In the first installment on free market health care reform solutions, I spoke of the problem with using third party payer in respects to health insurance and health care purchases. The effects of changing that one aspect of the health care industry would vastly improve our current system and would result in more jobs, better care, and a booming economy. To take the free market concepts even further, we must now look at how the uniqueness of the health care  insurance model makes it much more expensive than other insurances, how obesity is driving up health care costs for the obese and the fit, and how the market has already taken some steps to address rising costs.

Health care insurance is a very unique insurance purchase when compared to auto, health, or any other insurance product. When you purchase home owner’s insurance, you buy it in case of fire, flood or burglary. You do not buy it because you know you are going to need your roof replace, a new furnace installed, or your carpets cleaned.  If home owner’s insurance was treated like health care insurance, you would have to pay astronomical prices for the insurance because the providers of the insurance would have to cover maintenance, and in some plans would cover elective improvements like a deck or a finished basement.

To make it even more absurd, when getting your insurance through your employer, not only is your rate based on the amount of maintenance you use or the risk of your decisions, but they are also based on other individuals that you have no control over. Imagine if you invest in a security system, fire detectors and fire retardant building materials in order to lower the risk of your house catching on fire. This would be similar to exercising, eating right and having regular checkups. Currently, your home owners insurance would be reduced because of the responsible actions  you took. Now, if home owner’s was ran like health care, your rate wouldn’t be based on your actions. It would be based on your group’s actions. If a member of your group moves to a high crime area, has no smoke detectors and has very old wiring, your rates would need to take into account his chances of a fire. As you can see, you are punished for actions you have no control over. This model punishes the responsible and rewards the irresponsible. The effect is higher prices for all and no encouragement for good behavior.

As stated in part one of this blog, this third party payer model leaves you with a vicious cycle of increases in the price of insurance and cost of health care. With the removal of third party payer, we would be rated based on our own individual risk and behavior. By removing the group, you now  have an incentive to be responsible. Just like you may install a security system in your house to get a decrease in your home owner’s premium, you would be encouraged to get your BMI down to get a break on your health insurance. You cannot expect good health behavior patterns when people are shielded from the effects of their own actions by the group. You will also have the incentive not to frivolously waste health care services. You would not submit a home owner’s claim every time you need a shingle replaced on your roof, because your premium would rise to cover the risk of another shingle needing replaced. Your risk rating would be worsened by your continual submission of claims. Similarly, you would not run to the doctor every time you get a headache, and if you did you would be more inclined to pay out of pocket to prevent your risk profile being negatively effected. Paying out of pocket is a good thing. It cause you to shop and demand better prices, which results in more competition.

As you can see, the health insurance model is unsustainable as is. It must be allowed to move into the model of every other insurance plan we know of. People must be weighed on their risk. They must be rewarded with lower premiums for taking responsible action, and they must be punished with higher premiums for being irresponsible with their health.

Not being accountable for  your actions in respect to your health has helped lead to a large number of our population being extremely unhealthy. Currently, over 35% of our population is consider obese, and the number jumps to 65% when counting overweight individuals. What’s worse is the percentage has been climbing year after year. In 1990, no state had a over 15% of it’s population classified as obese. By 2008, no state had under 15%. Colorado is the only state with under 20%. The majority of the states now have over 25%. Does it surprise anyone with data like this, that we have a health care crisis? Obesity leads to diabetes, heart disease, cancer, stroke, sleeping disorders, and countless other health conditions.  Ten percent of our yearly health care expenditure as a country is for obesity caused diseases. This is a huge burden on the insurance industry causing higher costs for us all.

Previously, we explained how rising costs come about. If demand is increased without increasing supply, then price go up. With the data presented in the previous paragraph, it is obvious the demand for health care caused by obesity would undoubtly drive up the cost of health care. Demand for drugs is driven up astronomically, because the treatment of these obesity related diseases last the remaining years in the life of inflicted. Our society has a very destructive pattern of treating diseases instead of removing the cause of the disease.

