Looking into the Future…

What will happen to the American people and their country in the next decade or so? The future is not very “bright” if we continue on the way that we are now going. We now have a national debt equal to about our yearly GNP. Our health care costs are by far the world’s highest and are expected to reach $3 trillion dollars ($3,000.000,000,000) by 2016. Because of our ultra high health care costs, Medicare is expected to be in “trouble” by about that date and will have to start drawing from “general revenues” when it does. Social Security on the other hand is apparently OK until about 2036 or there about… I believe we will eventually have to make “adjustments” in what Social Security pays out. Most likely it will become more like a “welfare” program, perhaps paying a “flat rate”.

We could of course reduce our health care costs considerably by stripping the medical industry of all of its government enforced monopolies that it now enjoys. Doing the same to all the rest of the professions and licensed occupations would greatly reduce the costs incurred when people have to deal with these professions and businesses. At the least we could reduce our health care costs by a trillion dollars a year, just by elimination of waste, fraud, and “overbilling”. There is also a lot of “waste” in the private health insurance industry. All of this contributes to the excessively high costs we experience. We also do a great deal of “rationing” as it is, but this is generally hidden from public view. The way it is done is through insurance companies refusing to pay for services.

When I started working in 1959, I was paid $1 an hour. Some of the things that I could buy then for a dime are now a dollar here in 2014, an indication of the fall in value of the US dollar to one tenth of its original value. For example, the Hershey candy bar that sold for a dime back then costs a dollar today. Gasoline was around $.27. Currently it is $3.70 today. Today’s minimum wage converted back to 1959 levels would be about $.75, not the dollar that I was actually paid back then. And here is where the problem is: Wages are not 10 times what they were back then. The proposed $10 minimum wage would bring us up to what I earned per hour back in 1959, even though the government has been downplaying the true rate of inflation. And this is “where” one of our problems is.

Effectively the average American is falling behind so far as the value of the dollar is concerned here. This also affects government revenues. Since people are in effect earning only about three fourths (3/4ths) of what they earned 55 years ago, our total federal revenue, including the money that pays for Social Security and Medicare is less by 25% of what we would have today had wages stayed up with the level of inflation… This is one reason “why” we can no longer afford to do what we used to be able to.

How did this happen? In 1981 the federal minimum wage was $3.35 an hour when Ronald Reagan was sworn in as President of the United States of America. It was still $3.35 an hour when he left office in January of 1989. However, the value of the dollar was now only three fourths at the best of what it had been in 1981. Effectively “labor” became progressively cheaper with time.  Ronald Reagan also set into operation the destruction of organized labor. Union membership fell. Business profits on the other hand were up. It was a good time to be an employer. Unemployment was high enough that you could get all the workers you wanted and they were glad to work for $3.35. Unfortunately their “buying power” had fallen over the decade and in turn they were paying less in taxes. Reagan made up the “difference” by borrowing money, increasing the national debt. President George Bush tried to govern without raising taxes or the minimum wage, but he eventually had to give in on both. Not that it did a lot of good.

The problem is really simple enough.  A country, like an individual, cannot continue to spend more than what it gets in revenue. Additionally, when a country imports goods, it also has to balance these out with also exporting an equal value of goods or whatever in return. Just as none of us for very long can spend more money than what we receive. Unfortunately, we haven’t been doing that.  We import about half a trillion dollars worth “more” than what we export. Long term, countries that do that go “bankrupt” like Greece has done.  We are of course a lot larger a country with a much bigger economy, so it takes longer, but in the long run, the results will still be the same. That half a trillion dollars trade imbalance is really effectively an export of jobs as someone still has to make the things that we buy. Depending upon the value of the job lost, we have lost between five and ten million jobs. Note that these are mostly “production” jobs, although we also do export some “services” in the form of computer software, medical technology, and so forth. Just not enough to make up for the value of what we import. We also import goods made by American owned businesses who exploit the low cost labor available in these low wage countries. However these businesses have learned that they can avoid paying taxes on their earnings as long as they don’t bring the money back here to the USA.*

* This is easy to solve.  Stop taxing business. Businesses only pass the tax on to the consumer anyway. As we only get about 1/8th of our current revenues from taxing business, it really doesn’t make sense to continue to do these non-productive acts.

