out is an alternative — market-based — that is universally accessible and affordable (with affordability being as elastic as elastic can be), while still offering high quality. If there is a model in this world, I am unaware of it.

All efforts America has made to provide public support for health care since World War II, from the VA system to Medicare and Medicaid to Obamacare, have been awkward and grossly inefficient (if somewhat effective, overall). Unfortunately, blowing these systems up and starting a new system based solely on market forces would be catastrophic in the short term. And since politicians think in the short term, such a radical transformation is impossible.

Today’s Republicans realize there is reward in trashing Obamacare, but they also know that they do not have a better plan to replace it. If they really had a better plan they would have introduced it by now, and it would be on President Donald Trump’s desk for signature. The fact that they cannot agree among themselves on a replacement is testimony to how difficult a problem this is. (This does not excuse the Democrats, either.  They’d rather let the Republicans look foolish than offer their own “solutions.”)

Regards,

Bob Wells

If anyone asks about preserving “good” portions of Obamacare, you can respond:

“You can’t fix a turd.”
“And like a turd,” explained one physician a few years ago, “we had to pass ObamaCare before we could find out what was in it.” Remember Congresswoman Pelosi’s infamous quote?
Sorry to be so blunt but ACA Obamacare is so filled with theft by taxes, giveaways to hospitals and insurance industries, and theft of patient rights and physician autonomy, that it would be unwise to leave any of it on the books.  If it were re-activated and funded at sometime in the future, because we failed to repeal it on total, we would be at fault. Will our children face the true consequences of paying for it and being bound by it?

Best wishes for good health,

Craig M. Wax, DO
Family Physician
National Physicians Council on Healthcare Policy member

Real Stories of the ACA nightmare # 12- “Two out of three ain’t bad” – Meatloaf

A Canadian physician writes: “54 year old woman. Diabetic, hypertensive, high cholesterol. On Atorvastatin, Ramipril, Metformin. Presents to me with HbA1C of 8.9 – I adjust Metformin. Next visit, HbA1c is better, closer to 7.8. But BP is 190/100. I adjust the Ramipril. Next visit A1C is 7, BP is 135/80. Patient tells me not to check cholesterol. Because, she finally admits, she can only afford 2 out of 3 medications at a time, and she’s picking and choosing which ones to take depending on how horrified I am at the visit. But the cholesterol drugs are so expensive and her heater broke, so she needs a new heater, and she doesn’t want to know my reaction if she stops her statin.”

Posted with permission from the across the border

Real Stories of the ACA nightmare # 10 – “Free” care is awfully expensive

“I saw a patient that I met for the first time three months ago who is originally from Canada. She was in for her pre-op visit. She is in awe of the fact that she got surgery in three months. In Canada under a single payer system it would have taken at least three years she said. And her income tax rate was at about 50% to cover the programs.”

Posted with permission

Real Stories of the ACA nightmare #9 – A Tale of Two Patients

“Whereas Mr. Clinton has accurately diagnosed Obamacare’s fundamental problem, Mrs. Clinton has spent the past year either defending it or calling for even greater intervention in health care. Now momentum is building among her supporters and allies for a full-blown, single-payer system in which the government, using tax dollars, pays for all medical care of its choosing. Medicaid, Medicare and the Veterans Affairs hospital system operate on this model, and each provides sub-par care to their intended beneficiaries in many key ways…I have patients who show the dangers of going in this direction.

One patient comes from the VA. He requires very high doses of concentrated insulin to control his blood sugars. At my practice, we provided him with treatment quite effectively until he retired. Now the VA has been giving him the runaround for over six months. It has yet to even accept his application for the concentrated insulin he needs, which has driven his blood sugar to dangerous levels. It’s unclear when, or even if, the agency will get him the treatment he needs. His health is failing fast under the single-payer system.

The second patient is on Medicare. He has had type-1 diabetes for over 40 years, but thanks to advances in medicine he has been able to continue working on a consistent basis. When he turned 65 and went under Medicare, however, he lost his coverage for the specific treatment he needs. He has appealed this all the way up to a federal administrative law judge, but six months after the hearing he still hasn’t heard of a decision. His health, too, is failing fast.

Wouldn’t it have been better for these two men to keep their private insurance plans, which fit their needs and improved their health…My patients experience shows the danger of heading toward even greater government intervention in our health care system. If we empower bureaucrats to wield ever more power over patients’ health and well-being, the end result will be higher costs, fewer choices, worse care and even lost lives….For the sake of my patients, to say nothing of millions of other Americans, it’s critical that we get this one right.”

Real Stories of the ACA nightmare # 8 – From those who sacrifice for our freedom

“We’re on military insurance. When the first round of ACA went into effect, our premium jumped about $20. Which wasn’t horrible. Then we realized our coverage dropped. We used to pay $10-15 for the office visit co-pay. Now we’re paying $50-80 depending on the Doctor we visit. And getting approval for procedures (i.e. Gallbladder surgery) was horrible.”