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The Right Lessons from Obamacare's Meltdown
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The decision of several major insurance companies to cut their losses and withdraw from the Obamacare exchanges, combined with the failure of 70 percent of Obamacare’s health insurance “co-ops, ” will leave one in six Obamacare enrollees with only one health insurance option. If Obamacare continues on its current track, most of America may resemble Pinal County, Arizona, where no one can obtain private health insurance. Those lucky enough to obtain insurance will face ever-increasing premiums and a declining choice of providers.

Many Obamacare supporters claimed that the exchanges created a market for health insurance that would allow consumers to benefit from competition. But allowing consumers to pick from a variety of government-controlled health insurance plans is not a true market; instead it is what the great economist Ludwig von Mises called “playing market.”

Unfortunately, if not surprisingly, too many are drawing the wrong lessons from Obamacare’s difficulties. Instead of calling for a repeal of Obamacare and all other government interference in the health care market, many are calling for increased penalties on those who defy Obamacare’s individual mandate in order to force them onto the exchanges. Others are renewing the push for a “public option,” forcing private companies to compete with taxpayer-funded entities and easing the way for the adoption of a Canadian-style single payer system.

Even those working to restore individual control over health care via tax deductions, credits, and expanded health savings accounts still support government intervention in order to provide a “safety net” for the poor. Of course, everyone — including libertarians — shares the goal of creating a safety net. Libertarians just understand that a moral and effective safety net is one voluntarily provided by individuals, religious organizations, and private charities.

Government has no legitimate authority to take money from taxpayers to fund health care or any other type of welfare program. Government-run health care also does not truly serve the interest of those supposedly “benefiting” from the program. Anyone who doubts this should consider how declining reimbursements and increasing bureaucracy is causing more doctors to refuse to treat Medicaid and Medicare patients.

Medicaid patients will face increasing hardships when, not if, the US government’s fiscal crisis forces Congress to make spending cuts. When the crisis comes, what is more likely to be cut first: spending benefiting large corporations and big banks that can deploy armies of high-powered lobbyists, or spending benefiting low-income Americans who cannot afford K Street representation?

Contrary to myth, low-income individuals did not go without care in the days before the welfare state. Private, charity-run hospitals staffed by volunteers provided a safety net for those who could not afford health care. Most doctors also willingly provided free or reduced-price care for those who needed it. The large amount of charitable giving and volunteer activity in the United States shows that the American people do not need government’s help in providing an effective safety net.

The problems plaguing the health care system are rooted in the treatment of health care as a “right.” This justifies government intervention in the health care marketplace. This intervention causes increasing prices and declining quality and supply. Ironically, those who suffer most from government intervention are the very people proponents of these programs claim to want to help. The first step in restoring a health care system that meets the needs of all people is to start treating health care as a good that can and should only be provided via voluntary actions of free people.

(Republished from The Ron Paul Institute by permission of author or representative)
• Category: Ideology • Tags: Obamacare 
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  1. Congressman Paul cites that some consider healthcare as a right. And, many Americans, not including the Congressman, feel the government should fund that right through tax expenditures.

    My take is a bit different, although I too believe that government should play a financial supporting role in American healthcare. My take is that the health of the nation’s people is a very important strategic asset and that ensuring the strategic health of the nation’s people is worth every penny the government might spend as doing so keeps us both competitive and safe.


    • Replies: @John Jeremiah Smith
  2. @Longfisher

    My take is that the health of the nation’s people is a very important strategic asset and that ensuring the strategic health of the nation’s people is worth every penny the government might spend as doing so keeps us both competitive and safe.

    Free healthcare for 50 million illegals and their offspring, plus free healthcare for 35 million Negroes will keep us “competitive and safe”??

    Nope, don’t think so. Besides, you use the word “people” collectively. That implies that government should provide facilities that anticipate epidemiological forces that affect the collective. Jose Illegal, who is driving a bus without a license, which kills a half-dozen people and injures a dozen more, does not meet that criterion. And legal citizens who break a leg falling off a roof do not meet that criterion.

