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Could non-profit co-ops and “mutual aid societies” help make basic health care available for all?

in Ask Dr. Ruwart, Economic Liberty, Healthcare, Liberator Online by Mary Ruwart Comments are off

Could non-profit co-ops and “mutual aid societies” help make basic health care available for all?

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

Question:

I think part of the problem with today’s health care system is the over-reliance on insurance companies. They are (rightfully) in the business of making money, and as a result they keep raising premiums.

care

What about the idea of competing with them by fostering the creation of non-profit insurance and/or medical co-ops? In a co-op, any profits would stay in the co-op to offset the additional cost of helping those currently lacking basic care.

Answer:

You’ve pretty much described the “mutual aid societies” that once protected Americans against medical disasters — before government regulated them out of business for the benefit of the doctors and insurance companies.

David Beito’s wonderful book From Mutual Aid to the Welfare State describes them in detail.

The AMA condemned doctors that worked for a flat fee for these societies. Since the AMA controlled the licensing boards, physicians didn’t want to incur their wrath.

Even though the mutual aid societies served their members well during the Depression, insurance companies successfully lobbied for regulations requiring that mutual aid societies have large amounts of financial reserves on hand.

Thus, these effective co-op-like groups were essentially regulated out of business, putting us at the mercy of the often less efficient and less compassionate insurance companies.

The free market and human ingenuity creates amazing protection for us, but government intervention destroys it!

After Obamacare, Let’s Repeal All Government Involvement In Health Care

in Economic Liberty, Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

After Obamacare, Let’s Repeal All Government Involvement In Health Care

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

Everyone is talking about health care.

If you consider yourself a conservative, you might have felt a spark of excitement when Congress motioned to repeal the Affordable Care Act, or Obamacare, only to be let down once you learned lawmakers fell short of putting an end to President Barack Obama’s signature law.

obamacare

But to those who are serious about free market principles, the entire debate revolving around the end of of ACA is somewhat frustrating. That’s why health care in the United States hasn’t been good for decades, and Obamacare just made it a tad worse.

By the mid-1960s, the United States started to experience what heavy-handed intervention in the market does to supply and demand of services, and how it inflates the costs of such services.

With the passage of Medicare and Medicaid and new regulations that artificially trimmed the supply of doctors and hospitals, Americans noticed an increase in health care prices that, according to Mike Holly, “responded at twice the rate of inflation.”

Over time, medical special interests continued to lobby government for more regulations, further restricting competition and making it harder for members of the medical profession to make their services available at a lower cost.

With government’s involvement, demand for medical services increased thanks to subsidies, but with the restrictive regulatory monster only growing stronger with each passing decade, the supply of physicians, clinics, hospitals, and pharmaceuticals was further restricted.

As consumers began reporting hardships having access to care thanks to government’s overbearing involvement, government decided to act once again, targeting high costs by “partnering,” once again, with well-connected service providers and offering even more subsidies.

ACA, or Obamacare, is what happens when government tries to fix the problem by repeating its past mistakes.

With the passage of Obama’s signature health care law, the government ramped up subsidies, causing demand to continue to grow artificially while the supply was reduced thanks to the greater number of restrictions imposed on the market. As a result, powerful health care industry leaders grew into more powerful monopolies while entrepreneurs and independent physicians and clinics became overwhelmed and were forced to succumb to the system or get out of it completely.

So when Congress talks about repealing Obamacare as the only measure necessary to put an end to the incredibly maddening situation we find ourselves in today, don’t believe them.

For America to have a true free market system that will guarantee lower prices and increased supply of health care services to everyone, we must look beyond Obamacare. Or, as Mises Institute’s Ryan McMaken put it, we must “focus on repealing and undermining the edifice on which Obamacare was built: the highly regulated, subsidized, and manipulated healthcare markets that dominate today.”

Is Congress listening?

