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America doesn't need a 'health care czar'

By: Paul Hsieh, MD, OpEd Contributor
-
February 23, 2009

KEY DATA: Free market health reforms could reduce health insurance costs by over 50%.

TAKE HOME: President Barack Obama's plans for a "health czar" would represent an unprecedented and dangerous intrusion of government into the practice of American medicine.

Former senator Tom Daschle's withdrawal as President Barack Obama’s nominee for Secretary of Health and Human Services has left the White House administration scrambling to find a new "health czar" to implement their goal of government-run "universal health care."

But while the primary focus had been on Daschle's tax problems, Americans should also ask a more fundamental question: Why do we need a health czar in the first place?

The concept of a health czar follows naturally from the welfare statists' premise that government should guarantee health care to all Americans. Whenever the government attempts to guarantee universal medical care, it must also control its costs. Hence, someone must determine how health care dollars may be spent.

The Obama administration would control costs by creating a new Federal Coordinating Council for Comparative Effectiveness Research to determine which treatments are deemed most effective and thus eligible to be paid for by government. These decisions would be based on statistical averages that cannot take into account specific facts of individual patients.

Yet good physicians must consider precisely these specifics when treating their patients. If you are suffering from abdominal pain due to gallstones, who should decide whether medication or surgery would be more effective for you?

The doctor who has felt your abdomen, listened to your heartbeat, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?

Whenever the government controls the medical purse strings, it will inevitably dictate who receives what health care and when. He who pays the piper calls the tune.  A Canadian woman who feels a lump in her breast might wait months until the government approves her surgery and chemotherapy. In contrast, an American woman can receive the necessary treatment in days.

The fundamental problem with universal health care is the faulty premise that health care is a right. Health care is a need, not a right. Rights are freedoms of action (such as the right to free speech), not automatic claims on goods or services that must be produced by others.

There is no such thing as a right to a house,  or a tonsillectomy. Nor does calling it a right make it so. In socialized medical systems, health care is never truly a right, but just another privilege dispensed at the discretion of bureaucrats.

Patients do have the right to seek health care from doctors on terms they find mutually acceptable. Hence, instead of universal health care, we need free-market reforms that repeal prior government controls, lower costs and allow patients to exercise that right.

Patients should be allowed to purchase insurance across state lines and use Health Savings Accounts for routine expenses. Insurers should be allowed to sell inexpensive, catastrophic-only policies to cover rare but expensive events.

States should repeal laws that force insurers to offer (and patients to purchase) unwanted mandatory benefits such as in vitro fertilization coverage. Such reforms could reduce insurance costs over 50% -- making insurance available to millions who cannot currently afford it, while respecting individual rights.

Americans are not serfs in need of a czar. If we value our lives and our health, we should reject both the idea of a health czar and universal health care.

Paul Hsieh, MD, is co-founder of Freedom and Individual Rights in Medicine (FIRM) at http://www.westandfirm.org.



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Reader Comments

All comments on this page are subject to our Terms of Use and do not necessarily reflect the views of the Examiner or its staff. Comment box is limited to 250 words.

brian0918

Feb 23, 2009

Dr. Hsieh, Excellent piece! The inevitable result of universal healthcare is the inversion of the patient-doctor relationship. The patient's and doctor's interests, rather than being complementary, are pitted against eachother, with one side vying for the most effective treatment, and the other for political appeasement. The longer such a system is maintained, the more detrimental to that relationship. Your quip about how bureaucrats get their jobs reminds me of a great quote from industrialist J. J. Hill: "It really seems hard, when we look back at what we have done, and how we have led all western companies in opening the country... that we should be compelled to fight for our lives against political adventurers who have never done anything but pose and draw a salary."

 

LarryB

Feb 23, 2009

An excellent argument! And may I add, what are we doing with "czars" in America anyway?

 

Amit Ghate

Feb 23, 2009

Thank you for publishing this excellent editorial! And I agree with LarryB, American's acceptance of Czar's who will think for us and tell us what supposedly is in our interest is an ominous step down the road to totalitarianism.

