May 062013
 

Dr. Beth Haynes of the Benjamin Rush Society has a nice OpEd in the Huffington Post, “Almost All Americans Lack Health Insurance“.

She adds much-needed conceptual clarity in the discussion over health policy by discussing the nature of genuine insurance, as opposed to our current system. From her piece:

What is insurance? Think about your auto, life and homeowner’s insurance. Each of these is designed as a means to pay for unexpected, unpredictable, very expensive occurrences outside of the control of the policyholder. Insurance is a means of financially protecting people from the risk of unlikely but high-cost events. To build up sufficient funds, the insured pays a premium calculated on their specific chance of experiencing a covered event. Insurance companies can only stay solvent if what they take in as premiums is greater than what they pay out in claims (plus business expenses and a competitive profit).

So what is it we have that we call health insurance but isn’t? We have the prepayment of medical expenses. We expect our “insurance” to cover predictable, relatively inexpensive events like health maintenance checks, minor illnesses and injuries — and to pay for them with minimal out of pocket spending. Under Obamacare, these expectations will be mandated by law. The new law actually makes it illegal for insurance companies to charge individuals premiums equal to their risk of making claims. It’s like having a law requiring homeowner’s insurance to pay for lawn care, house painting and water heater replacement, while at the same time prohibiting the companies from operating an actuarially sound business.

Instead of genuine insurance, we are moving towards a system of bad pre-paid care.

For more details, read the full text of “Almost All Americans Lack Health Insurance“.

And by the way, under Dr. Haynes’ leadership, the Benjamin Rush Society has been sponsoring an excellent series of debates on important health policy issues. Go check out their website for details and videos!


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Forbes has published my latest OpEd, “Big Brother Has A New Face, And It’s Your Boss“.

I discuss how government policies linking employment to health insurance create a powerful incentive for your boss to control his costs by controlling your lifestyle.

My take home point:

…[I]t’s wrong for the government to use economic carrots and sticks to induce private employers to become enforcers of healthy behavior. This is just a subtler form of “nanny state” controls, such as NYC mayor Michael Bloomberg outlawing soft drinks he considers unhealthy.

And once employers start monitoring employee behavior on the grounds of “health costs,” there’s no end to the potential meddling. Who will be the next politically disfavored group after smokers or the obese? Do we want bosses discouraging their employees from owning guns or enjoying mountain biking on the weekends? This is a dangerous road.

(Read the full text of “Big Brother Has A New Face, And It’s Your Boss“.)

Update from Diana: This column was published last Thursday, and it’s gotten over 47,000 views! Way to go, Paul!


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Forbes published my latest OpEd, “Is Concierge Medicine The Correct Choice For You?

I discuss the benefits of this practice model for both patients and doctors as well as dispelling some myths.

(Some of this material is drawn from my recent SnowCon 2013 talk, “Concierge Medicine: The Last Bastion of Health Care Freedom”).

Denver-area readers might also be interested in this related recent short piece in 5280 Magazine: “The Doctor Is (Always) In“.


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Forbes has just published my latest OpEd, “Why Doctors Should Not Ask Their Patients About Guns“.

My theme is that physicians should not routinely ask patients whether they own guns, because it could compromise the integrity of the doctor-patient relationship.

Here is the opening:

Should doctors ask patients if they own guns? Currently, ObamaCare bans the federal government from using patient medical records to compile a list of gun owners. But following the Newtown, CT shootings, President Obama issued an executive order clarifying that “the Affordable Care Act [ObamaCare] does not prohibit doctors asking their patients about guns in their homes.” The American Academy of Pediatrics (AAP) similarly encourages physicians to ask patients if they own firearms — in the name of protecting child safety.

As a physician, I consider this advice misguided. Instead, physicians should not routinely ask patients whether they own guns, because it could compromise the integrity of the doctor-patient relationship.

I cite Dave Kopel (who was one of many scholars who debunked the standard 43-to-1 flawed statistic about the danger of guns in the house) and also discuss the little-recognized fact that swimming pools are far more dangerous to kids than guns, yet no one asks for background checks for pool owners.

And many thanks to Dr. Matthew Bowdish for permission to quote him at the end of the piece!

(Read the full text of “Why Doctors Should Not Ask Their Patients About Guns“.)


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Dec 272012
 

My latest piece is now up at Forbes, “The Battle Of The Narrative: How Ordinary Americans Can Fight ObamaCare“.

Here is the opening:

The 2012 election ensured that ObamaCare will not be repealed anytime soon. But opponents continue to fight back. 26 state governments have declined to establish insurance “exchanges.” 40 lawsuits are still pending against various aspects of ObamaCare. Ordinary Americans may not be able to directly affect these battles. But they can play a key role in the all-important battle of the “narrative.”

As the problems of ObamaCare inevitably emerge, the big question will be whether they will be blamed on the residual free-market elements of our health system or on the new government controls. This will be the battle of the “narrative.”

I discuss how ordinary Americans can take part in this battle for their health freedom.

(Read the full text of “The Battle Of The Narrative: How Ordinary Americans Can Fight ObamaCare“.)


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Nov 142012
 

The 11/13/2012 Forbes has published my latest OpEd: “5 Ways To Protect Yourself Against Obamacare“.

I discuss 5 practical strategies ordinary Americans should consider now, even as the fight for health care freedom continues. They include:

1) Get a good primary care doctor, if you haven’t already done so.

2) Use a Health Savings Account (HSA).

3) Consider a concierge or “direct pay” physician.