The basic concept of free trade as developed back in the 18th Century applied to trade between European countries with relatively similar labor costs and living standards. When trade takes place between countries with large differences in labor costs and living standards, the consequence is that there is a flow of wealth from the more wealthy to the less wealthy. We have in effect created tens of millions of jobs outside the US, but at the cost of destroying jobs here in the US. Not as many as we created, of course, since the cost of creating a job here is far higher than the cost of creating a job elsewhere. Nor can we survive as a “service economy” since most services are not “exportable” as goods are. And while Russia can do quite well exporting oil and gas, this is not an option for us.*

*We may be able to exploit the trillions of cubic feet of natural gas now trapped in the form of methane hydrates, an energy source so large that it could met our needs for a very long time. Unlike coal and oil, methane (natural gas) is much “cleaner” and also releases less carbon into the atmosphere when burned than does coal and petroleum. There are “risks” in using this source of almost boundless energy, but it is there waiting to be tapped. Compressed natural gas automobiles are already on the market, and it is possible to convert natural gas to the liquid fuel methanol if so desired. Additionally natural gas is the source of much of the fertilizer we use in growing food today…

 

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The Origin and Source of Human Rights

Where did our rights come from? Why do we have the rights we have and not others? How did people first get to have legal rights that governments are required to respect?

Historically the concept of people having rights against the power of the State came with the Magna Carta of 1215 AD when the English nobles of the time forced King John to sign an agreement as to the rights of the nobility against those of the king. There may be yet earlier examples such as orders by Muhammad regarding the rights of Muslims, but these were more based upon maintaining order among the various groups of the day. In so far as “western thinking” is concerned, the Magna Carta is the basis for establishment of the idea that the rule of kings was not absolute and that rulers had to abide by written rules. In any case, it is quite evident that rights were “taken”, not “given” by government. Our “Bill of Rights” was a requirement before the Constitution could be ratified in 1789.

Further proof that rights are “taken”, not “given” is the history of the Civil Rights Movement. While “non-violent” actions started to have their effect, it was when the riots and burning of cities by rioters took place that there was no longer any doubts as to what the consequences would be if we didn’t give people the legal rights they were demanding. There was really no choice but to give in here to the demands of those following Martin Luther King or face more of the sort of violent urban terrorism we were already seeing… We have also seen evidence that while non-violent actions have their role, it is really still the threat of armed violence that holds the “aces”. This is obvious when we look back at the history of the 1960′s. Their cry of “No justice, no peace!” leaves no doubts as to this.

We have learned over the ages that governments will always grow oppressive if they are allowed to do so. That if the people do not directly control what laws are passed, that in time the people will find that the government holds increasing power over their lives. This is a problem even in governments that are subject to the vote of the people. Those who seek greater power over the people can usually find or bribe politicians to pass the sort of legislation that they want. With Democrats this appears to now be some sort of a “nanny” state type of political ideology. With the Republicans the practice appears to be more of a “Social Darwinist” direction where one’s status in life is determined by income. Also, if you are a “minority”, racial, sexual, national, the Republicans don’t like you very well and will attempt if possible to keep you from expressing your opinions at the ballot box. Democrats will limit your level of personal freedom to one they see as appropriate. Suggest to a Democrat (as I once did) that repealing prescription laws would be a benefit to many people, and you will ignite a “flame war” as they do not believe that anyone but those with .MD after their names are “competent” to make such decisions for one’s self. An idea no doubt originated by the medical profession whose incomes depend upon it.

In any case, with time it seems as if we are becoming more and more less free to make decisions for ourselves. The size and scope of government (at all levels) is growing with time. Also, the ability of the people to influence the decisions made in their name is now lessened thanks to the Supreme Court decision that effectively removes all limits upon the amount of money that can be donated to political campaigns. If one candidate for office has say $100,000 to use for his or her campaign, while their more conservative opponent has the support of wealth and big business, you can guess the odds against those who support the people, not the wealthy and the big international corporations. This did happen in the past. The period from about 1880 to 1910 or so was a time in fact where the wealthy and big business did rule here in the USA. Where people were in fact killed because they attempted to form a labor union. And the federal government and the state governments were both on the “side” of the big corporations against the rest of us. “A People’s History of the United States” by Howard Zinn, while biased, is in fact an accurate accounting of what happened during that time. You should be able to find a copy at your local public library. Remember, this happened here, not somewhere else!