  3. mcs_in_ny says:

    When the US Constitution was written there was no such thing as a “health care industry”. If you got sick, you either recovered on your own or you died. Since there was little to no understanding of the causes of disease, there was little that “doctors” could do for you other than the most basic palliative care. If you got injured, a doctor might be able to set your bone or stitch you up, but if the injury was too severe or got infected you could kiss the offending limb goodbye. They didn’t call doctors “sawbones” for nothing. In such an environment there was little reason for government to become involved.

    The problem today is that health care is not run by private individuals and charities providing care because they feel a moral obligation to do so, it is run by for-profit entities – hospitals, medical groups, drug companies, device manufacturers, insurance companies, malpractice attorneys – all of whom seek to extract a profit from the health care value chain. In this environment the idea of private charity providing an effective safety net is pure delusion. If you accept the premise that society has a moral obligation to provide health care to people regardless of their ability to pay, the underlying assumptions of a “free market” are in tatters. We can debate the merits of “single-payer” vs other types of systems but to say government has no role is utter nonsense.

  4. Well, health care should be a government service. Single payer. That’s the way to bring the cost down and include everybody. But it’s not a task for this corrupt government. Health care in the U.S. will remain an abomination until we get regime change in Washington. I remember the olden days Ron. They ain’t coming back.

    • Replies: @woodNfish
  5. MarkinLA says:

    The problems plaguing the health care system are rooted in the treatment of health care as a “right.”

    No Ron, the problems plaguing the healthcare industry are rooted in it’s bullshit billing practices. I have Obamacare and it is lousy insurance. However, even though I haven’t had anything happen of a serious nature (10K or more), I can’t get any other insurance. I could work all my life and be bankrupted simply because some hospital puts any number it wants on a piece of paper and a parade of doctors waltz by my room and take just enough time to sign the roster – each at 300 dollars a pop until the bill is beyond my ability to pay.

    Lets look at Obamacare. I have a 4500 dollar deductible. However, what that doesn’t tell you is that I have to submit every bill through the insurance and it is chopped off by a factor of around 70%. In order for me to hit my deductible I would likely incur bills (which I would legally be obligated to pay if not for the insurance) of around 15K. Why should I be billed 1000 dollars for a simple sonogram of my kidneys? The test lasted 30 minutes, the tech doing it was probably paid no more than 25 dollars an hour, and the machine is being used all day long in that imaging center. They made plenty of money when they accepted my check for 293 but also tried to scam me into paying the whole 1000 by sending a bill before the insurance company sent me their statement. They even had the gull to put on the bill “Your insurance has credited 293 dollars to your deductible” hoping I would not know what that meant.

    • Replies: @Avery
  6. Avery says:


    The whole private insurance system is a scam.
    I have no problem paying doctors: they earn it, especially surgeons. But why should a useless private insurance CEO make $millions @ year just to be a middleman between me and my doctor. It’s legalized Mafia.

    There should be no private insurance for critical medical needs: none.
    Gov/taxpayers cover catastrophic care, and if you want anything above and beyond, then you pool the resources and share the costs in a private enterprise.
    Taxpayers shoulder the cost for the commons: defense, US mail, infrastructure,….

    Public health is commons.
    From what I hear, Medicare, despite its many problems, has the lowest overhead cost. (have not independently checked, so could be wrong).

    • Replies: @Anonymous
    , @Joe Schmoe
  7. jtgw says: • Website

    Whenever you make something a “right”, what you’re really saying is that you get to use violence to satisfy that right. So a right to your own property means you can use violence against those who would take it from you. A right to healthcare, on the other hand, means you get to use violence to force other people to provide it to you. Forcing other people to work for you is otherwise known as slavery.

    Poor people got group medical insurance in the old days, though:

    • Replies: @Joe Franklin
  8. Anonymous • Disclaimer says:

    Ignorance of common man is appalling.!