 

Raman Gupta

Feb 23, 2009

Dr. Hsieh, thank you for another excellent op-ed that elucidates the principles behind the health care debate, for the few people who still care about such things. To those people, I would also recommend another excellent article by the author and by Lin Zinser, both of FIRM that expands on the concepts mentioned here: http://www.theobjectivestandard.com/issues/2007-winter/moral-vs-universal-health-care.asp

 

James PIotrowski, PA-C,MS

Feb 23, 2009

A very clear and to the point article. Its funny that the members of Congress clammoring for national health care, will exempt themselves form it's coverage. leaving as you say only the serfs to depend on the hand out. Market reforms can work. I tell my patients if you like government housing you'll love government health care.

 

Roxanne Albertoli

Feb 23, 2009

I have a right to be left alone, to work with the doctor I choose, to pay the doctor when and if I'm happy with his or her work. I have a right to my life. Does that mean anything if the government can take my money for health care, then deny me access to the health care I want??!! I agree 100% with Dr.Hsieh: I am NOT a serf!

 

Seerak

Feb 23, 2009

Yeah, those "czars" worked out really well for the Russians. Am I the only one who has noticed that the intellectual heirs of those who deposed the czars there, are the ones seeking to install them here?

 

Grant

Feb 23, 2009

I see many knowledgeable people in here. I didn't want to believe that people are so shallow to believe in fairy tails about bad social health care, but here we are. Haw many of you people have experienced the benefits of the socialized health care? That's what I thought! Comment on something that you defenetly know. The fact is that americans gave the begining of so-called "Medical Tourism." Let me ask you all something, would medical tourism exist if the health care in the U.S. was so great?

 

Mike Zemack

Feb 23, 2009

Just the fact that the idea of an American czar has become acceptable enough to the American people that a president can unabashedly “appoint” one (or more) is an indication of how ignorant most Americans are about the nature of rights. That ignorance is paving the way for tyranny, as too many people are willing to give up their rights for a free tonsillectomy. Ronald Reagan once said, “"Freedom is never more than one generation away from extinction." Dr. Hsieh and others who understand and are willing to speak out in defense of the true meaning of the principle of individual rights indicates that the end of freedom in America is not a foregone conclusion. But we are well along that generation path, and our time to turn the country around is growing short.

 

Mike Zemack

Feb 23, 2009

Just the fact that the idea of an American czar has become acceptable enough to the American people that a president can unabashedly “appoint” one (or more) is an indication of how ignorant most Americans are about the nature of rights. That ignorance is paving the way for tyranny, as too many people are willing to give up their rights for a free tonsillectomy. Ronald Reagan once said, “"Freedom is never more than one generation away from extinction." Dr. Hsieh and others who understand and are willing to speak out in defense of the true meaning of the principle of individual rights indicates that the end of freedom in America is not a foregone conclusion. But we are well along that generation path, and our time to turn the country around is growing short.

 

Jan Bridger

Feb 24, 2009

Replying to GRANT: I have had socialized medicine in several countries around the world, including in Europe. I want my health care in the U.S.-- and in Colorado, where Paul Hsieh resides, because medicine is less socialized, less expensive and there's less waiting than abroad or in California, New York, Connecticut, Michigan, etc.

 

Pierre

Feb 24, 2009

1. Reform Tort Law 2. Regulate and liberate the insurance industry: When the customer (patient) does not care what the treatement costs (they are just paying the insurance premiums), then costs skyrocket - same as in gvmt/military contracting

 

Michael Garrett, M.D.

Feb 24, 2009

Dr Hsieh is correct in his analysis. Health care is a need, not a "right." And attempting to provide it for everyone at taxpayer expense will necessitate "czars" to decide what is "medically necessary." This is how health care is rationed in socialist systems.

 

Kaktuss

Feb 24, 2009

Grant: I was a "beneficiary" of socialized medicine for most of my life, and my advice is: do not try it at home! Do you want to spend the entire post-surgery period in a hallway with nurses nowhere to be seen? Do you want to watch your grandmother die in ward where stench alone can make a healthy person sick - and be unable to do anything about it? I thought so!