GOP Will Fail To Bring ACA Down Because Lawmakers Don’t Understand Economics

in Economic Liberty, Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

GOP Will Fail To Bring ACA Down Because Lawmakers Don’t Understand Economics

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

The Affordable Care Act, also known as Obamacare, has been slowly falling apart from day one. With President Donald Trump promising to repeal and replace the health care legislation once in office, he pressed both the House and Senate to pass legislation that “fixed” what was wrong with President Barack Obama’s signature legislation. But perhaps, that’s the problem: The idea that a piece of law can be fixed simply by passing more legislation addressing the same issues is nothing but a sham.

GOP

Access to health care can only be expanded, helping those among us with the most meager of means to be able to obtain the care they require, once all laws regulating health care and insurance are abolished, not reformed. Unfortunately, neither the Senate nor the House GOP’s health care bill goes as far as necessary to allow the health care market to heal completely from the failures brought about heavy-handed government intervention.

According to Senior Research Fellow and health care scholar at the Mercatus Center Robert Graboyes, the latest version of the GOP’s health care bill does nothing to “repeal and replace” Obamacare. As a matter of fact, he writes on Real Clear Health, the bill simply alters the law. Calling the changes proposed by the bill “arcane,” Graboyes says neither of the GOP’s last attempts at tackling Obamacare dismantle the law’s structure. Instead, he explains, the only thing both the Senate and the House versions of health care reform are able to eliminate is the individual mandate, lifting requirements that force all Americans to obtain health insurance or else pay a penalty to the Internal Revenue Service (IRS).

Still, the Senate version of health care reform legislation is just as dependent on government spending as Obamacare, ignoring that access to care will only be widened once the private sector isn’t restricted by regulations brought about the very marriage of Washington, D.C., politics and health industry heavyweights.

Instead of trying to tackle the health care problems that were provoked by health legislation in the first place with more laws, it’s time lawmakers recognize that the only way people will obtain better and more affordable care is by allowing the market to heal. And for that to happen, legislators must get out of the way completely, letting the private sector come up with the answers.

As Ron Johnson writes for the New York Times, the private sector relies on root-cause analysis to pursue improvement and offer better solutions to consumers without losing sight of the “KISS” principle (“keep it simple, stupid”). Without getting out of the way, health care providers will not be able to adapt and patients will continue to suffer to obtain basic care amidst health insurance skyrocketing premiums. Is that what we want?

ACA’s Medicaid Expansion: Not Good for Your Health

in Economic Liberty, Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

ACA’s Medicaid Expansion: Not Good for Your Health

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

In 2010, just a few weeks before Congress passed the Affordable Care Act, President Barack Obama said that taxpayers “end up subsidizing the uninsured when they’re forced to go to the emergency room for care…. You can’t get … savings if those people are still going to the emergency room.”

healthcarePart of what the current administration’s signature health law was supposed to do was to increase cost savings so visits to the ER weren’t as common. After helping to pass the law, then-Speaker of the House of Representatives Nancy Pelosi claimed that “the uninsured will get coverage [so they are] no longer [being] left to the emergency room for medical care.”

Six years have passed since those who supported ACA and its main provisions promised to bring the number of ER visits down and yet, a study published in the New England Journal of Medicine shows that assuming ACA would lower the number of ER visits was a mistake.

With the expansion of Medicaid in states like Oregon, ER visits increased. But the increase is not the only consequence of Medicaid expansion. When compared to 2015, this year’s Medicaid expansion spending is 49 percent higher per enrollee than what government had expected.

In order to expand Medicaid in Oregon, officials used lottery to expand Medicaid benefits to a limited number of lower income, non-disabled adults.

According to the study’s authors, “Medicaid’s value to recipients is lower than the government’s costs of the program, and usually substantially below,” perhaps because, researchers found, expanded Medicaid coverage “resulted in significantly more outpatient visits, hospitalizations, prescription medications, and emergency department visits.”

When it comes to how Medicaid expansion pushed individuals to the ER, researchers explain that, during the past 15 months, Medicaid increased ER visits by 40 percent.