Where this affects people is that starting your own business today is more difficult than ever. There is more and more regulation, more “hoops” that you have to jump through. There are all those government agencies, both state and federal who issue rules that you have to follow. I had my own business from 1983 to 1995, but even then there were signs that things were going to get worse instead of better because of government regulations. Big business doesn’t like small businesses. Mainly now because the small business can sometimes give better service at lower cost. Monopolies are always more “expensive”. But the sort of massive profits possible today has only come through monopolization, along with holding the wages of workers down by “union busting” and relocating the business to a country with lower wages, governments who can be “reasoned with”…

You might wonder what relationship this has to “rights”, but for some being able to go start a business of your own is important to them. Certainly we wouldn’t like living in a society composed of Walmart, Comcast, one where “monopoly” was now the standard. One where everyone was an “employee” and that was now your only choice in life. One where there was a lot of unemployment and your “boss” effectively now ruled your life. The freedom to start your own business, to be self supporting, is still important to many people even today. Those who immigrated here from Europe back in the 19th Century came here often with the hope of someday having their own farm or small business…

There is another issue that I think has historical implications. The freedom to own firearms is a freedom that is more special to Americans than those of other developed countries. There are far too many examples of governments becoming oppressive tyrannies because some group was able to seize power and establish a police state. “Unintended Consequences” by John Ross illustrates this rather well. Unfortunately only the more conservative Republicans support the Right to Keep and Bear Arms. Of course us libertarians do so to an even stronger degree, but we don’t win very many elections either. Hopefully that state of affairs might change in the near future…  We have seen far too much of disarmed people being forced to “go quietly into the night”.

Jerome Bigge, NRA Life Member.

 

 

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Some facts and figures…

By the time Obamacare is in full operation, it has been estimated that the total US health care costs will come close to $3 trillion ($3,000,000,000,000) dollars a year. That’s about $9500 per capita. $792 per month. $184 a week, $26.28 a day.  Average for the rest of the developed world is about half of that. Or $4750 a year on a per capita basis. There is a difference in the standard of living between the USA and the rest of the developed world, but it isn’t all that large when you check things out.  Proof if any is needed that there is definitely a whole lot of waste, including unnecessary tests and treatments that are of no value to the patient, but serve to put money in a provider’s pocket, or in many cases, in a number of people’s pockets at the same time. We also waste quite a lot of money on things that don’t actually contribute very much to health.

Of this $3,000,000,000,000 dollars, 10% is going to medical fraud according to the FBI. Thats $300,000,000,000 dollars.($300 billion).  Another estimated 10% goes to “bill padding” which is a legal “gray” area. There’s another $300,000,000,000 dollars ($300 billion). About a third of all health care expenses are either wasteful or unnecessary. A third of $3,000,000,000,000 is $1,000,000,000,000 ($1 trillion dollars). Add all of this together and we are (defrauded, overcharged, get unnecessary wasteful care) to the tune of $1,600,000,000,000 dollars a year. ($1.6 trillion). And you thought those Wall Street bankers were bad?  At least with the bankers, you had a choice whether to deal with them or not. Much more difficult when it comes to dealing with our government enforced health care monopoly where you have very little actual “say” in things. In any case there can be no doubt that there is a very large amount of “waste” in our health care system. At least a trillion dollars worth. Which with everything else means we’re getting $1.4 trillion dollars worth of actual service, but paying $3 trillion to get that $1.4 trillion. Which means the other $1.6 trillion dollars isn’t really making us any healthier…

Some of this overlaps so the actual figure is likely in the $1.5 trillion range. It might be asked whether or not we get “better care” than do those Europeans who pay half of what we pay. Overall, probably not since their lifespans tend to exceed our own. However this is likely an effect of better coverage without so many people being excluded from regular health care. If we compare our over 65 population to theirs, there’s not much difference. 65 of course being where everyone who reaches that age with few exceptions goes on Medicare. There are “environmental” differences and different eating habits, but the difference in life spans is more due to early deaths of Americans without health care. While Obamacare may be able to provide some with health care who do not have it now, the cost/benefit ratio is pretty bad, especially when compared to what is actually possible if we were willing to start considering allowing people the freedom to make their own arrangements for health care.  I refer those interested to the WordPress.com site “selfpaypatient.com” where you will find alternatives to the idea that everyone has to buy into President Obama’s “Patient Protection, Affordable Care Act”.  Which is really not all that “protective” or “affordable” when you get down to it. It is most a “giveaway” to private health insurance companies, who deliver 80 cents worth of benefits for every dollar’s worth of premiums. That means 20 cents out of every dollar of your premium goes to things that have nothing to do with actually providing you with health care! Even the credit card companies give you a better deal than that!