    Did you know that obozo care outlawed catastrophic care? In fact catastrophic care is only real insurance.!! I used to pay $200 for unlimited catastrophic care with mere 500 deductible.!

    For average crap like visiting Dr I never bothered.! I used natural care ie with food. I never ever fall ill like grain guzzlers.! And healthier than people half my age.! Healthcare is people own responsibility.! Insurance should be for unforseen scenario like trauma care only. Even cancer patients should be left to die because they eat too much GMO, use too much chemicals at home or have taken too much vaccines.!

    Big pharma is out of control thanks to monopoly provided to it by none other than govt.!

    • Replies: @Avery
  9. Mikeybikey says: • Website

    Man, the socialist trolls are out in force. Healthcare is a right and government is best at taking care of the commons.
    Uh huh. And the VA is not govt. run healthcare? Right.
    As well as the US post office is in the black?

    Slavery is a state of mind and these folks are pioneer homesteaders.
    Which is why they deserve Obamacare – which is merely the latest icing on the cake of govt. interference in healthcare/as if we had a real free market before.

  10. @jtgw

    US 9th amendment says the people have the power to define civil rights, not the federal government.

    US 10th amendment says the people and state governments reserve the power to protect civil rights, not the federal government.

    • Replies: @jtgw
  11. Anonymous • Disclaimer says:

    There should be a range of healthcare, just as there is in any other product: cars, hotels, meat. That virtually every hospital in the US has to provide roughly the same level of care – with all the bells and whistles – is a noble concept, but not practical with the cost of treatments nowadays. In Mexico, where I live (across the border from San Diego, not in the interior), private hospitals exist on all levels: from the most advanced (with all the mega-priced robotic equipment and MRI machines you’d find in the US, along with highly accredited [ie. very expensive] surgeons and doctors) on down to functional hospitals that use older equipment and doctors from lesser universities. You use what you can pay for ; if you cannot pay for anything you use the General Hospital, which can be free if you submit a little paperwork. Giving birth is still $400 out of pocket at the General Hospital, and people walk out with their healthy babies at the same level of success as in the US.

    Everything in the US is geared towards ‘million dollar treatments’ – the surgery, the life-saving drugs. Not practical anymore in a limited resource world. Consequently, we all suffer with higher premiums every 6 months – a never ending upward spiral.

    • Replies: @jtgw
  12. jtgw says: • Website
    @Joe Franklin

    OK. I’m not sure how that relates to my point.

  13. jtgw says: • Website

    Funny how the alt-right frets about Mexicans pouring in and destroying our Anglo-Saxon culture of liberty, when the Mexican healthcare system is freer.

    I agree with you about the need for a range. The fact is that most people don’t need much care, except for emergencies, until they’re old and decrepit; that’s just how humans are designed. The vast majority of care goes into treating the elderly, i.e. staving off inevitable death for a few years with some fancy treatments. So countries with socialized healthcare really show their deficiencies when it comes to treating the elderly or those unfortunates with chronic conditions. My native Denmark is notorious for very long waiting lists for cancer treatment, for example. Many die early because of how the government rations care, and yet we have to believe that the state knows best, knows who deserves to live and who deserves to die.

  14. Avery says:

    {Ignorance of common man is appalling.!}

    The abuse of the hapless, defenseless exclamation mark ‘!’ by some abusive ignoramuses is truly appalling.

  15. D3F1ANT says:

    HILARIOUS that those of us who knew this would happen were mocked and ridiculed by the Left. I mean…it was just simple math. Nay…it was simple common sense. How can these RUBES on the Left embrace this schlock? They insist that the world operates the way they WISH it would operate. They just can’t accept reality. The sad part is that we ALL reap the harvest of their folly.

