As with pretty much every area of political discourse in the United States today, the congressional wrangling over health care lacks a thoughtful, compassionate, informed republican perspective.
Of course the (captial-R) Republican Party has been a miserable failure in representing (small-r) republican views in my lifetime, so I’m not sure why in this instance I expect anything more.
The problem is that in this instance, the statist / socialist perspective is fundamentally correct about one thing: The health care system of the United States is poorly designed for efficiency and efficacy as a system.
Imagine, if the current system were invented as a full system, the kind of conversation leading to its invention: “Let’s base health coverage around employment status – most of the people who are employed can have a product we’ll call “insurance” but that will really be a buffet-style hodgepodge of health services. We’ll have a whole slew of different plans and practices so as to avoid large-scale negotiation for the benefit of the consumer. People who are self-employed or not-employed will be kinda screwed, as will those who happen to be sick the day before they get a job – pre-existing conditions are a liability, you know. People who are young and destitute or people who are over a particular arbitrary age will be covered by a mix of their home state government and the federal government. All the while, no solid block of informed consumers will exist to challenge the status quo as a market force.”
Now I realize that’s an oversimplification, but my point is that, while pretty much everybody sees the need for a massive change to the health care system, only the statist / socialist perspective has risen up with a really great sounding alternative:
“Every single person will be required to pay into a collective hold, for which on their behalf a single entity will negotiate the best prices and practices. Each person then will be entitled to coverage with a fraction of a percent of the system’s resources leaving as overhead or profit.”
It’s not hard to understand how a person can find this alternative compelling!
Making it even more difficult to resist, proponents are able to point to many nation-states around the world where such systems are deployed effectively and to the delight of the citizenry.
Now, on the other hand, look at the narrative of reform offered by the anarchist / republican perspective. I don’t know of one. I can’t think of one! Instead, we merely point out the many (and scary) inevitable pitfalls of asking the most powerful military hegemon in history to take care of our health. We sound terribly academic and disconnected, and we offer no systemic perspective on what our ideal system will look like.
This is the problem.
Thus, henceforth, I’m suggesting that we stop or at least curtail all criticism of the current “reform” proposals. We take Obama (and the curious word “Obamacare”) out of our lexicon and out of our cross-hairs. Instead we relentlessly espouse our vision for taking care of people – all people – without the heavy hand of government.
I don’t know all the details, but just to get us started, it goes something like this:
We start by ending all criminal liability for the act of putting anything into one’s own body. We restore and strengthen the notion that, across the system, each person is the sole owner and operator of their own biological organism.
We restore and re-examine the role of plant-based medicines, making coca, poppy, hemp, and all other plants legal to cultivate.
We repeal those laws which create the artificial concept of “intellectual property,” at least as far as psychoactive compounds are concerned. We thus end government protection of pharmaceutical companies who inflate their prices by thousands of percent. Medicines of all kinds become affordable again, and lo and behold! More, rather than fewer, enterprising young scientists become interested in open source medicine.
We create a rich, comfortable, and easy-to-use wiki-like environment, in which people can list the symptoms of any malady from which they may be suffering. They can also list the remedies which have helped them in the past, and together, as a community, we can create a massive database of trends for all sorts of diseases.
In this online environment, people in similar biological conditions can talk to one another in a live environment and have occasional support meetings and form consumer support-and-wellness groups.
Practitioners of medicine, both conventional and alternative, can advertise their services and be hired as advisors by these support groups, being paid directly instead of through a convoluted coverage system. If, for example, they want to make $50 / hour, they can charge a 10-person group $10 each for a two-hour session, and answer all of their questions.
The concept of “insurance” can be re-introduced and distinguished from buffet-style comprehensive coverage. Most people will likely opt-out of insurance, realizing that the act of purchasing insurance is actually a bet that they will become sick or die sooner rather than later. On the other hand, some will purchase policies to cover unlikely catastrophic events. Such insurance will be very cheap.
People can once again choose for themselves which tests and procedures are important, and the incentive structure will be one of conservation, as they’ll have to pay for each one.
As overhead and systemic costs are reduced, people who currently find themselves spending outrageous amounts on “coverage” for themselves, their families, and their employees can instead invest in medical centers or charities in their communities which can care for people who truly need complicated and expensive procedures but can’t pay for them.
Support groups can also use their presence to help doctors help the poor. In the example above, if each participant pays $11 for the session, the doctor will have an extra $10. Assuming the doctor is willing to work for half price for charity, she needs to administer only five such sessions a week in order to administer a free one for people who cannot afford the $10 fee. Surgeons can work the same way, albeit on a larger scale, just as they did before government regulation got us into the mess we are in today.
Some doctors and other medical professionals will make long-lasting relationships and be able to charge a bit more money as they get older and more trusted. Some of them will make very good money practicing their art, and that’s OK. In fact, that’s great. Young people will again have a reason to follow their passion for caring about people instead of studying pharmaceutical patent law or insurance adjustment expediting.
Of course none of us has all the answers, but I think that most people have never stopped to think about what kind of alternative the republican / anarchist perspective has to offer in the health care debate. It’s time to change that.
Also, and perhaps most importantly, the open-source movement and the progress of technology make all of these ideas (and lots of even more innovate ideas!) not only possible, but inevitable. So it’s time for us to become optimistic and take some pride in our ability to help each other and keep each other well.