Does this mean we should adopt the style of health care used elsewhere? A lot of what drives American health care costs however can be corrected by getting “government” out of the picture. Repeal of prescription laws for example makes it possible for more people to obtain the benefits of medical drugs without having to first “bribe” a doctor for a prescription. Also, in many cases, doctors prescribe more expensive “brand name” drugs when a lower cost generic would do just as well.  There is no doubt that drug company ads do influence what medicines get prescribed. There are currently two drugs now commonly used to treat osteoarthritis. One, a generic, can cost as little as 10 cents a pill. The other, a well advertised brand name, can cost as much as $1 a pill if not more.  Both are about as effective. There are some slight differences in their possible side effects, but for most people with osteoarthritis, the generic will be about as effective as the brand name. The real problem is “access”. We lost our freedom to take care of ourselves back in 1938. The AMA was successful in granting doctors a legal monopoly over medical drugs.

This in turn raises the question as to how much “self care” would be really possible if the laws were changed. The answer to this is “how much are you willing to study?” Along with how much responsibility for your health are you willing to take? There are simply things you can’t do for yourself regardless of how much knowledge you have. However the more knowledge you do acquire, the more you will know what you can do and what is best left up to the specialist of your choice.  I’d suggest starting out with a good first aid course. There are Internet sites such as “WebMD” that are very useful. Amazon.com sells books such as “The Physician’s Desk Reference”.  Add a good book on medical drugs and you’ll start to have some idea of what is really practical for you to deal with. You can obtain lab tests at a much lower price if you shop around and watch for some group offering these. Blood pressure meters are cheap. You can buy a kit for measuring your blood sugar and cholesterol. You can also obtain formal education if you wish to go further and perhaps use your knowledge for gainful employment as say an EMT. Or go even further on and become a paramedic. Obviously, thanks to Obamacare, the health care field is going to be “growing” jobs with all the newly insured seeking treatment. Of course when the country eventually goes bankrupt, then the value of that education might be more useful in keeping yourself healthy than providing service to others…

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Additional information: The VA’s medical costs are 64% of US average health care costs. This indicates that the form of “socialized medicine” the VA uses actually costs 36% less! I have estimated that if we achieve health care coverage for all American citizens, the cost would be in the $3 trillion dollar range under our present operating system.  But if we were to use the VA as an example of how to run a health care system as good as that of any nation on Earth (see Phillip Longman’s “BEST CARE ANYWHERE”), then the national cost of health care would be $1.92 trillion dollars, giving us a savings of $1.08 trillion dollars. This also brings US health care costs into the same “ballpark” as those of the rest of the developed world! No doubt the repeal of prescription laws would bring this figure even a bit lower. Whether or not we would want to adopt the VA system (far more likely under a Demarchic political system), it does show that there actually are existing “alternatives” to our present extremely wasteful health care system where fraud by those involved in the health care system accounts for 10% of our total costs. Paying 12% of our GNP for health care instead of 18 plus percent certainly would free up a lot of funds to do other things such as repairing our crumbling infrastructure and fixing the damages due to the Wall Street bankers and their creation of fraudulent investments that came close to driving the developed world into another Great Depression!

The retort here will be that this is government run health care instead of privately run health care. However, there is also the issue of cost and efficiency to consider. It does show that “government” (especially under Demarchy) can do somethings better… It makes no sense to apply the concept of the free market in places where it is a failure. When we consider that the AMA was created back in 1846 with the same objectives as those of any labor union, it shows the difficulty in preventing the growth of a monopoly. Which is exactly “why” our health care costs are almost twice that of the average for the rest of the developed world. There is no sense in having libertarians oppose “efficiency”.

This is the major problem with all political and economic and social ideologies.  They are not a “one size fits all”. All of them fail in one way or another when they encounter the “real world”. Libertarianism does solve “more” problems than do the ideologies of the “Right” and the “Left”, but it is still only one “tool”, and there are limits to its application. If we wish to actually “solve” the problems we have, then we have to admit that there is a proper role of government as long as it is truly representative of the people. On the other hand we need to understand that efficiency is still the best way to control the cost of anything.

Jerome Bigge, “muskegonlibertarian.wordpress.com”

To contact me, my email address is “jerbigge@toast.net”

 

 

 

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The Use of Force in a Libertarian Society?