Researchers found that even if patients have Medicaid, there’s “no evidence that Medicaid coverage makes use of the physician’s office and use of ERs substitutes for one another.”

What many choose to forget is that Medicaid expansion was made possible because of ACA. And according to the government’s own projections, each Medicaid enrollee cost the taxpayer roughly $6.366 in 2015, 49 percent higher than past predictions. This cost spike is mostly due to the fact the federal government reimburses 100 percent of state spending on enrollees who were added after the expansion was launched.

When ACA became law, states were given enough incentives to pay insurance companies high payment rates so new enrollees were cared for, but the high payment rates could only be covered by the federal taxpayer. Since many physicians are leaving the system altogether, preferring to not accept new Medicaid enrollees due to lower rates, patients continued to use ER at a high rate, even higher than years past. So coverage, in this case specifically, did nothing to help patients in need. The result is higher cost to the taxpayer. Instead of making people healthier and helping individuals who are unable to afford medical care, researchers found that the result has been the exact opposite, invalidating ACA apologists.

Will they continue to ignore these results?

What are rights?

in Conversations With My Boys, Liberator Online by The Libertarian Homeschooler Comments are off

What are rights?

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

Editor’s Note: This was written to introduce the idea of rights to the Young Statesman.

What are rights? There are two types or rights: Negative rights and positive rights. If you’ve ever heard the Ten Commandments, you’re familiar with Negative Rights. Thou shalt not…. Negative rights make you refrain from encroaching on the person or property of another.

RightsThou shalt not kill. Thou shalt not steal. Or as Libertarians like to say: Do not encroach upon the person or property of another. Simple, no? These rights don’t require you to Do anything. Only to refrain. A negative right essentially protects you from the encroachment of another person, a group, and the State. The negative right tells you that you can expect not to be subject to violence or coercion.

Negative rights are based on the idea of ownership. You own yourself and you own your property. No one has the right to infringe upon your life or your liberty or your property because they properly belong to you. For a negative right to be violated, one person, group, or State must encroach upon another. (Thou shalt not kill apparently doesn’t apply to tornadoes or earthquakes so if you’re killed by a tornado we don’t say that your rights have been violated.)

If you’ve ever heard someone argue that all people have the right to healthcare, education, food, shelter, or clothing they were making an argument for Positive rights. Positive rights make everyone responsible for providing one another with goods, services, and resources. Positive rights negate the principle of ownership. Every single argument for Positive rights without exception, no matter how kindly intended or reasonable, is an attack on self ownership and property.

Positive rights are based on the principle that we do Not own ourselves nor do we own our property. Therefore access to the property and person of another without their consent–theft and servitude–is fair and reasonable.

Positive rights require that you Do something. This is a violation of the principle of self-ownership. If I own myself, I am not required to Do anything at the behest of another. A Positive right guarantees the encroachment of another person, a group, and the State against your person and property. You will be subject to violence and coercion if you violate the right of another to your labor and property.

Constitutionally, the preservation of Negative rights is the purview of the State. Negative rights are ancient and history has shown that despots violate them first by claiming the ‘general welfare’ or ‘common good’ is being served and after establishing that the people will tolerate their breach they will do away with them in all but name.

Nurse Practitioners Want to Help Patients, but Stifling Rules Stand in the Way

in Economic Liberty, Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

Nurse Practitioners Want to Help Patients, but Stifling Rules Stand in the Way

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

The fight to serve Americans freely, offering low income patients the option of having access to affordable care, has been an important battle for nurses in certain states.

According to Watchdog.org, nurse practitioners in Pennsylvania are beginning to question the straining and oftentimes useless requirements they must meet in order to help their patients.

MedicIn many states, nurses with advanced degrees and special certifications are allowed to perform several functions primarily performed by physicians. While giving these nurse practitioners the freedom to help patients without access to expensive health insurance is important, many states limit their effectiveness by forcing nurses to seek the approval from doctors before being able to help patients in need.

