Turning to government for health care destroys patient-doctor relationship
As the debate over access to health care in America continues, the question is not whether health care is a right, the question is whether government has a right to your health care. Physicians take the Hippocratic oath. This does not assure every person will receive health care; but, in an emergency, if a doctor is near or can be summoned, the injured person will receive care.
How the physician is compensated for services rendered is the rub. When individuals perform services for other individuals it is customary for the benefitting individual to compensate the benefactor. Compensation assures the service will be performed again.
Altruism, on the other hand, does not create cooperation. When abused, it creates enmity, division, and instability. For these reasons, individuals have learned over millennia the importance of compensation. This time-honored tradition builds a trusted interdependence between individuals that promotes good will. It wasn’t very long ago when physicians were paid what patients could afford to pay. Sometimes the payment was in coin, currency or barter.
The idea of taking out a health insurance policy is a relatively new idea and a good one for accidents or maladies that are life-threatening. Money can be pooled and invested by the insurance company affording the company profit or earnings for the risks involved. The risks are quantifiable and therefore manageable. The cost to the patient/consumer is modest as the claims are limited. Insurance against accidents or life-threatening maladies is an economic tool of the free-market price system. It is symbiotic because both parties benefit from the relationship.
Risks, however, become too high and unquantifiable when insurers insure everyone against all illnesses. The pooling of money becomes untenable, infeasible; it just doesn’t work. So, we leave the symbiotic world of insurance and enter the world of estimated pre-paid services. Since the idea of insurance no longer applies, it begs the question, why are insurance companies engaged in services they can no longer perform?
The answer is quite simple. Under the guise of insurance, they make money as middlemen. What the doctor and the patient lose is symbiosis. The time-honored compensation that built trust and good will is gone, usurped by rapacious economic carnivores. As long as one segment of individuals is subsidized by another segment of individuals, the scheme works.
But eventually health insurance for the segment of individuals who are not subsidized becomes too expensive. They, too, demand the right to be subsidized. The agent with the most money to provide the subsidy is the government. And so, government is encouraged to subsidize all individuals.
The economic calculation is clear: expense exceeds income. Government will run out of people’s money, but not before the doctor/patient relationship is destroyed. The government, as the final arbiter of the compensation, takes control of the doctor/patient relationship. The relationship is now between doctor and government. The patient receives the health care the government says he or she will receive. The doctor receives the compensation the government regulations mandate.
In the end stages of this perverted takeover of the free-market price system, a black market emerges to reinstate the time-honored compensation for services rendered and to inculcate trust and good will.
The point is, health care should be between the patient and the doctor. We have, for too many decades now, experimented with coercion. Whether via mercantilist or socialist programs, the present health care system demonstrates such programs don’t work. Health care is complicated because it’s been tied into a Gordian knot by government and its mercantilist insurance companies.
A market driven health care system is the best and most affordable way to deliver the care. We must get the majority of the people out of the current system of coercion and back into the free-market price system. Once that’s done, it will be easier and more affordable to address humanitarian concerns.
Does providing health care for those living in poverty or living with on-going, pre-existing medical conditions mean that people without such conditions are mandated to have the same kind of health care? No!
Should the care of those who have these conditions be the responsibility of insurance companies and/or government? Again, no. Charities used to, and can again, provide and fund that care. After all, it is the people who pay for the care of those less fortunate, either by coercion (taxation and higher premiums) or voluntarily (charity). The best way for the people to pay for that care is not necessarily via coercion.
Debating the idea of health care as a right is irrelevant. The real question is whether an intrusive government has the right to dictate your health care. The answer, unequivocally, is no.
John Jensen is the manager of Pequot Commercial of East Lyme, a commercial real estate company serving eastern Connecticut and western Rhode Island.
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