4) Consider medical tourism, when appropriate.

5) Help your doctor work on your behalf.

For more details, see the full text of “5 Ways To Protect Yourself Against Obamacare“.

I’ve also discussed some of these ideas in my 7/25/2012 interview on Diana’s “Philosophy In Action” podcast, “Surviving Socialized Medicine“.

See also my article in the Summer 2010 issue of The Objective Standard, “How to Protect Yourself Against ObamaCare“. (Link goes to free preview, full text is subscriber gated).

Update #1: Dr. Richard Amerling of AAPS offers similar suggestions at: “Defensive Medicine: How To Survive ObamaCare“.

Update #2: Thanks, Instapundit, for the link!

[Crossposted from FIRM blog.]


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Oct 022012
 

PJ Media has published my latest OpEd, “How Medical Licensing Laws Harm Patients and Trap Doctors“.

My twin themes are that (1) Government licensing of doctors is both morally and economically wrong, and (2) the interaction between current licensing laws and upcoming ObamaCare laws will harm both patients and doctors in unanticipated ways.

This piece is adapted from a short talk I recently gave on Milton Friedman and medical licensing. I don’t agree with Friedman on some important issues, but he was excellent on the issue of occupational licensure.

I also cite economist Shirly Svorny and Dr. Milton Wolf for their proposals to move us in the right direction.


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Sep 102012
 

PJ Media has just published my latest OpEd: “In Top Journal, Obamacare Boosters Push ‘Global Spending Target’“.

I discuss the latest push for a “global spending cap” on health care — but public and private.

Here is the opening:

Free-market economists have long known that “controls breed controls.” In health care, leading Obamacare supporters are now proposing unprecedented new government controls over all medical spending — private as well as public — to “solve” problems caused by prior controls. Welcome to ObamaCare 2.0.

In a recent article in the New England Journal of Medicine (NEJM), several prominent Obamacare supporters have called for a binding “global spending target for both public and private payers.” In regular English, this means a government-enforced cap on how much Americans may spend in aggregate on their health care, both public and private.

The co-authors of this article include former Obama administration officials Dr. Ezekiel Emanuel (former White House health care advisor and brother of Rahm Emanuel, former White House chief of staff), Dr. Donald Berwick (former head of Medicare), and Peter Orszag (former budget director)…

In particular, I cover 5 implications of this new approach.

1) This means rationing.

2) Get ready for the lobbyist feeding frenzy.

3) The government will exert increasing control over how doctors can practice.

4) Controls breed controls.

5) We need free-market reforms more than ever.

These “global spending caps” have already been enacted into law in Massachusetts.  Under a second Obama administration, the rest of the US would likely follow.

(Read the full text of: “In Top Journal, Obamacare Boosters Push ‘Global Spending Target’“.)


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Forbes has just published my latest piece, “Will Obamacare Play Games With Your Actual Life?

My theme is that new ObamaCare rules on readmitting sick patients could tempt hospitals to “game the system” to your detriment.

Here is the opening:

Have you ever boarded an airplane, pushed off from the gate, then sat motionless on the runway for 45 minutes? This can happen for many reasons. But the federal Department of Transportation counts a flight as “departed” once it leaves the gate, not when it leaves the ground. Hence, airports have an incentive to “game the system” and artificially inflate their on-time departure statistics by sending planes from their gates even if they don’t go anywhere.

Under new ObamaCare rules, hospitals will have a similar incentive to “game” the system to improve their Medicare statistics, even at patient expense…

Read the full text of “Will Obamacare Play Games With Your Actual Life?


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Aug 232012
 

My latest OpEd is now up at Forbes, “If You Want Human Progress To Stop, Institute A Maximum Income“.

In this piece, I discuss the importance of making a moral defense of those who have earned wealth honestly, not just an economic defense.

Here is the opening:

Suppose a young medical researcher, Dr. Smith, discovered a safe, reliable vaccine for breast cancer. If a woman took a single pill at age 30, she’d never develop breast cancer. But the pill costs $1,000. How many American women would take that deal?

Most women would likely jump at the opportunity. For $1,000, a woman would be forever spared the expense and inconvenience of future annual mammograms. She’d never have to worry about her doctor calling to say, “Your mammogram showed a suspicious spot; please come in for a biopsy.” The 12% of women who would have developed breast cancer during their lifetimes would be spared the pain and risks of surgery, chemotherapy, and radiation therapy.

Each woman would gain an enormous value in terms of money saved, peace of mind, and potential added years of life, far exceeding the $1,000 cost. Roughly 2 million American women turn 30 each year. Assuming Dr. Smith made a 10% profit from each sale, he would earn $200 million a year. Most people would regard that as a completely fair outcome.

But not Hamilton Nolan…

(Read the full text of “If You Want Human Progress To Stop, Institute A Maximum Income“.)

I’m also delighted to announce that Forbes has invited me to be a regular contributor, after my prior guest OpEds.  My focus will be primarily on health care, economics, and related issues, from a free-market perspective.

You can find my earlier Forbes OpEds here:

The Federal Government’s War On Medical Innovation” (8/8/2012)

Is President Obama’s Prostate Gland More Important Than Yours?” (7/5/2012)

The Dangerous Synergy Between The Nanny State And Universal Health Care” (6/18/2012)

Just Who Should Control Your Healthcare Spending?” (5/15/2012)

I’d like to thank all my regular readers for their support and encouragement — it means a great deal to me.

And thank you all for circulating my work by Facebook, Twitter, blogging, and e-mail!


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