Unfortunately we have people in public life who claim to be “libertarian”, but are quite willing to use force (state police power) against those who don’t happy to agree with their ideas. This really does violate the basic libertarian idea that “force” is to be only used in self defense. Not because you happen to think that what someone is doing is so “objectionable” that the use of force against the person is justified. For example, was the Civil War morally justifiable under the libertarian standard of using force only in self defense? The Civil War really started over the Confederacy firing upon Fort Sumter, which was “US property”. The Confederates were actually the aggressor as they had fired the first shot at the fort. Had the Confederates not done this, it is possible that our history could have been much different since President Lincoln would have been forced to initiate violence against the “South”. Most likely there would have been much less support for using violence to keep the “South” as part of the Union. American history from that point on would have been quite a lot different… On the other hand slavery was an “abomination” that increasing numbers of American citizens believed had to be put to an end regardless of whatever the consequences would be. A number of private individuals were willing to use “force” to end slavery despite the fact that people would be killed on both sides should force be used.  It does appear here that there may well be cases where the use of force is morally correct.

It will be held by some that the use of force against tyrants is justified in the name of justice for those who live beneath the tyrant’s rule. Unfortunately such a policy means that military action would then be necessary against anyone who is considered to be a tyrant. Unfortunately there are so many who might “qualify” for the title of “tyrant” that virtually endless war would be necessary. We do not have the resources, the manpower to be the “world’s policeman”. And even if we did, we’d doubtlessly end up with yet more enemies. We might however supply those who live under tyranny with the means to overthrow it. Individuals might be willing to expose themselves to possible death by assisting those now living under tyranny with the means to overthrow it. There are historical examples of this. Those who came to America during our own revolution with the intention of helping us overthrow the power of Great Britain over the American colonies. There have always been those who were willing to put their own lives at risk in behalf of those fighting for freedom.

What about issues such as abortion? Are we justified in using force to prevent women from having abortions? (this is a different issue than paying for them) It should be noted that those women with sufficient funds can travel to another country and have their abortion there. To stop this we would need to make it as difficult as possible for a pregnant woman to leave the US. In other words we would have to violate her rights in order to keep her here. There is also the issue that abortion is legal in some states. So we’d also have to keep her locked up like in the book, “The Handmaid’s Tale”. Even if we don’t go that far, it is now likely that “back alley abortionists” will arise to meet the “demand”. Just as organized crime arose to meet the “demand” for alcoholic drinks during Prohibition. This sort of thing always happens when there is no consensus on an issue. It would make far more sense to make provisions for finding homes for unwanted children. There are people who would like to adopt, but due to the way our laws are written, have difficulty qualifying for an adoption. There are people who would be glad to adopt, but who don’t meet some requirements due to race, marital status, or sex. For example, it would be virtually impossible for a single man or woman to adopt a baby under today’s laws. This is why sometimes these people have to seek an adoption outside the US. Simply because the laws are written in such a way that a legal adoption cannot take place despite their fitness to actually raise a child.

There is also the issue that people who happen to oppose a certain action will now support legislation to have the government use force against those who do things others don’t like. A lot of our “victimless crimes” fall into this category. In effect they are willing to use force against other people as long as it is the “government” doing it instead of going and doing it themselves. Our drug laws fall into that category as did Prohibition. The same thing is true of prostitution and pornography. People who disapprove of these things in effect “hire” the government to use “force” in their name to prevent others from doing things they dislike.

Similar to this is the use of government force for economic gain. An organized group gets the government to make it so that goods and services are only available from the group in question. The licensed professions and occupations do this. They use their political power to get the government to grant them privileges that the rest of us are not allowed to enjoy. This is usually done for economic reasons since a government enforced monopoly over certain goods and services allows those who are “privileged” to obtain a higher price for their goods and services. “Protectionism” isn’t always related to international trade. It is often used for the economic gain of the privileged vis a vis everyone else. At one time here in the US we had “Fair Trade” laws that prohibited selling new goods below a certain price. This allowed the smaller retailers to create a “closed economy” where discounters were in effect “outlawed”. While profitable for the businesses in question, it did of course rise the price that the consumer had to pay. Much the same way as tariffs allow national businesses to sell their goods (and sometimes services) at a higher price. The idea is really the same in all these cases. The “force of government” is used to create a less competitive business environment where the consumer is denied the ability to seek the best price possible.

What can we conclude from this? First, the use of force is a “last resort” only to be used after all other means of resolving the issue have been attempted. Second, the use of force is only “allowable” under circumstances where human life and welfare is at stake. Third, the use of force for one’s own economic gain is always prohibited, regardless of the nature of the agency used. What is wrong for you to use force is also wrong if the government uses force in your behalf against others for the purpose of your own personal economic gain.

