As they await the Supreme Court ruling on the Affordable Care Act, legal critics of the law say their case is about liberty. If the government can instruct people to obtain health insurance, they keep asking, what’s to stop it from requiring them to buy broccoli?
But the real threat to liberty in this case isn’t a hypothetical broccoli law. It’s the problem that the mandate remedies -- the failure of the health-insurance market -- and the long-standing national crisis of rising health-care costs that Congress finally found a way to address.
It’s not a coincidence that in every advanced country in the world, including the U.S., the government is heavily involved in the health-care market and has been for generations. Everybody needs medical attention, at some point, and virtually everybody needs health insurance to pay for it. Nobody can predict when he or she will need care and virtually nobody can pay for it out of pocket. Even the law’s challengers acknowledge these facts.
See how the lie is set up? The premise put forward -- that everyone needs medical attention at some point, and virtually everyone needs insurance to pay for it, is put forward as a "fait accompli" without first asking the following questions:
- Has it always been this way? Can you, for example, show us that health insurance was necessary in, oh, 1776? 1850? 1913? 1953? 1970?
- Has everyone "needed" medical attention "at some point" historically as well? Was that true in 1776? 1850? 1913? 1953? Or 1970?
It's a fact that virtually everyone has in fact "needed" medical attention "at some point" historically. But America, and the rest of the world, managed to economically progress for hundreds of years without force-placed "insurance" or the government being materially involved in health care.
An honest inquiry is therefore forced to ask the following question: What happened?
That's relatively simple: Government happened.
Before EMTALA in the 1980s, passed under Ronald Reagan, if you didn't have health insurance or money and had a grievous health condition of immediate concern (e.g. a heart attack) you would be taken to a charity hospital or charity ward for treatment. There various groups, mostly religious organizations, had purchased space and supplies and doctors donated their time to treat those who couldn't pay. It wasn't a perfect system; you might in fact die.
But if you have a heart attack while sitting in the ER the odds are pretty good you're going to be leaving that hospital in a box -- and this is with you literally feet away from the best medical intervention we know how to muster! The simple fact of the matter is that irreversible brain damage happens at about 4 minutes without circulation and the clock starts ticking when you fall over. 4 minutes is not a long time.
Now here's what you may not know. The average response time of a BLS (basic life support) ambulance is 10 minutes from the time of the call on a national basis. There are many major metropolitan areas where on many nights the average response time is 20 minutes.
There are few if any jurisdictions where you can reasonably expect an EMS response within that 4 minutes from the time you pick up the phone (remember, the time on the phone with the E911 center counts!)
So what was the truth of EMTALA? The truth was that there were a handful of high-profile cases where someone had a bad outcome, and probably would have even with the law in place. But EMTALA created the "need" for "universal" medical insurance because it forced everyone to be treated irrespective of ability to pay and irrespective of a provider's willingness to give care for no renumeration.
In other words government created this crisis -- intentionally. And who cheered it on? The Catholic Church which took their historical role as the source of charity care freely provided by people of faith and offloaded it onto government -- that is, you -- via the rank abuse of the government's monopoly on force.
This is not a singular event. After the Civil War the first parts of Gun Control were passed. Why? To keep "those people" from being armed (having a gun is a rather strong deterrent to the group of KKK members who want to burn a cross on your front yard -- or burn your house!) Guess who commits the majority of murders today and who are the majority of victims, despite being less than 20% of the population? That's right -- black people -- the very people the government intentionally attempted to, and did, effectively disarm.
You used to be able to order a gun in the Sears' Catalog and have it sent to you through the mail. Really. That was rather anonymous in that there were no records (other than Sears' invoice files) and nobody knew what the package was from Sears -- for all they knew you had bought a few pairs of pants.
Government created a problem that it then "came to the rescue" to solve it. However, it didn't solve anything -- the fact of the matter is that it made the problem worse in that now we have the majority of both homicide perpetrators and victims among those the original "gun control" laws targeted for restriction! That these laws have not been stricken from the books is iron-clad proof that original intent of gun control was in fact to disadvantage black people and it is still is.
Similarly, the market has not failed in the case of Health Care -- government broke it, on purpose, with EMTALA, cheered on by the very organizations that used to be the source of public charity for these good works.
But it gets worse.
Government also intentionally drives up the cost of care, making it difficult to afford in myriad other ways. There are many drugs that cost $10, $20 or even $100 a day. The pharmaceutical companies defend this pricing by pointing out that it takes billions of dollars to develop new drugs, and that if they cannot charge that sort of price then there will be no development.
But they don't charge that price everywhere -- only here. In Canada the government forbids this sort of cost game, and the same drug is 1/10th or even 1/100th of the price it is here. In other nations the government tells the drug companies that if they don't charge what they believe is a "reasonable" price they'll simply ignore the patents and make them on their own, and the company will get zero.
This is force, but it's rather funny how the drug companies, rather than simply walking off, take the lower price and supply the drug. Why? If it's below the cost of production they'd never do that -- so obviously it isn't.