  16. @mcs_in_ny

    While I think Dr. Paul’s anti-militarist positions are heroic, I think the problem with Obamacare is that it puts government coercion behind corrupt private interests. I agree with mcs in ny’s view that the Social Contract requires some sort of public provision of health care as part of the incidents of civilization. This is the case in every other “western” country, though this provision is in danger based on the neoliberal dogma now being put forward particularly by the yankee imperium.

    • Replies: @jtgw
  17. Anonymous • Disclaimer says:

    The trouble with Ron Paul is that I cannot imagine he would ever have needed to check his bank balance and trouser pockets to see if he had enough money to see the doctor or take his child to see the doctor.
    Why not compare figures? Here in New Zealand with its single payer system, it costs me $17.50 ($US about $15) to go to the doctor to renew my blood pressure prescription. The prescription costs $5 for three months supply. Can someone me your figures?

    Our national health provider, Pharmac, negotiates with drug suppliers all around the world for the best deals. It also fully funds many expensive treatments – so that there has been controvery this year about including the very expensive drug Keytruda for cancer treatment. In the last month it has been added. I understand it is about $8000 each time.

    Noone questions our system except to complain when a new treatment is not fully funded.

    • Replies: @jtgw
  18. jtgw says: • Website
    @exiled off mainstreet

    That’s basically what Ron Paul is saying: we don’t have a free market in healthcare, but a cronyist system whereby the government protects a few companies against competition. And the reason we have this system is because of the false idea that healthcare is a right (there are no positive rights, and no “social contract” either, for that matter) that the government should protect; this simply gives government the excuse it needs to clamp down on the market, pushing up prices in the process.

    When the government arrogates to itself drug approval, for example, you get the EpiPen situation where only one company is allowed to manufacture the item, since none of the others can get approval.

    Socialized healthcare doesn’t fix the cost problem. Healthcare resources are scarce, meaning that they cannot be allocated to every need by central mandate (this is also why central planning doesn’t work in general). This is why you get the notorious waiting lists in single-payer places like Canada: if the government provides all the services, it has to ration care. The best way to allocate resources where they’re most needed is to allow the market and the price system to function freely. As Scott Alexander points out, this is why people can buy affordable chairs and mugs, when there is little or no government oversight of those industries.

    • Replies: @Joe Schmoe
  19. jtgw says: • Website

    Paul does mention that it used to be standard for doctors to waive payment for poor patients. That only works if you don’t require everyone to pay for medical services through insurance, though, which was also how they used to do things.

    Your point about the NZ system is interesting, particularly since a lot of libertarians look up to NZ as a country that actually reversed a lot of earlier socialist policies, to the great benefit of its economy and the people’s welfare. So on the one hand your government pays for care, but on the other hand, it takes advantage of international competition. Without that competition, you would not enjoy low prices; in the US, the government actively hampers competition and makes it very difficult to shop abroad. Whether the full funding of services by the government is a good thing is, of course, another question. The money must come from somewhere, so one should think about the costs being imposed on other parts of the economy and the harm that may cause.

  20. Val says:

    I have an Obamacare policy, and I don’t like it because of INTENSE pressure to get a flu shot, even though I haven’t had a cold or flu in many years. I’ve been pushed by appointment clerks, medical assistants, pharmacy techs, lab clerks, (never a doctor,) and been told by these minimally trained people that it’s safe, although they know absolutely nothing about my health. I’ve gotten calls, emails, letters, and postcards. If Obamacare was a person, I could easily get a restraining order for harassment. It’s awful, and no means no. I shouldn’t have to say it over and over again. I’m giving strong consideration to just paying the fine next year. This isn’t medical care, it’s a give away to vaccine manufacturers, and with a $6,500 deductible my policy is hardly usable. I think the supreme court expressed it well, this is just a tax on the people not insured through an employer.

  21. woodNfish says:

    Yeah! It works for the VA doesn’t it?! /s

    • Replies: @WorkingClass
  22. @Avery

    From what I hear, Medicare, despite its many problems, has the lowest overhead cost. (have not independently checked, so could be wrong).