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Medical Freedom and Personal Responsibility

One thing to be considered if a person decides to take charge of their own health in a libertarian society is that once you make the decision to take care of yourself without paying a doctor is that you have assumed responsibility for any possible consequences. This is not something that people should take lightly. However being responsible for what happens is the “other side of the coin” when you desire the freedom to make your own decisions regarding your health and its proper maintenance over your life time. Otherwise you’re better trusting your doctor, although that is be more costly than doing it yourself.

This means doing the necessary study to know what you are doing and when the situation is beyond your own skills to deal with the issue. Take the issue of medications. Do you know the side effects of the medication you have decided to use? For example, the medication generally used to deal with the aches and pains of arthritis can effect your stomach, especially if you take them without first eating a meal. There can be an effect on the liver and kidneys depending upon the medication in question. Possible problems with your heart can arise depending upon the selected medication. The risks from the common OTC medications are somewhat less, but taking aspirin or Motrin or Aleve can effect the stomach if taken without food. Certain supplements also effect things. To learn what the effects are will require that you do some study. Read the warnings that come with the medication. Visit “WebMD” for more data. Read the “user reviews” to learn more about what sort of problems the drug of your choice might cause. You can check for reactions from one medication with another. Some medications do not “play well” with others. You can also access other sites by searching for them using “Google”.  You can never know too much when it comes to your own health, even if you still rely on a doctor to take care of things. Unfortunately doctors are too pressed for time to be able to know exactly what problems you may encounter with any certain medication. So knowing “where” to obtain the necessary information is important so that you know what you are dealing with here.

You should also consider that some common prescribed medications can have adverse effects. For example, blood pressure medications can cause you to become dizzy when you stand up suddenly. The accepted blood pressure level of 120/80 is not always desirable for everyone. Some people, especially seniors, may experience a certain amount of dizziness caused by a fall of blood pressure when standing up. Seniors “falling” is more common now than it was before the medical profession put everyone on these medications. It is perhaps interesting to note that NASA considers a blood pressure of 130/90 to be acceptable, and in the past, yet higher blood pressures were accepted. Medical standards are not anywhere as “standard” as you might think. There are “trade offs” involved. Is the risk of falling due to lack of sufficient blood pressure greater than the risks of having a blood pressure higher than today’s recommended level? Various medications for pain control may very well also shorten a person’s life span. There are a whole lot of these type issues in medicine today. Much of this will eventually end up being the individual’s right to decide for themselves.

The opinions of health insurance companies are likely to be along the line of “least risk” in that they have an obligation to pay benefits, one that they will seek to avoid if possible. In a libertarian society where the medical profession does not enjoy a legal monopoly over access to medical drugs as they do now in our “statist” society, there might be better “solutions” to the issue of paying for health care than those we currently have today. I’ve mentioned these in previous posts. Health savings account, loans, perhaps belong to some organization devoted to “health sharing”. In the past there were fraternal organizations that hired a doctor to take care of the members of the organization. No doubt various “solutions” to the problem of health care costs will arise once the power of the state is no longer in control of the health care system. We must be realistic about these things and not expect miracles. On the other hand the sort of national “medical monopolies” we have will no doubt come to an end, opening up the cost controlling benefits of medical “free trade”.

These are all issues that libertarians should be considering now even if we do not yet have the right to make some of these decisions for ourselves. There is also another factor to be considered. Roughly 1/3 of all health care services in the US are likely unnecessary, and in fact occur just because it puts money in someone’s pocket because they have power over you. Medical fraud has been estimated at 10% of our total $2.7 trillion dollar health bill. Of course when Obamacare kicks in, this figure will doubtlessly go even higher yet, especially as there can be no doubt that those “on the inside” will find means of “milking the system” for all they can get. There is also an issue that medical mistakes now cost an estimated 100,000 lives a year, an almost unbelievable figure.  That’s about three times the number of fatal automobile accidents, three times the number of fatal shootings in total. Thirty times the number of Americans killed on 9-11-2001. No doubt some accidents are unavoidable, but that is still a large number, evidence of an unacceptable level of carelessness.

For those curious, I recommend obtaining from your public library the four books written by Rosemary Gibson and Janardan Prasad Singh. There are others such as “Overdosed America” by John Abramson which should be of interest. For anyone willing to search through a state public library system like we have here in Michigan, there are many more.