Now, I am not saying the government should step in and force people to get healthy. That is not needed. I am a freedom loving capitalist. If you want to fill up on Twinkies and Jujubes all day while reclining to the Jerry Springer show, have at it big boy. What I am saying is you pay for your actions. Do not expect those who make the tough diet and exercise decisions to subsidize your bad habits. If the free market reigned, third party payer would be gone, insurance companies would base your premiums on your risk and all the high fructose corn syrup lovers would pay for the medical resources they consume. You would quickly see the obesity rate decline, because the obese would be punished by higher premiums. With this decline, you would have insurance rates and demand on health care resources decline. Hey, didn’t we say earlier you have to decrease demand to lower cost. Well, voila, you just did it. Now you have a much healthier society both physically and mentally. The economic effects are too vast to even get into. Let’s just say everything has opportunity costs, and when we put more and more money into health care, that money it held back from other economic activities. With that money freed up, it can go into other parts of the economy that would more than likely improve our lives.

As you can see, both the first part and the second part of this blog really come down to one change. That change is removing third party payer. That one aspect of health care has caused this entire disaster we are now debating. The government cannot fix this by throwing more money at the symptoms. The free market is the only thing that can fix our health care system. It is the only thing that can fix any of our societal ills. Even though the government and the third party payer issues exist, the free market has already taken action to address issues with rising health care costs.

Let’s take a look at the regular doctors visit. Because of the demand for doctors, typically you have to schedule a doctors visit a few days out. When you do go to the doctors, you sit and wait in the waiting room. Then you sit and wait in the treatment rooms. Finally, when the doctor comes in, you see him for 15 minutes, and you’re done. This isn’t all just to have fun with you. This is because of the demand for the doctor’s services. The free market saw this an opportunity and developed the concept of walk-in clinics at your local pharmacy. These clinics are staffed by nurses that can take care of common illnesses. These nurses are schooled enough to address these issues and do so without the same cost of having a highly skilled doctor. Unlike government, the free market allocates resources based on the most efficient use those resources. When the power of the free market is released, it will create a plethora of solutions like this. Consumers will have many more choices and will be the beneficiaries of that horrible “profiteering”. Just remember profits are derived by someone developing and providing a solution to a need. Without that profit motive, that need would go unserviced.

While listening to the debate on health care, the problem seems so vast and complex. We really just touched the surface of the revolution  you would see if the free market prevailed. I did not even get into the disastrous effects the intrusion of the federal government has already wreaked on the health care industry. Hopefully, I’ve provided some food for thought and helped you realize just because a problem seems huge doesn’t mean that the solution has to be. The solution presented here is very simple, but the benefits are more than I can even touch on. As in any debate, seek the truth and use your logic and reason to come to a solution. Problems are exacerbated by those who think things are so complex that it requires “government experts” to fix it.

P.S. I’m sure as the debate progresses, I’ll have more topics to write about. Please provide feedback. Ideas are weak when not challenged. If you disagree, challenge my ideas, so I can either strengthen them or discard them. If you agree with them, share them with others.

Yesterday, the Senate finance committee passed the Baucus bill, well wasn’t a bill, but a set of ideas. One only need to look at the new $507 billion in new taxes to see why government should leave the reform to the private sector. This bill will not only drive up demand, thus driving up costs, but it will also drive down supply and stunt job creation. Obviously, if supply is driven down, cost also go up, and without job creation people can’t afford health insurance anyways. Ok, so let’s take a look at these new taxes and see how they will affect the market. Below is a list of new taxes from CNSNews.com.

(CNSNews.com) – The health-care bill that the Senate Finance Committee will vote on today will cost a total of $829 billion over 10 years, with $507 billion of that cost being covered by new federal taxes and fees, according to the Congressional Budget Office (CBO).

These new taxes and fees include:

– $201 billion in new taxes on high-premium health care plans.

– $83 billion in new taxes paid by workers who will receive less employer-sponsored coverage or lose that coverage altogether but will be compensated with higher wages or monetary benefits, which are taxable.

– $23 billion in penalty fees paid by employers who do not comply with the federal insurance mandate.

– $4 billion in penalty fees paid by individuals who don’t have health insurance.

– $16 billion in new income and Medicare payroll tax revenue due to changes in Medicare.

– $180 billion in other tax revenues items calculated by the non-partisan Joint Committee on Taxation (JCT).

According to the JCT, this $180 billion in new taxes would include: A new tax on prescription drug makers that would account for $22.2 billion over 10 years; a new tax on medical device manufacturers that would bring in $38.6 billion; and a new annual tax on insurance companies would net the government $60.4 billion.