To the thousands of patients who benefit from having access to nurse practitioners, the process may seem confusing. But they are not alone, healthcare providers also share their frustration.

To nurse Jerry Driscoll, a nurse practitioner running Primary Homecare, doctors “are signing paperwork on patients they’ve never seen,” making their job extremely difficult. After all, nurses like Driscoll “can order their insulin, but not their shoes” he said.

In an interview with Watchdog.org, Driscoll explained that issuing prescriptions or even ordering medical devices such a simple walker or orthopedic shoes is impossible for nurse practitioners in Pennsylvania, forcing organizations such as Primary Homecare to spend thousands of dollars yearly to maintain collaborative agreements with local physicians.

If Primary Homecare didn’t have to spend $25,000 a year due to the state’s laws, Driscoll explained, he would be able to give his patients much better care. Some of the pieces of equipment Driscoll’s company would be able to afford if laws were different include mobile imaging equipment and other technologies used for blood tests. On top of that, not having to spend so much on agreements with physicians could also lower the cost of care to patients, making access to direct healthcare much more affordable.

Last year, lawmakers in the state sought to put an end to this problem by introducing legislation that would have ended the mandatory collaborative agreements between physicians and nurse practitioners.

While the last attempt had failed in the previous session, the bills introduced in the State House and Senate last year are currently languishing in legislative committees. If at least one passes, Pennsylvania would be the 22nd state to allow “full practice” models, giving nurse practitioners the freedom to practice more broadly but still within the scope of their training.

But before nurses are able to obtain the freedom they require to better care for their patients, they must fight the crony capitalists at the Pennsylvania Medical Society, who are opposing the bills currently under review.

According to the medical association, physician oversight of nurse practitioners is essential. The idea that the arrangement between physicians and nurse practitioners is just a formality is far from the truth, said Karen Rizzo, the president of the Pennsylvania Medical Society.

But according to recent studies, the notion that patients get better care from nurse practitioners in contact with physicians is nothing but a myth.

Nurse practitioners, the five studies conclude, improve patient outcomes while also reducing healthcare costs by as much as 29 percent. One of the studies has also suggested that patients who have access to nurse practitioners have lower hospital admission rates.

As Pennsylvania struggles with 155 areas in which patients have little to no access to adequate health care, loosening nurse practitioner’s requirements could help to give more patients access to quality care at a lower price.

What are lawmakers waiting for?​

State of The Union Address: What this Administration Got Wrong About Obamacare

in Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

State of The Union Address: What this Administration Got Wrong About Obamacare

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

During President Barack Obama’s final State of the Union address, this administration’s signature healthcare law was seldom brought up. As a matter of fact, little time was dedicated to healthcare overall. But the few references to the Affordable Care Act (ACA) have been mostly ignored, suggesting that little to no attention is dedicated to healthcare law as the media focuses on the 2016 presidential election.

But to Brian Blase, Senior Research Fellow with the Spending and Budget Initiative at the Mercatus Center at George Mason University, the administration’s claims deserve a second look.

In an article for Forbes, Blase looks at how the current programs are performing. With the hopes of helping Americans have a better understanding of ACA and its consequences, the scholar analyses the administration’s claims and reports on his findings.

cooperative

According to the current administration, ACA was designed to fill “the gaps in employer-based care so that when you lose a job, or you go back to school, or you strike out and launch that new business, you’ll still have coverage.” To Blase, however, things aren’t that simple.

If the administration had made the portability of coverage a main priority, the law would not have to be as complex as it is.

Blase also argues that portability as a main goal would have prompted a piece of legislation that would have attracted considerable bipartisan support. Why? Because most healthcare experts on the right and center have always advocated for increased portability, urging lawmakers to severe the ties between insurance and employment.