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The Great Depression A Lesson To Be Learned

The Great Depression started in 1929 and didn’t end until the 1940′s. Why did it last so long? Was it a failure of the free enterprise system or was it caused by government regulation?  The truth appears to have been the second. Government regulation…

When the Great Depression started in 1929, President Herbert Hoover believed that it was due to a collapse of economic demand. That people didn’t earn enough to buy up the supposed “glut” of products for sale. That the economy had actually “locked up” and it would take the power of government to break it free. The way President Hoover decided to use was to prohibit business from reducing the wages and salaries of those employed. Thus, even if a business wanted to, they couldn’t adjust their labor costs to reflect the change in economic conditions. Business couldn’t readjust its labor costs to reflect the lower demand caused by the economic contraction. If a business couldn’t adjust its labor costs, it had no alternative but to lay people off. Which of course made things even worse than before. Laid off people didn’t have the money to buy anything except what they absolutely had to buy, and even then, people had to skimp as much as they could since increasing lay offs meant greater competition for whatever jobs still existed. But the federal government had effectively made it so that business could not cut wages. You could lay people off, but you had to continue to pay those still in your employ their established wages even if that meant losing money because of less sales for whatever goods and services were produced. You could say that the federal government had imposed upon business a “minimum wage” which required employers to pay the same wages they’d been paying when things were good. The effect was to effectively kill the hopes of anyone laid off from being employed because you had to supposedly pay the same wages as you were now paying your other employees even if the new hire was actually willing to work for less money to learn the job. I suppose the idea was that this would prevent an employer from laying off workers, then rehiring them back at a lower wage. Just how well all of this was enforced is hard to say, but it certainly did make it difficult for employers to stay in business as you might guess.*

* Our leaders believe that raising the minimum wage is a good idea even if there is a lot of unemployment and people are having a hard time finding jobs. Looks like we haven’t yet learned the “lessons” that the Great Depression taught us.  Is Obama another Hoover?

The result was of course that things grow progressively worse with time. Hoover got voted out in favor of Roosevelt. FDR felt that “price supports” were necessary so that businesses could receive enough profits to stay in business. Of course as many people were losing their jobs and trying to survive as best they could, keeping prices high only made things worse… Under the Roosevelt administration the government sent out agents to check businesses to see that they weren’t reducing prices or having sales. That was a violation of the National Recovery Act if I recall correctly. The Supreme Court overturned it, but Roosevelt then threatened to “pack” the Court, which greatly discouraged the justices from forbidding FDR from doing what he wanted. There were price supports on agricultural products, which mainly made food more expensive when people were having a hard time trying to avoid starving to death. We still have those price supports on agricultural products today. Supposedly this is to preserve the “family farm”, but most farming today is done by large “industrial” farms, much different from the supposed “family farm” we’re trying to “save”.

Of course FDR did try to have the government provide jobs since government regulations made it rather difficult for private business to do so. We had the “Works Progress” administration which used taxpayer money to pay unemployed people to do work. Much of this work was “useful” (there were no labor unions to oppose it) and it did help somewhat. No doubt the government could hire people to do similar work today, but organized labor would certainly protest the idea. With a growing government deficit, FDR decided to raise taxes, which discouraged investors and tended to cost what precious jobs business had managed to create. It wasn’t until the US started spending major amounts of money on national defense (Pearl Harbor) that the US economy eventually climbed out of the Great Depression.

I think that we should learn from this that excessive government regulation costs jobs and hinders economic growth. There are enough studies of the Great Depression to leave no doubt as what we shouldn’t be doing today…

 

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The Concept Of Patient Controlled Healthcare.

Who should be the ultimate decision maker in health care?  The doctor? The insurance company? Or should it be the patient? I think most people reading this would say that it should be the patient? After all, he or she is the one who will be the most effected by any medical decision. The doctor can give his advice, based upon his own knowledge, but the patient is the one who is the most concerned. The role of the insurance company is just to pay for the services rendered, although naturally the insurance company would like to pay as little as possible. This is why insurance companies refer to the benefits that they have to pay out as their “loss ratio”. To the insurance company, any benefit paid out is seen as a “loss”. Money that can’t be spent on wages, salaries, or dividends to stockholders. We can however replace the role of the insurance company with Health Savings Accounts filled with pre-tax dollars, create a system of long term loans to pay for needed health care. In a libertarian society health care will in any case be far less costly than what we have now… There will likely be medical insurance that kicks in only at a high level to cover those diseases where the cost of treatment will run into the tens of thousands of dollars. This type of insurance is not all that expensive, and would cost considerably less than what most people will be expected to pay under Obamacare. Obamacare itself being quite “wasteful” in that the value of the insurance is no where near the level a better design would allow. Insurance should not be used for low cost services that can be paid “out of pocket”. Of course there would be no coercion as to buying insurance as that is up to the individual.*

*The requirement of “must treat” would not exist in a libertarian society.