 

Scott

Feb 24, 2009

Excellent article Dr. Hsieh. I am also a physician and you have put into words my exact thoughts on this issue. Perhaps Washington would benefit from the opinions of someone such as yourself rather than a 'suit' who has no or little knowledge of how health care in this country actually works on a day to day basis.

 

Grant

Feb 24, 2009

"Kaktuss," I don't have idea in what country that happened, but if you all like your health system the way it is, so be it. I just don't like the way here all paeople are brainwashed and when they hear about socialized health care they think about socialism and even worst things. It is rediculous how everyone is against everything socialized, but if you all just once open your eyes you will see that most of the services here in the United States are socialized. Services like Police, Fire departments, United Postal Ofice, even the banks became socialized. The last one even helped to save your banks, so tell me what's your opinion next time when you are rejected to have a lifesaving surgery only because you have a HMO.

 

Betty

Feb 24, 2009

Grant, I think you are the one confused. In the States we have the right to be treated by any doctor we want -- as long as you pay for it. We may have insurance or not, and that may be a factor -- but we are not denied care. The idividual determines the value of the service -- the State doesn't determine the value of the individual. In socialize medicine, the state, not the patient determines care --- you don't get eye surgery until you have gone blind and such things. Socialized medicine is all about money and has nothing to do with care. You can't go outside the system for the care you desire -- the State makes the decisions for you. Freedom is more valuable than money -- many things are more valuable than money --- including health. Anyone who thinks that healthcare will be free in a socialized situation is an idiot -- it will cost you very dearly.

 

Grant

Feb 24, 2009

"Betty," live in peace. You have rights to believe in whatever you want. I just wish that people would stop pretending and do something for themselves finaly, but if this is what you want that's ok with me. Once again; peace.

 

jon@blaze.com

Feb 25, 2009

Paul Hsieh is deeply misguided. Our medical system is corrupt to the very core, and it's about time for some proper oversight. Of course doctors don't want oversight. They want to be able to keep financially raping patients in order to preserve their over-inflated salaries. The greed of doctors has manifested into the American Medical Association, whose sole purpose is to inflate doctor salaries at the expense of the health of everyday citizens. The AMA falsely predicted an oversupply of doctors in 1994. (http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm). The purpose of this was to constrain the supply of doctors. Simple economics says that the less doctors there are, the more they can charge for their services. And this is exactly what happened. The sad fact is that doctors are too driven by greed, and are thus cannot be trusted to regulate themselves. Thus we need someone to step in and keep an eye on them.

 

JG

Feb 25, 2009

jon@blaze.com, who will regulate your prescribed regulators?

 

jon@blaze.com

Feb 25, 2009

JG: A man I know named Barack Hussein Obama. I'm sure he's sick of seeing doctors bankrupt the sick and injured just so they can buy another Hummer or put a down payment on their new vacation home. There will be a day of reckoning as the masses fight back against those who have held health care hostage for so long. What incentive do doctors have to lower health care costs? Their aim is to keep it as high as possible, so more of the pie comes their way. They cannot be trusted. Thank god for lawyers, the only real police that we have on the corrupt and greedy medical profession.

 

Ianno

Feb 25, 2009

@Paul Hsieh, MD, OpEd Contributor. Go and see how healthcare is organised in the Netherlans and be amazed how efficient it is organised for every man, woman and child. I hope that you know were the Netherlands is.

 

JG

Feb 25, 2009

jon@blaze.com: "JG: A man I know named Barack Hussein Obama" You are free to give up your life and life's decisions to whosoever you choose -I will not interfere. I have, however, not given permission of any such kind to anyone to make those decisions for my life! The battle in fundamental terms is between those who take responsiblity for their own lives and those who want to find paternal dictators to take care of them, while destroying those very self-sustaining people they need to help sustain their lives and those of their dictators. Think about it!!