    Medicare is the fastest growing expense to the gov’t. It is the program most responsible for rising costs.

    I know way to many old lady friends in the 70+ years old crowd who got knee replacements so they could continue to sit on the sofa and watch TV. The elderly have extremely high medical costs and Medicare keeps them going to cost ever more. If they had to pay the costs themselves, they would elect to die rather than pay the bill. I will likely be elderly someday, so I don’t exclude myself here.

    • Replies: @MarkinLA
    , @Avery
  23. @jtgw

    people can buy affordable chairs and mugs, when there is little or no government oversight of those industries.

    Chairs and mugs are made by slaves overseas. I exaggerate, but not much.

    Medical care in the USA or other western country has to pay the employees full retail price. We have no dollar a day lab techs, nurses aids, etc. We have no $5 a day radiology techs or nurses. It is not scalable like selling music on the internet where the cost to provide the service is near zero. The real costs are high and made higher by the armies of gov’t paper pushers and their corresponding clerks etc. in private industry that provide no care to anyone. Government wants to use health care as a full employment program that they control for the benefit of their friends in corporations. Single payer could be more cost efficient if, and only if, they eliminate most of the paper pushers. But government won’t do that here anymore than they did in England becuase the health service is a jobs program. And not everyone is competent enough to provide medical services, so they are paper pushers.

    • Replies: @jtgw
  24. jtgw says: • Website
    @Joe Schmoe

    If government is involved, there will be much pushing of paper.

    • Replies: @MarkinLA
  25. JackOH says:

    Ron would have us believe the problem with Medicare is its very existence. Then we’re told the problem with Medicare is declining reimbursements. These two characterizations of Medicare are diametrically opposed to one another. If you believe the existence of Medicare is a problem, you want to see a total Medicare budget of $0. If you believe declining Medicare reimbursements are a problem, you want to see a Medicare budget more than the current half-trillion dollars, or thereabouts.

    So what’s the problem again, Ron?

    I’m a longtime admirer of Ron Paul, but this pap could have been written by a summer college intern in the American Medical Association’s PR office.

    • Replies: @jtgw
  26. MarkinLA says:
    @Joe Schmoe

    What about doctors recommending unnecessary procedures and office visits to pad their bills – especially if the Medicare patient is not part of an HMO and each visit means money?

  27. MarkinLA says:

    Ever see the paper pushing done by private insurance?

    • Replies: @jtgw
  28. jtgw says: • Website

    Yeah, government regulations turn everyone into a bureaucrat.

    • Replies: @MarkinLA
  29. jtgw says: • Website

    It shows that Medicare is not self-sustaining, but can only survive by bleeding the rest of the economy dry. If Medicare reimbursements were stable, you might at least argue that it works.

  30. @woodNfish

    I said “But it’s not a task for this corrupt government.” Government is not the problem. Bad government is the problem. Forgive me if you already know this.

    • Replies: @woodNfish
  31. woodNfish says:

    Wrong – government IS the problem, especially our present TOTALLY corrupt federal mafia. Government creates problems so it can fix them by creating more government. It is even worse with our criminal government.

    • Replies: @WorkingClass
  32. MarkinLA says:

    It isn’t government regulation, it is the attempt by private insurance to computerize billing.

  33. Avery says:
    @Joe Schmoe

    I wrote overhead cost, not its share of the Federal (taxpayers’) pie.

    What I meant is the administrative costs compared to private insurance.
    It is claimed that Medicare overhead is about 2% vs 15%-30% for private insurance (I have not verified this).

    You are right that Medicare costs are skyrocketing.
    But that’s due to the fact that it covers people 65 and older and medical care obviously grows exponentially as people approach end of life.
    It is a huge problem, but there is no easy solution.

