The December 22, 2008 edition of the Wall Street Journal has printed two contiguous LTEs written by Objectivists criticizing Obama’s health care plans. One is by Richard Ralston, director of Americans for Free Choice in Medicine and the second is by myself. Both were in response to their December 9, 2008 article, “The Obama Health-Care Express”.

Here are the two LTEs:

Three Big Problems With Obama’s Health-Care Plan

You are probably correct that a major new national health-care program will be rushed through the next Congress without substantial debate through some mechanism such as budget reconciliation. That is because many of its elements would not survive close examination. The fatuous claim of Sen. Max Baucus that placing the nation’s medical care under the rule of an “independent” council of presidentially appointed experts would not constitute government management of care is only the most conspicuous example. Others include the claim that computerizing those remaining medical records still on paper would reduce insurance costs by $2,500 a year per family.

But the main reason for the big rush is that nobody has a clue how the government will pay for it — anymore than they know how the current unfunded liability of Medicare and Medicaid can be honored.

The last thing that proponents want is for anyone to ask where the money will come from, except perhaps questions about such details as the individual rights of patients and physicians to make their own medical decisions without the approval of presidentially appointed experts.

Richard E. Ralston
Executive Director
Americans for Free Choice in Medicine
Newport Beach, Calif.

Businesses expecting to save money under President-elect Barack Obama’s universal health-care plan are going to be in for a rude awakening. President-elect Obama’s plan includes an employer mandate in which businesses must either pay their employee health insurance or else pay into a government fund to cover the uninsured.

A similar mandate has already been in place in Massachusetts for two years. As health costs there have skyrocketed, the state government has asked for more and more “contributions” from businesses. During this financial crisis, the last thing America needs is yet more economic burdens on the businessmen who create jobs and prosperity.

The fundamental problem with Mr. Obama’s plan is the premise that health care is a “right” that must be guaranteed by the government. Health care is a need, not a right. Rights are freedoms of action, not automatic claims on goods and services that must be produced by another. Attempting to guarantee an alleged “right” to health care must necessarily violate actual individual rights and will destroy the American economy in the process.

Paul Hsieh, M.D.
Sedalia, Colo.

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The November 22, 2008 edition of the Colorado Springs Gazette has published my OpEd on the bailout crisis and lessons for those advocating “universal health care”:

Asking For Trouble in Health Care

Paul Hsieh, M.D., Guest Columnist

In the 1990s, politicians wanted to make home ownership as universal as possible. They used laws such as the Community Reinvestment Act to force banks to make unsustainable loans to millions of people. They also expanded quasi-government agencies such as Fannie Mae and Freddie Mac to guarantee these loans.

This scheme could last only a few years. In 2008, the housing bubble finally burst and economic reality caught up with the politicians. American taxpayers were stuck with the tab for these “toxic” mortgages. The result was the Wall Street Bailout of 2008 and the worst economic crisis since the Great Depression.

In 2008, politicians want to guarantee “universal health care” with new laws and new government programs. President-elect Barack Obama wants to require health insurers to sell policies whether or not those policies are economically sustainable (for instance by requiring them to issue policies regardless of pre-existing conditions). He has also proposed creating a massive new “National Health Insurance Exchange” to help ensure “universal coverage.”

But no politician can evade the laws of economic reality. Massachusetts’ program of “universal coverage” requires hundreds of millions of dollars of federal money a year to stay afloat, paid for by the taxpayers of the other 49 states. If the U.S .attempted this at a national level, there would be no one to bail us out.

When Obama’s proposed national system inevitably collapses under the weight of market inefficiency and bureaucratic overhead, this will merely pave the way to fully socialized single-payer health care. Health care spending now comprises one-sixth of the U.S. economy. Forcing taxpayers to pay for everyone’s medical expenses would make the $700 billion Wall Street bailout look like pocket change in comparison.

Even worse, under nationalized health care the government will eventually have to ration medical services to control costs. This is already commonplace in other countries. A Canadian woman who feels a lump in her breast oftens wait months before she receives the surgery and chemotherapy she needs. In contrast, an American woman can get the treatment she needs within days.

According to The Telegraph, Great Britain’s National Health Service paid bonuses to primary care physicians who reduced the numbers of referrals to hospital specialists – thus forcing those doctors to choose between their oaths to their patients or the government which pays their salaries. Whenever government attempts to guarantee a “right” to health care, it must also control it. Bureaucrats then decide who gets what health care and when, not doctors and patients.

The fundamental problem with “universal health care” is the mistaken premise that health care is a “right.” Rights are freedoms of actions (such as the right to free speech), not automatic claims on goods and services that must be produced by others.

Individuals are legitimately entitled to health care that they purchase with their own money, are promised by prior contractual agreements, or are given to them via voluntary charity.

Attempting to guarantee an alleged “right” to health care must necessarily violate someone’s actual rights – the rights of those compelled to pay for it. The ultimate victims will again be the taxpayers, just as they were the ultimate victims of the Wall Street bailout.

Instead of universal health care, we need free market reforms that reduce costs, reward individual responsibility, and respect individual rights. Some examples include eliminating mandatory insurance benefits, repealing laws that forbid purchasing health insurance across state lines, and allowing individuals to use Health Savings Accounts for routine expenses and to purchase low cost, catastrophic-only insurance for major expenses. Such reforms could lower costs up to 50 percent, making health insurance available to millions who cannot currently afford it.

We can’t go back in time and avoid the Wall Street Bailout of 2008. But we can still make the right decision with respect to health care. We must reject calls for “universal health care” or else we’ll be faced with a massive “Health Care Bailout of 2018.” The events of the past few months have taught us some important lessons about economic reality. The only question is whether we’re willing to learn from them.

Hsieh, of Sedalia, is the co-founder of Freedom and Individual Rights in Medicine.

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The October 23, 2008 edition of The Economist has printed another LTE of mine, this time on Massachusetts’ health care “reform”. This one is in the print edition (as opposed to my first LTE there which was online-only.)

They did minor editing, but kept the central meaning intact. The letter is the 4th one down:

Freedom to choose

SIR – The Massachusetts system of “universal” health care remains afloat only because of hundreds of millions of dollars in federal support (“In need of desperate remedies“, October 18th). One reason costs are so high in Massachusetts is that individuals are forced to purchase benefits they neither need nor want. Under any system of mandatory insurance, the state must necessarily define what constitutes an acceptable insurance policy, meaning that individuals are buying insurance on terms influenced by lobbyists and bureaucrats, rather than based on a rational assessment of their needs. If the federal government adopts the Massachusetts system on a national scale, it would merely multiply those problems fifty-fold.

Dr Paul Hsieh
Co-founder Freedom and Individual Rights in Medicine
Sedalia, Colorado

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