 

sick

Feb 25, 2009

the american people and doctors are currently serfs to "mismanaged" health care companies who are for profit middle men, provide nothing to the american people, and dictate to physicians and patients what they can and cannot do based not on good medicine but on increasing there profit margins. Approximately half of the money given to insurance companies is not used for health care! True health care reform is eliminating third party for profit management and moving the medical malpractice circus out of the hands of parisitic lawyers to a arbertration system which is fair and objective. The country would save billions without spending a penny.

 

Mike Zemack

Feb 25, 2009

A key fact that needs to be grasped here is that the current semi-socialized, semi-private American healthcare system is one that has been crippled by massive government interference and rights violations. The third-party-payer system, government imposed insurance mandates, EMTALA, government “insurance” programs like Medicare, Medicaid, and SCHIP that undermine the private insurance market, the medical malpractice crisis, and other government intrusions makes our current system anything but a fair alternative to “universal healthcare”. The current system is unsustainable. An honest appraisal of the choice between government control and a free market first requires an understanding of a free market, which is a system based upon the recognition of individual rights. Then one must grasp the crucial point that the choice we face is NOT between government-run healthcare and the current convoluted contraption, but between government-run healthcare and a free market.

 

Mike Zemack

Feb 25, 2009

A key fact that needs to be grasped here is that the current semi-socialized, semi-private American healthcare system is one that has been crippled by massive government interference and rights violations. The third-party-payer system, government imposed insurance mandates, EMTALA, government “insurance” programs like Medicare, Medicaid, and SCHIP that undermine the private insurance market, the medical malpractice crisis, and other government intrusions makes our current system anything but a fair alternative to “universal healthcare”. The current system is unsustainable. An honest appraisal of the choice between government control and a free market first requires an understanding of a free market, which is a system based upon the recognition of individual rights. Then one must grasp the crucial point that the choice we face is NOT between government-run healthcare and the current convoluted contraption, but between government-run healthcare and a free market.

 

Libertarian42

Feb 26, 2009

This is pretty simple. Socialized medicine violates the Constitution's 4th amendment (secure in your person), 5th amendment (cannot be deprived of LIFE, liberty or property), the 9th amendment (rights not listed in the Constitution are not automatically lost) and the 10th amendment (any power not granted to the government is left to the states and people). The Constitution is clear. Universal health care is unconstitutional. It is morally wrong and unlawful. If someone wants to hand over their life to a politician, fine, but you sure as hell better not take my rights away while you give yours away.

 

isaiah a share, md

Mar 1, 2009

The probably ccorrect idea that healthcare is not a "right" in a political sense is forcing me to rethink the issues involved. But why can't there be a more efficient "single payor" system than the current wasteful hodgepodge of profit driven companies. Why not a model that is like how the public utilities were formerly structured, with govcernment set limits on the profits generated and on the levels paid for administration? The agency involved could, by law, abe only a moneyu payoing machine, with proscribed proihibitions re it being able to influence policy-or is this imposible because someone else in the government would inevitably get in on the act?

 

Dennis Mingus

Mar 2, 2009

Did we lose the cold war? Look how things have changed in America, since the fall of the Soviet Union.

 

Rich

Mar 7, 2009

I like your notion that health care is a need, not a right. Rights should not require the goods or services of others; it should be part of the definition. I should point out that the reason certain benefits are "mandated" in current insurance policies is in order to amortize their costs over a wider base; otherwise, policies that contain these benefits would not be affordable to anyone (ie, IVF). There may be a solution to this problem outside the standard policy, but that is outside my understanding of insurance underwriting.

 

Mar 7, 2009

By Dr. Hsieh's arguments police protection, fire protection and even free speech are "needs" and not rights. Even speech requires access to media services. It is not just about mumbling whatever you want in the shower or closet. All require services and in a complex society where we no longer own or live off the land every right requires the services of another. We have accepted that for most issues. Why are we so antidiluvian about health care? In fact even there, today the insurance bureaucrat, not the doctor, decides what is best medicine. I'm guessing and would prefer to rely on an argument between a doctor and a bureaucrat neither of whom have vested economic interests than between a doctor and an insurance agent who sometimes "bribes" the doctor to cut costs.

 


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