Dear Anna Eshoo,
Thank you for sending me your latest update on health care reform. You seem to sincerely believe that the current proposals before Congress will improve access to medical care, but I must register my strongest disagreement. The following is in response to just one of the bullet points you included in your latest communication.
You write that the bill will create “a new Health Insurance Exchange, a one-stop comparison shopping marketplace1, including a public option to compete2 with private insurers to help lower costs3 and improve coverage4.”
1. A government-mandated Health Insurance Exchange is not a “market place” but a state-run insurance cartel. A market consists of the exchange of value for value. Governments produce no values. When government becomes involved in economic exchanges, it can only do so by transferring wealth—wealth it must first obtain from those who produce it. A system of wealth transfer is not a market but a Welfare Program. Voluntary welfare programs are called charity and can be accomplished while preserving the sanctity of individual rights. Wealth transfers by the state are achieved only by violating the liberty and property of some for the welfare of others—thus turning the state into a violator of the very rights it was created to protect.
2. Government cannot be a market competitor. Market interactions are voluntary; government interactions are not. Governments legislate, mandate, regulate, tax, and subsidize—of which entail the use of force. The essence of a market is free and voluntary exchange. To the extent that government controls a segment of the economy, it is a creature not of the market but of the state—which means a creature of coercion.
Additionally, fair competition requires a level playing field, and a single set of identical rules for all competitors. But a “competitor” that can draw upon the infinite resources of the US national debt to subsidize itself and its “customers,” and at the same time has the power to tax, regulate and otherwise and hobble its “competition” is not competing, but is in fact running the show under the guise of competition. In sports, it’s called cheating. In business, as in government, it’s called extortion or fraud.
3. Under government-run programs, “costs” cannot be lowered—merely shifted from one set of individuals to another set of individuals. Costs are not lowered by changing who pays the bill. Costs of producing goods and services also do not change simply because the government mandates a specific legal price. Costs, and free market prices, are a function of the supply of and demand for scarce resources with alternative uses. Free market competition, including the inappropriately maligned profit motive, is the only mechanism by which scarce resources can flow to the most efficient providers of the goods and services in greatest demand. All government contributes to this process is to forcefully interject the political goals of some onto others who, if left to their own judgment, would have chosen differently.
4. A public option can only “improve coverage” for some at the expense of others, and even then, only for the short term. A system which disconnects consumption from payment can only drive demand higher, putting greater and greater pressure on limited supplies, leading either to sky-rocketing prices or government rationing. Under the current proposals, today’s uninsured or under-insured will only gain “coverage” through forced mandate or government largess. Private insurance option will be limited to government-approved plans—further increasing costs and deceasing choice, until affordable only by the very rich.
Ms. Eshoo, it is indeed troubling that medical care is not affordable for a sizable portion of our population. However, contrary to the proposals you support, I believe that the solution lies with less government, more freedom and real market competition. Regulations which prevent competition across state lines should be abolished. All insurance premiums should be treated equally by tax law. Insurance companies should be free to offer whatever policies people are willing to purchase, and then held strictly to their promises through contract enforcement. Licensing laws for practitioners and medical supplies (drugs, devices, etc.) should be drastically liberalized—if not eliminated-- allowing people to purchase the goods and services they can afford. Fraud, breach of contract and malpractice should be the standards for legal action.
You have dedicated decades of effort to increasing accessibility to medical care. I hope your devotion to this laudable goal can motivate you to reexamine your basic assumptions, and to consider solutions which will both provide increasingly affordable medical care while at the same time will protect and preserve our inalienable rights to life, liberty and property. A program that violates individual rights is neither compassionate, nor sustainable.
Beth Haynes MD