The right of decision making was to a great degree forcefully stripped from the patient and transferred to doctors by the passage of prescription laws by the government in 1938. Prior to that time the patient had the ultimate power as he or she did not require a prescription in order to purchase medicine for his or her own use. If they knew what medicine they needed it was a simple matter to purchase it from a local drug store. I can honestly say that the medical freedom of the patient was stripped from them by law and handed over to the doctor. The doctor became the person who controlled the patient’s access to medical drugs. Of course the doctor thought this was a wonderful thing because it gave the doctor a great deal of power over the patient and his or her health. Power that could be and is used to enhance the income of doctors over and above what it would be in a social order where they did not have this power. The so-called “shortage” of primary care doctors is due to the fact that holding the power of access to medical drugs is a good way to extort additional money from existing patients. Without these laws, there will be a much larger incentive to seek patients from the general population who now need a doctor’s services, but who are not currently served. We do have enough doctors, we just need to have them use their valuable time more efficiently. However there are a lot of things where lesser trained providers would serve just as well, which would result in savings.

Of course some will say that the patient is incompetent to make such decisions for himself or herself. This appears to be the viewpoint held by our two major political parties today. The Democratic party views these laws as necessary to keep people from harming themselves. Republicans favor these laws because they believe other wise people will drug themselves and become addicts to the drug of their choice. The truth of course is much different. For most medical drugs, there is no good reason they should be “controlled”.

Only two categories of medical drugs can be abused by addicts. These are the opiates and the antidepressants. Both are “habit forming” and both have withdrawal symptoms. The opiates are used to control pain, but the antidepressants are used in far larger numbers to control people’s moods. Children today are frequently treated with an antidepressant drug to control their behavior in school. One unpleasant consequence of using antidepressants is that they have a “rebound” factor. As the drug wears off, there is a tendency to create the opposite effect. I have myself witnessed this effect and it was rather “scary” in a way as the individual in question was behaving in a way that seemed to now hint at suppressed violence that could be released at any time. I should note here that there is some evidence that this effect caused by antidepressants may be responsible for a number of “school shootings”. The Sandy Hook shooting appears to be one. I believe if the medical records of all of these shootings could be accessed, it might be found that this family of medical drugs was indirectly responsible. They may well be “dangerous” enough that it would be wise to put stricter controls over their use. They certainly should not be made available OTC.  In fact they are likely to be more “dangerous” than any of the opiate family of drugs.

The major problem appears to be the design of the US health care system which is based upon a concept where the patient has little more to say than my dog when I take her to the “vet’s”. Of course the health care establishment likes it that way because it allows a higher level of profit than what would be possible if the patient was the final “decision maker”. It is likely in such cases that the patient, being in control as the ultimate payer, would make a different decision than would the doctor or the insurance company, both of whom earn a larger profit than they could earn in a system where there was now true competition for patients. Much as in buying most consumer products you do have a wide range of choices. As for the cost of paying for basic health care services yourself, I suggest that you visit the website selfpaypatient.com, which is sponsored by WordPress. There is also a book which can be downloaded to your Kindle from the Amazon.com website.

Is it possible for patients to make such decisions? We have a great deal of available data as to the effects of different medications. Considerably more could be done in this field once patients become the decision makers. Most likely a company like Google could establish an effective program that would allow anyone who was willing to pay a fee to access a great deal of data. Somewhat similar to the offer that Amazon makes with its “Prime” system. Given this, along with a reasonable amount of study, most people would be able to make relatively intelligent decisions regarding their health care. It is also possible that learning to take care of your own health to a much greater degree than is possible today could be part of everyone’s high school education. An hour a day would be sufficient to cover the “basics”. Without prescription laws save for the two drug classes I’ve mentioned, the cost of taking care of your own health would be much less than it is today. It would certainly be more “useful” than a lot of stuff that students are taught. Knowledge that is never used once you graduate is simply a waste of time for both student and teacher. There are only a certain number of class room hours available, and they should not be wasted on low value things.

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