    But can someone explain the justification of private insurance?
    Why should a CEO make $millions @year for simply being a middleman?
    A doctor earns his high wages: bloody work; long hours; on call 24hrs…
    Same with nurses: dirty work; long hours; relatively low pay…

    What does a private insurance executive do, other than wear a suit, “work” in a nice office with regular hours, and legally skim money off the top that really should go to doctors and nurses.

    • Replies: @JackOH
  34. @woodNfish

    No actually YOU are wrong. There has always been and always will be government. The problem we have is BAD government. I don’t blame you if you cannot understand this. A lot of people will agree with you that ALL government is bad. But if that is true then all government should be eliminated. How do you propose doing that and how will we be better off with no government whatsoever?

  35. woodNfish says:

    I don’t know what you think you read, but I didn’t write it.

    I wrote our government was totally corrupt and it is. I never wrote I wanted no government at all. I just don’t want the one we have.

    • Replies: @WorkingClass
  36. JackOH says:

    “But can someone explain the justification of private insurance?”

    Avery, the American Medical Association’s Council on Medical Service and Public Relations suggested Clarence Rorem’s group health insurance idea to Big Business beginning in May 1943. Rorem had been going nowhere until then. After all, why should employers pay for anything consumed by workers and their contractually qualifying dependents?

    Big Business bought into Rorem’s very bad idea out of fear of national planning, mandatory full employment policies, and other socializing measures, and they believed the AMA’s sales pitch that the Wagner-Murray-Dingell national health legislation then being talked about was a precursor to all that. Group health insurance was and is a politically motivated entity. The notion that group health insurance is a product of free markets in action is total rubbish.

    Group health insurance isn’t just a very bad idea, it’s been suicidal under Medicare-inflated medicine for an untold number of American businesses that are running losses because of group health insurance costs, and would be running profits under cash medicine or a national, taxpayer-funded health care scheme commonly used elsewhere.

    • Replies: @Avery
  37. Avery says:

    Thanks for the background info.
    Had a feeling there had to be some kind of machination, since neither doctors nor patients benefit from the present system.

    {……under cash medicine or a national, taxpayer-funded health care scheme commonly used elsewhere.}


  38. MarkinLA says:

    since neither doctors nor patients benefit from the present system.

    Well you must not be aware of the many Medicare/Medicaid scams run in the immigrant communities.

    • Replies: @Avery
  39. Avery says:

    I am very well aware.

    [$1 billion alleged Medicare fraud, money laundering scheme leads to Florida arrests]

    Just one example, amongst perhaps hundreds.

    I was talking about honest doctors, overwhelming majority of them.
    It’s not like every other doctor is engaged in Medicare fraud, is it?

    • Replies: @Avery
  40. Avery says:

    But then again, what is a lousy $1 Billion, compared to $Trillions the MIC loots from the overtaxed, abused American taxpayer.

    [Pentagon Cannot Account For $6.5 Trillion Dollars]

    Has anybody been arrested for it? Of course not: Fed Gov can lie, cheat, steal, waste, break the laws it imposes on the rest of us Hoi Polloi …….and nobody goes to jail.

    How about the 2008 financial meltdown: how much did it cost the US taxpayers? $10T, $15T? Any banksters in jail for the massive scale mortgage fraud they engineered?

  41. @woodNfish

    Sorry. So what is it I’m “wrong” about at #30?

    • Replies: @woodNfish
  42. woodNfish says:

    You are wrong that government isn’t the problem. As I wrote government creates problems and then tries to “fix” them by growing even larger. Today our government is not only a behemoth, it is totally corrupt and is destroying our economy and our civil society.

    Thomas Paine wrote, “Government is evil, society is good.” He is still correct today.

    • Replies: @WorkingClass
  43. @woodNfish

    Ha Ha! Thanks Mr. fish. But you are still wrong. Government is not the problem. Bad government is the problem. I am familiar with you as a commenter and I admire your stubbornness. But this is just silly. Go in peace my friend.

  44. jtgw says: • Website

    Bad government is government founded on aggression against its own citizens; good government is defined by having the consent of the governed.

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