Posted in Access to healthcare, advance-pricing, Economic Issues, Health Insurance, Healthcare financing, Medicaid, Medical Costs, medical inflation, Medical Practice Models, Medicare, out-of-pocket costs, Patient Choice, Price Tansparency, Quality, Uncategorized

G. Keith Smith, M.D. — Health “Coverage” as a Distraction


I think it is good to be alert to any discussions that are “downstream of a flawed premise.” Let me explain.

When I hear, for instance, that the “flat tax” is preferable to the current income tax, I think to myself that this is a discussion of the knife versus the axe, a conversation far downstream of one addressing government spending or the very legitimacy of denying someone their earnings. After all, victims don’t generally care what the mugger does with their money. They just resent being mugged and no discussion about whether the mugger used a knife or a gun will likely provide any solace.

Similarly, I would argue that arguing for everyone to have health “coverage” is far downstream of the more original problem: the cost of healthcare. To provide “coverage” for everyone in the current climate of gross overcharging primarily serves the interests of those who employ the “what can I get away with” method of medical pricing.

The fierce push back against true price transparency by the cronies in the medical industry makes more sense in this context, as price honesty denies them access to everyone’s blank checkbook as the health cronies are well aware.

Supporters of government-guaranteed “coverage” object with the following arguments.

First, coverage is equated with healthcare. While millions of Canadians streaming across the border to secure their health needs could be used to refute the idea that coverage is synonymous with care, this disconnect has become more apparent in this country. Each passing day reveals Medicaid and Medicare “coverage” to be a “black mark,” an actual obstacle to obtaining care, as these government programs and their associated rationing through price controls and hassles are creating the lines the central planners intended. Physicians are either dropping out of these programs altogether or they are limiting their exposure to patients with this “coverage.”

Another objection points to the relief from financial devastation that having “coverage” represents. Keep in mind that not only are well over half of the bankruptcies in this country medically related, but almost three quarters of those filing for medical bankruptcy have insurance. This points powerfully to cost as the root cause of medical economic ills.

Acknowledging this is a slippery slope for the objector, however, for no economic system better provides for resource allocation than the market and the cronies and their government pals know this as well as anyone.

The market is the only source of price deflation with simultaneous improvement in quality. This powerful competitive mechanism has brought affordability to countless products and services in all industries and has begun to bring rationality to health care pricing as more physicians and facilities honestly post their prices for all to see.

Rather than focus on “coverage,” which allows the cronies to continue their financial feeding frenzy, we should remain unalterably focused on cost. The competition unleashed will result in a medical price deflation the likes of which will cause even the most skeptical objector to re-evaluate the role of “coverage” in the provision of payment for health care.

This is no prediction. This is exactly what is happening here in Oklahoma where so many health professionals have embraced the same market discipline every other industry must endure. The reasonable prices and high quality of care, have had such a wide appeal that Oklahoma City has evolved into a medical tourist destination for many patients far from here, while simultaneously bringing savings in the millions of dollars to those who actually pay for healthcare, locally.

This is my answer to another objection from those who claim the inapplicability of market competition to health care.  Whether the focus on “coverage” is a deliberate distraction by the crony propaganda machine or a well-meaning but misguided attempt to provide better access to care, we must keep our eyes on the “price transparency ball.” The Oklahoma market is already harshly judging those attempting to avoid this gaze and I believe this trend will continue as long as we identify, challenge and reject conclusions downstream of their flawed premises.

Posted in Economic Issues, Free Society, Free-Market, Leadership, Liberty, Philosophy, Policy Issues, Poverty, Rule of Law, Subsidies, Uncategorized, Wealth

Why Hong Kong’s Economy Has Grown 7x Faster Than Cuba’s Since Since the 1950s – Foundation for Economic Education

By Dan Mitchell

“Communists claim that their ideology represents the downtrodden against the elite, yet the evidence from Cuba shows wretched material deprivation for most people.

In Hong Kong, by contrast, incomes have soared for all segments of the population.”

How important are key individuals in shaping the success or failure of economies? …Neil Monnery’s A Tale of Two Economies is in some sense a polemic against historical determinism, at least insofar as promoting economic reforms is concerned.It stresses the importance of two single individuals, one a great man for many, one an obscure official and political unknown to the most, in shaping the destiny of their respective countries. …Ernesto “Che” Guevara and John Cowperthwaite. …Monnery insists that both of them were “deep and original thinkers.” …The key difference between the two was perhaps that Cowperthwaite had a solid education in economics… Neither the way in which Hong Kong progressed, nor Cuba’s, were thus inevitable.

Monnery points out that Hong Kong’s success happened not because Cowperthwaite and his colleague were trying “to plant an ideological flag,” but because they were “professional pragmatists.” …Then the success of relatively libertarian arrangements in Hong Kong perpetuated itself. …Cowperthwaite tested what he knew about classical economics when he “first arrived in Hong Kong, in 1945” and “was put in charge of price control.… He soon realized the problems with attempting to set prices low enough to meet consumer needs but high enough to encourage supply, and in a dynamic environment.” He opposed subsidies that he saw as “a brazen attempt to feed at the trough of government subsidies.” …Cowperthwaite is a hero to Monnery, who emphasises his competence, and even more, his integrity.

https://fee.org/articles/why-hong-kongs-economy-has-grown-7x-faster-than-cubas-since-since-the-1950s/

Posted in Access to healthcare, advance-pricing, Consumer-Driven Health Care, CPT billing, Defined Contribution Benefit Plans, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Government Regulations, Health Insurance, Healthcare financing, Patient Choice, Policy Issues, Uncategorized

Why Value-based Payment Methods Won’t Fix Healthcare

I’ve read several posts today on so called “Value-based payment” strategies and I couldn’t resist adding my 2-cents.

