I blog about free markets in medical care and transparent pricing.
I anesthetized a man with laryngeal cancer the other day. Nice guy, no insurance. He will soon be bankrupt, but not because of any bill we sent him. Not because of any bill that his surgeon will send him.
He will be bankrupt because the system is corrupt. He ultimately will require chemotherapy and radiation, neither one of which is available to him without going to a big hospital. His radiologist (even though working at a hospital) will not send him huge bills. His oncologist (unless they are a hospital employee) will not send him huge bills. The hospital will bankrupt him. The drugs he will receive are unnecessarily expensive for a number of reasons, all but one of which are due to government interference. The FDA, whose purpose is to limit new competing manufacturers by enforcing rules and regs which only the big boys can comply with, drives the price of new drugs through the roof (you didn’t think the FDA was there for your safety did you?). This occurs due to the rules and regs themselves and also due to the lack of real competition that results from enforcement of the rules and regs. The hospital adds the final blow by adding a markup to these drugs of up to three thousand percent. That’s right..no typo.
If he needs to actually enter a hospital or requires a tracheostomy, his bills will easily overwhelm his finances. Merciless hospitals will gladly keep adding to his tab as their take from the uncompensated care scam (where they get rebates from taxpayers for the amounts they bill for which they aren’t paid) depends on generating large and un-payable bills. All the while these hospitals will “poor mouth” it talking as if they are going broke from patients like this man. They will also make a point to educate all of us about their value to the community, as if bankrupting this man qualifies.
This man’s bankruptcy will be the work of the American Hospital Association. It will be the work of the big insurance lobby and that of big pharma. It will be the product of their greed and that of those in government all too willing to accept their bribes to make their bankrupting way of doing business the law.
These corporate suits have now written a health care bill that will completely finish off their small competitors, paving the way for the abuses that only companies without competition can get away with. This is corporatism. This is fascism. This is what Frederick Hayek warned us about in his “Road to Serfdom.” The only thing worse than government, is government in bed with big business. We don’t need to make sure everyone has insurance so these companies can make even more money. We need to talk honestly about the costs, as very few of the costs in the health care marketplace can be justified, let alone even discovered.
Unless we wake up to the government-enabled scams of the health cartel, we will find ourselves on “kill” lists to spare their stock prices. I don’t think our soon-to-be bankrupt laryngeal cancer patient will survive to see the kill lists, but you and I will, unless a bold and fresh market-driven approach is adopted.
G. Keith Smith, M.D.
The idea that a branch of the leviathan federal government (that is in charge of reviewing the power of the very same leviathan government) would issue a ruling that would limit the power of the very same leviathan government is naive. This corrupt “brother in law” arrangement, as Gary North has called it, precludes any objectivity by SCOTUS. As Tom Woods has said, it should come as no surprise that a government that is in charge of determining its own powers has expanded its powers. Today’s ruling was a surprise only in that Roberts sided with the left.
The court’s decision has insured that the bill will continue to do what it was intended to do all along: bestow power, money and favors upon those who brought their check books to Washington as this debate unfolded nearly 4 years ago. Small insurance companies, unable to comply with the Medical Loss Ratio provision will go out of business. That was the point. This is the reason that the large insurers supported this bill. Less competition for the big boys who will now be in complete control. Small hospitals (particularly rural hospitals) will more likely succumb to hostile takeover bids by the big city corporate hospitals. That was the point. That is the reason the American Hospital Association supported this bill. Physicians will sign on as hospital employees unable to afford the computerized medical record expense or just feeling disgust toward the end of their careers. That was the point. Physicians who will as employees do as they are told are much easier to control than the private practitioners focused on the needs of their patients.
The pharmaceutical industry, whose profits were protected by this bill, will continue to make incredible amounts of money. That was the point. Newt Gingrich, lobbyist, and his HIT (health information technology) clients have already walked with billions. They will continue to do well. That was the point.
The whole focus was getting everyone insurance. The bill doesn’t do that! It does, however, penalize people for not buying insurance. Seriously, who benefits from that?
There never was a discussion about costs. The reason for this is that if costs are rational, the cronies listed above will not achieve the same profit margins. Costs will be discussed, whether the elite want them to be or not now, as the court’s decision will cause the cost of health care premiums to increase very shortly. This will force an examination of the costs of care, the result of which will alarm those who have not paid attention to this aspect of the issue. More and more facilities and physicians will post their prices to the embarassment of the large hospitals and insurance companies that supported this legislation.
The curtain on this sham will finally come back as more and more physicians opt out of Medicare and Medicaid, leaving folks with “coverage” but no care. Make no mistake: the losers of this court’s decision are the poor and the elderly. No one will see them. This will be the deadly proof that this bill was never about health care at all, but about business as usual in Washington. The court’s decision will truly reveal that the purpose of this bill like almost all others was to make already rich people much richer.
G. Keith Smith, M.D.