To Blase, the primary purpose of ACA couldn’t be to keep Americans covered through the several changes they experience if the law standardizes health insurance and ups the requirements concerning coverage levels. By implementing a complicated tax and subsidy system to support ACA, the Obama administration forced consumers to fall prey to distorting price controls that make insurance coverage actually less affordable.

If the administration’s main goal with ACA was to keep people covered no matter what, the law wouldn’t also have been written in a way that increases gross premiums so radically, making low-income earners less likely to get good coverage.

While Blase spent a good deal of time focusing on this particular claim, another subject also caught his eye.

During the address, president Obama claimed that ACA has helped businesses to create jobs, not eliminate them. To Blase, this particular claim is troubling mostly because it’s not necessarily wrong. It’s misleading instead.

Claiming jobs were created because of the enaction of ACA is not a fact, since job growth naturally increased after the deep economic recession the country had just been recovering from when ACA became the law of the land. During the recession, millions of people were kicked out of their jobs, but as confidence grew, more jobs were inevitably created. That’s just a natural consequence of the labor market dynamics and is not at all connected to the enactment of ACA.

If the current administration is, indeed, concerned with how its healthcare programs are performing, Blase suggests, its review of ACA would lead to its repeal. Why? Because ACA is actually a negative pull on the economy.

According to the Congressional Budget Office, ACA will actually shrink the labor market in America. If the congressional projection is correct, two million full-time jobs will be lost due to ACA alone.

Increasing Costs Tied to Obamacare Make Healthcare Ministries More Appealing Than Insurance Providers

in Economic Liberty, Healthcare, Liberator Online, News You Can Use by Alice Salles Comments are off

Increasing Costs Tied to Obamacare Make Healthcare Ministries More Appealing Than Insurance Providers

This article was featured in our weekly newsletter, the Liberator Online. To receive it in your inbox, sign up here.

As the country is distracted by the presidential election, issues that aren’t getting as much air time as Donald Trump or Hillary Clinton become a side show.

With reports concerning the ineffectiveness of the Affordable Care Act, or Obamacare, hitting the news but being ignored by major news channels, crusaders take it to the Internet to discredit Obamacare critics. As new reports argue that Americans are fed up, smaller publications seek to downplay some of the fears brought up by conservatives and libertarians all along. When faced with evidence that shows ACA is making healthcare less affordable, will these pro-Obamacare crusaders back down?

Health Care

Exactly two days before Christmas, the New York Magazine ran an article tailored to take conservative-leaning Americans to task. The subject? One of the left’s most adored achievements (and one of the right’s biggest, and most disputed, creations): Obamacare.

According to Jonathan Chait, the author, the NY Mag piece was conceived in order to debunk arguments presented by Ross Douthat, who wrote a column on Obamacare for New York Times earlier that same week.

While the piece discusses the number of covered Americans before and after the enactment of Obamacare and other points made by Douthat, it’s when Chait focuses on the cost of healthcare before and after the enactment of ACA that things get interesting.

In the NY Mag piece, Chait introduces a seemingly detailed blueprint of how ACA has bent the overall healthcare cost to the average consumer. Yet he ignores actual evidence proving that no, Obamacare hasn’t helped to keep the cost of healthcare low. As a matter of fact, the constant meddling with the insurance business and the healthcare industry in the past has done nothing but to increase the overall cost of health care. Now, those who lost their previous plans and who are unable to sign up for insurance after Obamacare went into full force are being cornered. As a result, they are choosing to pay the IRS fee instead of getting coverage.

Even those who supported President Barack Obama’s signature law are getting desperate.

But as a number of consumers lose their hope, a report recently published by the Wall Street Journal shows that things might have just gotten worse.

According to the WSJ, the cost of health insurance is such a heavy burden for those who lost their insurance plans after ACA became the law of the land that many consumers are now turning to healthcare ministries to cover their medical expenses.

That’s right. Health insurance costs are so out of control that consumers are turning to ministries, which operate outside the insurance system, in order to get access to the health care they need.