VBP can’t fix these fundamental problems because it is still based on a price-opaque shell game I like to call Fee-for-Coding, which results in:

1) Price insensitivity on the utilizer’s part.

2) Misaligned incentives on the provider’s part.

3) Lack of important price signals between buyers and sellers due to lack of advance pricing capabilities.

VBP utilizes the same fundamentally flawed economic system as our current billing model.

Moving to value-based care will require…

1) A system where prices are known in advance of care (not trauma or emergency care where extent of injuries or illness are unknown at onset – but even still a lot of those can be estimated ahead of time based on scenarios).

2) …that physicians be paid to be available to solve our problems, where payment is not tied to documenting work in a chart.

3) …that we move to a system that is based on defined contributions as opposed to defined benefits. As John C. Goodman is fond of saying, “money should follow people”, not programs and insurance policies.

Value will be elusive until we let the discipline of the market work in healthcare.

https://www.linkedin.com/pulse/why-value-based-payment-methods-wont-fix-healthcare-robert-nelson-md/

Posted in big government, Economic Issues, Free Society, Free-Market, Government Regulations, Government Spending, Income Inequality, Job loss, Liberty, Policy Issues, Tax Policy, Uncategorized

A Case for Less Central Planning & More Individual Economic Freedom

Data analyzed from the Fraser Institute’s Economic Freedom Index makes a solid case for the benefits of more individual economic freedom and less central planning.

Across time and comparing all levels of society, be it communities, States or between countries, those with more economic freedom as measured by the Economic Freedom Index enjoy…

  • Less unemployment
  • Higher incomes
  • Less poverty
  • Less income inequality
  • Less gender inequality
  • Less child labor abuses

All six of these factors should tend to maximize cooperation between groups and foster more peace and less conflict. By extension, then, it appears a case can be made that the ideal role of government is to prevent us from harming each other, ensure a fair regulatory playing field, enforce laws fairly, honor contracts and otherwise grant maximal economic freedom to individuals to do as the wish so long as they don’t harm others financially or physically.

Posted in Dependency, Economic Issues, Free Society, Government Regulations, Income Inequality, Liberty, Philosophy, Policy Issues, Poverty, Progressivism, Representative Republic vs. Democracy, Tax Policy, Uncategorized, Wealth

Watch “What’s Right About Social Justice – Learn Liberty” on YouTube

If the concept of social justice simply means justice for the individuals who make up society, then it appears the utopian socialist-progressives and the libertarian free-marketeers may have some goals in common.

However, when it comes to the ways & means to achieve those goals, the ideological divide is still wide.

So maybe rhetoric on both side should always start with…

“what is the most effective strategies or economic policies to allow people to optimize opportunity and escape poverty.”

Posted in Economic Issues, Education, Entitlements, Free Society, Free-Market, government incompetence, Government Regulations, Liberty, Philosophy, Policy Issues, Poverty, Rule of Law, Uncategorized, Wealth

Watch “John Stossel – Influence of Milton Friedman” on YouTube

Milton Friedman’s core message was that personal freedom and economic freedom go hand in hand.

Pursuing life, liberty & happiness must be accomplished by individuals, and can’t be granted to us by bureaucrats or gov’t programs.

Milton Friedman understood this and trumpeted this message throughout his life.

Posted in big government, Cost of labor, Crony Capitalism, Defined Contribution Benefit Plans, Economic Issues, Education, Employee Benefits, Entitlements, Free Society, Free-Market, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Job loss, Liberty, Organizational structure, Policy Issues, Poverty, Uncategorized, Wealth, Welfare State

An Inquiry into the Nature and Causes of the Wealth of Sweden: A Path from Poverty to Prosperity

“Without economic growth, there is no wealth to share.”

Johan Norberg

Lessons for America?

Welcome to another edition of Friday’s Philosophical Foray beyond Healthcare!

One of the most important history lessons in the power of economic freedom to alleviate poverty and improve the lot of the ordinary citizen did not occur during the industrial revolution in America.  It has its roots in a relatively obscure Swedish leader & political philosopher. He was a Finnish-Swedish clergyman, writer, and political philosopher, whose ideas and advocacy pre-dated that of Adam Smith. 

The freedom of Swedish people to pursue self-determination which empowered individuals to trade, act and associate voluntarily with others was championed by the words & deeds of Anders Chydenius (1729 – 1803).

After his death in 1803, Chydenius’s libertarian ideas where perpetuated by the Aftonbladet news publication in Stockholm, a news outlet started by Lars Johan Hierta, which was instrumental in spreading the message of economic freedom against the guilds and mercantilism which dominated Swedish economic policy under the King.

In 1840, the new Finance Minister Johan August Gripendstedt, the architect of Sweden’s new market economy, continued the market reforms. His policies ignited economic expansion and growth based on free trade, sound monetary policy and modicum of govt regulations. 

Between 1850 – 1950, Sweden’s per capita GDP increased almost seven-fold.  Infant mortality improved by 86% and life expectancy increased by 26 years!  By 1950 Sweden was one of the richest developed countries and had one of the most open and deregulated economies in the world; with tax rates LOWER that the United States and most European Countries.

Until 1960, Sweden had low taxes, minimal gov’t intervention in the economy, free trade and strong private property rights.

To explore this subject in detail, please watch Johan Norberg discuss Sweden’s rise to prominence in his video below.