Those same firms then get passed laws that make it illegal for you to buy something in one place at a mutually-agreed price and sell it somewhere else -- like here in America. The drug companies claim that there's a "safety" issue with reimportation. The truth is that counterfeiting is always illegal and always has been.
The effect of these laws is to force the United States consumer to pay the full cost of development of essentially every advanced drug and device in the world, which the rest of the world then gets to enjoy for reproduction cost plus a small profit, while we are literally forced to pay the bill for their development.
Incidentally this sort of price-fixing is a felony in virtually every other area of commerce; if I buy and own a thing I may do what I wish with it, including reselling it, in anything approaching a free market.
If this intentional screwing through legal preference went away your price of an "on patent" drug would likely fall by 80% or more. The cost in other areas of the world would go up -- a lot -- maybe by a factor of two or more. Some therapies might indeed not be developed. But that's no different than the state now, before they're developed, is it?
Nor is there competition when it comes to medical facilities. You must have a license to open an MRI, for example. The owners of MRIs in your area will lobby furiously to prevent you from opening a new one if there is no "need" -- and they define "need" as "we can't serve all the patients who want this service." Worse, these medical providers control the licensing process and thus can simply deny that license -- and they do!
Most entrepreneurs define "need" differently, and so does the market. If there were two oil change places in your town and both charged $250 because they conspired to do so in order to jack up their profits you might be inclined to open a third one and charge $30. You not only would get the majority of the business but the other two would see their profit margins cut rather significantly as they were forced to cut prices or go out of business. Consumers would benefit from the lower price. This is the essence of competition but it is legally barred in the medical field by the very people who bleat about how horrible it is that you can't afford health care.
These people, including both the medical providers such as doctors, hospitals, treatment centers such as MRI and CAT scan operators and government have actively conspired to hold prices high through monopoly control over the number of businesses that can offer a service, and the terms on which it can be offered.
Again, this is unlawful in virtually every other line of business. If I got together with the three competitors who opened internet services about the time I did and fixed prices at $100/month, then got the government to make it illegal to open a new company to provide internet service without getting their permission first I would have made a lot more money. But that conduct, assuming I could pull it off, is a felony in the general sense.
In the health care "screw the consumer" industry it is not only legal it is practiced every single day.
Then there's the health provider racket itself. If you've been treated in a hospital or other similar facility and looked at the bill you've probably seen this. $20 for an aspirin that cost 10 cents, $50 for a scalpel (that cost a dollar) and similar. When you add up the numbers at the bottom you probably also saw that the "bill" was for $30,000 but the insurance company billed, and was paid, $2,000 -- and this was marked "payment in full."
Huh?
It's generally illegal to discriminate against people who buy a thing of like kind and quality, especially when the "charge" presented is one of adhesion -- that is, you're deprived of any meaningful ability to negotiate up front.
It's rather hard to negotiate when you're flat on your back unconscious having a heart attack, right?
So what generated this "need" for health insurance? It's simply this -- if you don't have it you'll be bankrupted, but the reason you'll be bankrupted is that you will be charged 5, 10, even 100 times as much as someone who does have it -- all in a concerted attempt to force you to buy that insurance up front.
Oh, that's illegal too -- it's called a "tied sale" and any attempt to impose one is against anti-trust law. It's a per-se violation -- except in the medical industry, of course.
Proof that this is the case is found by the fact that you can get on a plane and fly to India to have a procedure performed at one tenth to one quarter of the cost in the US. But there is no "insurance" and no treatment without money. The hospital there is outfitted with US-supplied medical devices, the physicians were trained in our hospitals and the rooms look like something out of the Ritz Carlton and are priced more like them too -- instead of $10,000 a day.
In short as soon as you actually buy health care in a free market you find that the market price is one tenth to one quarter of what it costs here in the United States for like kind and quality.
So now, having carefully constructed this paradigm not by the market, not by natural forces, not because of the inherent qualities of medical care the government now comes in and attempts to mandate that you buy what a bunch of companies who conspired with government and among themselves to make such a service a "must have" put together!
We, the people, argue over whether this is equivalent to a mandate to buy broccoli.
No, folks, it is not.
The violation of your rights and of the Constitution, the raw, unbridled theft and fraud undertaken by this so-called "industry" playing on your fear of mortality and chock full of intentional distortions that are put together for the singular purpose of financially raping you, already happened.
What we're now arguing over is whether government should be able to codify that financial******into statute, removing the last option you have to resist -- to accept your mortality and, should you lose the lottery when it comes to medical care and be unable to negotiate something privately at a more-reasonable cost you can afford or to travel somewhere that has an actual free market medical system, to pass onward.
The lawmakers advocating this deserve ejection from public office, The New Republic deserves a boycott of itself and its advertisers and the University of Chicago deserves to have its degrees rendered worthless in the marketplace, with its graduates subjected to blackball, so long as this sort of crap continues to be emitted from it.
Yes, the University and its professors have the right to free speech. But we, the people, have the right of free association -- including the right not to associate.
Let's enforce our rights and see how they like the free-market consequences of exercising theirs.
