IPFS Vin Suprynowicz

The Libertarian

Vin Suprynowicz

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JUST A LITTLE MORE GOVERNMENT CONTROL OF MEDICINE? PLEEEASE?

Moving a full year before the next biennial legislative session in order to demonstrate the state’s minority party has “concrete ideas,” Nevada’s Assembly Democrats last week unveiled a notion for “making medical care more affordable” that’s not really as fresh as they pretend. It’s mostly socialized medicine, with a few other purposeful warpings of the free market thrown in, just to guarantee some unintended consequences.

Mind you, these latest proposals appear to be tiny steps towards more government redistribution of medical services and the wealth to pay for them -- though such a direction has always led to lines, rationing, and a reduced quality of care, anywhere it’s been tried.

As usual -- just as when fish are attracted with loose chum thrown in the water in advance of the baited hook -- the offer is something “free.”

The first new Democratic proposal would “help” small businesses offer health insurance to their employees by giving them a state subsidy of up to $100 per employee per month toward premiums. But the businesses would have to pay at least half the cost of the insurance -- which can easily reach a thousand dollars per month per employee -- to be eligible for the modest subsidies.

“We as Democrats believe this is the right thing to do,” explained state Sen. Steven Horsford, D-North Las Vegas, who estimated the plan would cost the state $6 million to “help” 5,000 businesses and their employees.

“We will ultimately save taxpayers much more money because the state won’t have to pay for the health care of the uninsured (employees),” Horsford said.

Ah yes, the “save us money in the long run” argument. When do the dividend checks start flowing back to taxpayers for all those other “wise investments” the big spenders have been dragging us into for the past 70 years? And notice it’s only a promised “savings” because the socialists already mandate that taxpayers have to cover the health care costs of those whose bad life decisions leave them in no position to pay their own way -- mandates that replaced the older and simpler “free charity care for the indigent” system, which created no sense of entitlement but rather allowed both parties to garner the grace of voluntary giving.

In fact, state subsidies do just the opposite of “saving money.” Do parents pay less for college tuition now than before huge government tuition loans and guarantees were available? No. Tuitions were merely increased to what parents could afford -- PLUS the amount they can borrow.

Likewise, health insurance premiums are likely to increase by the amount of these tiny state subsidies, leading to a thoroughly predictable call for the subsidies to be raised again and again, merely to “catch up.”

Only six million dollars? Mr. Horsford should test his routine at one of the local comedy clubs. Would someone go back and look up the 1965 estimates for the long-term costs of Medicare, please?

Meantime, businesses that decline to participate -- since the lion’s share of costs would still be theirs -- can expect to be demonized, and then eventually to face a “mandatory” version of what’s now offered with perfumed promises about how it’s “all voluntary.”

And let’s not lose track of where that money is coming from -- additional taxes on middle class citizens who already struggle and save to be able to pay for their own health care.

The Democrats also plan to reintroduce a controversial bill that failed in 2005, forcing hospitals to charge uninsured individuals prices similar to the heavily discounted rates insurance companies pay for medical procedures.

Assembly Majority Leader Barbara Buckley, D-Las Vegas, complained that hospitals charge the uninsured as much as four times as much as they charge patients who have insurance. “It makes no sense that if you don’t have health insurance, you pay the highest rate,” she said.

Does it make any more sense that businesses have to pay higher wages to groups of employees who have “unions” bargain for those wages, just as insurance companies use the strength of numbers to bargain for lower rates for their policy holders? Will Ms. Buckley also submit a bill requiring union workers to work for the same low wages as non-union workers? Wouldn’t that be just as “fair”?

Jacked-up hospital prices are indeed disgraceful. But they’re largely the result of existing government price-fixing -- Medicaid and Medicare refusing to pay real costs, which leads to cost-shifting.

The state should participate in those federal Ponzi schemes as little as possible (not open them up to more not-really-poor people than required, as legislators do now). The state could also mandate prominent posting and notification of medical costs in advance, and encourage hospitals to do price-comparison advertising, fining any professional associations, trusts or cabals that block such free competition.

Another Democratic proposal would help consumers deal with medical debt by reducing the interest and fees collection agencies charge, which Buckley called “predatory.” The plan would help people pay steep medical bills without being driven into bankruptcy, she said.

Maybe. But bills rarely go to “collection” if patients are making a good faith effort to pay them. And how can government have it both ways -- barring any requirement for “cash up front,” but also making it harder to collect something on delinquent debts? Unless the goal here is to drive private enterprise out of the health business, entirely?

A better solution would be tax-free medical savings accounts, facilitating advance savings -- which President Bush has proposed, but which have drawn nothing but hoots of derision from “compassionate” Democrats.

Small businesses do not fail to offer health insurance benefits because they hate their employees or because they’re in favor of disease. The problem is cost, especially for small risk pools.

If legislators want to actually reduce the costs of medical care and make medical insurance easier to afford, they could start by eliminating all state “coverage mandates,” allowing insurers to offer more affordable plans. (In reality, the proposed subsidies will only bring more government “strings” as to the kinds of coverage mandated.) They could then examine what legal roadblocks stop small employers -- or even individuals -- from pooling together to put a doctor or doctors on retainer, as the Independent Order of Foresters and other fraternal organizations did a century ago.

Stop using state licensing requirements to help a non-competitive medical monopoly ration supplies. Encourage more doctors to reject Medicare, Medicaid, and medical insurers altogether, offering less expensive medical care for “cash on delivery.” Eliminate all payroll taxes. Bar lawsuits against doctors who offer acknowledged “bare bones” coverage without massive office staffs and absurd batteries of expensive tests, by stipulating that the courts must do their job and rigorously enforce “no-sue” contracts.

The Assembly Democrats doubtless care. But they propose more heavy-handed government “fixes” for problems that were largely caused by government regulation, redistribution, tolerance of lawsuits when care was provided in good faith, and heavy-handed “licensing” mandates, in the first place.

Make no mistake -- “little government subsidies” are a lot like being “a little bit pregnant.” They lead to bigger things.


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