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

Real Patient Lives vs. Corporatized/Government Healthcare, Part III

A friend of IP4PI shares yet another VA failure:

A VA patient came to me with a one month history of RUQ/R lower ribs pain. The VA had diagnosed him with “constipation” and prescribed laxatives, but despite a thorough bowel emptying, he was no better. I started with, “How did this begin?” He said he was shoveling some gravel on a hilltop, slipped and tumbled down. He had a rib fracture! I used to work at the VA, so I know how this went: “I’m having pain here (under R ribs) and..” (doctor staring at computer, knowing someone in admin is watching his screen too, making certain he clicks all the right boxes, so they get their bonus checks) “Yes, yes, RUQ abdominal pain. We’ll do an abdominal film” Showed constipation. Prescribe laxative. Next.. Most lay people can tell the difference between a fracture and a turd, but not (turns out) a doctor with their face in a computer and a gun to their head.

Achieving Highest Quality Care for American Heroes – VA to Vets Series by Dr. Wax

IP4PI Founder Dr. Craig Wax has published a trilogy of op-eds devoted to American Veterans:

VA to vets: Delay, deny, wait till they die.”
As a physician, I have the privilege of knowing and helping thousands of individuals. One patient in particular stands out as a victim of government’s malignant ineptitude. He is an affable, hardworking 71-year-old male, who is a veteran of the Vietnam War. There was no Veterans Day parade for him but scorn and disdain, given the anti-war sentiment at the time.
Read more: http://www.washingtontimes.com/news/2015/dec/1/craig-m-wax-va-vets-delay-deny-hope-they-die/

More VA delaying, denying, and more vets dying.
This is the second installment of my VA mistreatment and stonewalling veterans series. These experiences were shared by a patient, who is a Vietnam veteran.
Read more: http://m.washingtontimes.com/news/2016/jan/31/craig-m-wax-more-va-delaying-denying-and-waiting-u/

A Veterans Affairs reform that can work.
I have been heartened in recent months to see moves towards exactly this solution, which was previously touted by Dr. Ben Carson. Executive branch officials working on this issue have given strong indications that they see Tricare as the model for veterans healthcare.
Read more: http://www.washingtonexaminer.com/a-veterans-affairs-reform-that-can-work/article/2603066#!

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.”

VA to vets, “Delay, deny, wait till they die”

Craig M. Wax: VA to Vets, “Delay,
deny, wait till they die.” – The Washington Times

As a physician, I have the privilege of knowing and helping thousands of individuals. One patient in particular stands out as a victim of government’s malignant ineptitude. He is an affable, hard working 71-year-old male, who is a veteran of the Vietnam War. There was no Veterans Day parade for him but scorn and disdain, given the antiwar sentiment at the time.
He returned with severe post-traumatic stress disorder (PTSD), sleep apnea, hypertension and multiple other issues. He married, had children and has worked just about every day in industry until his retirement. His medical conditions grew worse and worse, as his PTSD was not diagnosed till age 69.

The Veterans Administration (VA) has done little to recognize, admit responsibility, and take care of the medical consequences of the political military work our brothers and sisters performed abroad. He has fought the VA to recognize his PTSD, medical and hearing disability for years. It took three years, for instance, just to get a partial disability rating, despite his years of psychological counseling for severe PTSD. This patient revealed during an office visit that veterans share the impression that the VA’s true motto is, “Delay, deny, wait till they die.”

We all have heard of the VA scandals including the one that documents the deaths of over 300,000 vets while on the medical waiting lists to be seen. And to compound insult with further injury, VA employees were financially rewarded to take dying vets off the waiting list to make the waiting times appear shorter (http://www.cnn.com/2015/09/02/politics/va-inspector-general-report/index.html). And still, Washington government bureaucrats still rave about how “great” VA healthcare and its electronic health record’s (EHR) are every day.

When will we as independent, individual citizens, stand up for those who have fought for our rights and sovereignty? When will we stand up against the bloated federal bureaucracy in Washington DC and demand that administrative ranks be thinned, budgets be balanced, and our debt paid down instead of given away as political presents to politicians’ cronies in exchange for votes and contributions to fill their campaign coffers?

Let’s not model our healthcare system after the VAs death by administration. Similar failure for patients is what ACA/Obamacare, Medicare, Medicaid and other government malignant ineptitude programs will ultimately lead to. Let’s reestablish the free market in healthcare for individual insurance and private individualized care. Individual citizens should be empowered to make their own decisions about what care to obtain and how to obtain it guided by each individual’s value system.

Government burdensome red-tape regulations have only raised costs and complicated care administration and delivery since the federal government first intervened during World War II with tax-deductible employer-sponsored insurance, again in 1965 for Medicare and Medicaid, and again in 2010 with ACA/Obamacare. Free market competition will again create innovation, effectiveness and lowest cost of care. 

CRAIG M. WAX: VA to vets: 

Delay, deny, wait till they die

http://m.washingtontimes.com/news/2015/dec/1/craig-m-wax-va-vets-delay-deny-hope-they-die/