Instead of functioning as an insurance provider, these ministries provide health care cost-sharing arrangements to those who share the same religious beliefs.

Ministries now count with about 500,000 members nationwide thanks to ACA. Previous to the law, there were about 200,000 members enrolled in the system. But things could get crowded soon, making it hard for ministries to take in more members.

While ACA gives these ministries an exception to the law, only groups that have operated continuously since at least December 31, 1999 are eligible. Without the possibility of expanding the number of participating ministries, helping those in need could become too heavy of a burden.

When the exception was added to the law, it hoped to satisfy a relatively small number of groups that argued that nonparticipation was a matter of religious freedom. Now, ministries are being sought after as a matter of survival. And as ministries become crowded, insurance commissioners begin to complain, claiming these groups operating outside ACA are hurting consumers.

But with ministries costing about 30 percent less than private insurance, consumers who choose the more affordable path can’t be blamed for taking the easier way out.

Claiming to have the consumer’s best interest at heart, insurance commissioners from Kentucky, Washington, and Oklahoma have, in the past, decided to take action against ministries in their states. Thankfully, legislatures blocked the efforts. But as the cost of care continues to grow and the number of uninsured only shrinks because of the threat associated with non-compliance, other states may attempt to put an end to faith-based healthcare providers again, hurting thousands of consumers if they succeed.

In light of this report, will NY Mag’s Chait finally agree that Obamacare is making healthcare less affordable? Probably not. Nevertheless, ministries may have to fight yet another battle to stay open if membership growth remains steady.

They Said It… From John Stossel, Judge Napolitano And More

in Liberator Online by James W. Harris Comments are off

(From the They Said It… section in Volume 19, No. 17 of the Liberator Online. Subscribe here!)

FOX Business' John Stossel

BAN THE BANNERS: “I wonder just how many things social conservatives would outlaw if they thought the public would accept the bans. [Tony Perkins, president of the conservative Family Research Council] doesn’t approve of gambling, gay marriage, plural marriage, sex work or making a political statement by burning a flag. … Meanwhile, liberals keep adding new things to their own list of items to control: wages, hate speech, high-interest loans, plastic shopping bags, large cars, health care, e-cigarettes, Uber, AirBnB and more. One choice America needs urgently is an alternative to politicians who constantly want to ban more things.” — John Stossel, “Two Anti-Choice Parties,” syndicated column, Sept. 24, 2014.

MADISON WI POLICE CHIEF SAYS LEGALIZE MARIJUANA: 

Madison, Wisconsin Police Chief Mike Koval

“We’ve done such an abysmal job using marijuana as a centerpiece of drug enforcement, that it’s time to reorder and triage the necessities of what’s more important now. …The crusade on marijuana has been a palpable failure — an abject failure. …So let’s acknowledge the failure for what it is, and rededicate ourselves to…a better way to deal with people who have addictions.” — Madison, Wisconsin Police Chief Mike Koval, interviewed in Wisconsin State Journal, Sept. 14, 2014.

THE MILITARIZED USDA: “In May of this year, the USDA Joanna Rothkopf[U.S. Department of Agriculture] Office of the Inspector General filed a request for ‘submachine guns, .40 Cal. S&W, ambidextrous safety, semi-automatic or 2 shot burst trigger group, Tritium night sights for front and rear, rails for attachment of flashlight (front under fore grip) and scope (top rear), stock-collapsible or folding, magazine — 30 rd. capacity, sling, light weight, and oversized trigger guard for gloved operation.’” — Joanna Rothkopf, “Why is the Department of Agriculture asking for submachine guns?” Salon.com

LIBERTY VERSUS PHONY SECURITY:

Judge Andrew Napolitano

“The government can’t deliver the mail, pave potholes, balance the budget, fairly collect taxes, protect us from Ebola, even tell the truth. Who would trust it with personal freedoms?” — Judge Andrew P. Napolitano, “A Euphemism for Tyranny,” Washington Times, Oct. 14, 2014.