Also, a provision that raises the threshold at which medical expenses become tax deductible, from 7.5 percent of income to 10 percent of income, would reportedly yield the government $15.2 billion in new revenue from sick and disabled Americans with high out-of-pocket medical costs.

via CNSNews.com – Finance Committee Health Bill Includes $507 Billion in New Taxes and Fees.

Now let’s take each one of these taxes and see the law of unintended (let’s hope they are unintended) consequences in action.

The first tax is $201 billion on high-premium health care plans. These are the Cadillac plans that many union guys get. You know, the blue collar guys that supposedly the Democrats love to help. So, one must ask why would you tax these plans and what is the effect of the tax. One only needs to look at the cigarette tax to see the purpose. You tax cigarettes because you want to make it more expensive to smoke and thus drive down the number of people that smoke. Similarly, taxing these high-premium plans will increase the over all cost of them and dissuade companies that offer them from continuing to do so. This is the first example of the socialist principle that if we can’t all have a candy bar, none of us will have one. Because we can’t all have Cadillac health care plans, none of us will. Who does this help? This surely doesn’t help the average Joe. Hmmm, wonder if this applies to Congress’s Cadillac plan?

The second tax listed is $83 billion paid by workers who will receive less coverage from employers or lose coverage, but in turn will get paid more because the employer doesn’t have the insurance cost. Here we go again, with liberals looking out for the common man. The plan drives up the cost of insurance, which is likely to cause many companies, especially small businesses, to drop or reduce the health insurance plans for their employees. “No problem,” says the Baucus bill, “We’ll just tax you the worker.” These taxes are what they believe will be higher wages. The government is showing its hand here. It knows that all costs of an employee lowers the employees wages. Keep this in mind next time the government wants to tax the corporation more. Ok, back to this tax. So, when your employer drops your insurance, the government is betting you get a raise. You better hope they are right, because you’ll be mandated to buy your own insurance or pay a fine.

The third tax is $23 billion in fines paid by employers who don’t comply with the almighty state. OK, so now the government is back to raising the cost of your job to the employer. If you are the employer, is this going to increase your likely hood of hiring or decrease? Also, if you are an employer, you are going to compare the cost of the penalty compared to your current insurance costs. If the penalty is less, you are going to go with the penalty. The difference between fines and insurance costs is insurance costs grow ridiculous amounts every year, and fines will be a fixed cost. From a business planning stand point, that is a plus for going with the fines. So now, not only do you not have health insurance, but money that could be going to paying your more is being sent to the government with no benefit to you.

The fourth tax is $4 billion paid by YOU! That’s right, buy health insurance or pay the government. Isn’t freedom great? So, let’s wrap our heads around where we are right now. If you have awesome health insurance through your employer, the government is going to make it more expensive by taxing it. When you employer drops that, they are going to pay a penalty. Then you  have to hope you get a raise of which you’ll pay taxes on. If you deem you can’t afford to buy health insurance yourself, guess what, you will now pay a fine as well. There sure is a lot of spending going on here, with the end result being you still don’t have health insurance. If you are younger, you may still be better off paying these fines though and holding off on health insurance, because you can just wait till you are sick to buy into health insurance. What the heck, the government is preventing insurance companies from turning down anyone for any reason. Hey, they are just looking out for the common man. Thank your lucky stars!

How many more taxes do we have to go through. I’m starting to throw up a little in my mouth. OK, push through it! The next tax is $16 billion in new Medicare payroll tax due to changes in Medicare. I’ve tried to determine what the hell this means, but have been unable to find exactly what’s proposed here. It sounds like they would raise the payroll tax. If it’s raised on the portion you pay, you just got a tax increase. If it’s raised on the employer’s side, companies just got another reason not to hire or to pay you less.

The last part is a whopping $180 billion in other taxes. So what are these taxes? This is where you get some of the most ridiculous parts of the bill that will do the exact opposite of the the bill claims to do. So, $22.2 billion will be a new tax on drug makers, $38.6 billion on medical device manufactures, and $60.4 billion on insurance companies. So, let me guess, these companies are just going to swallow the crap the government just got shoved in their mouth. This is why politicians should stick to speeches and leave the market to the private sector. Companies don’t pay costs. Consumers pay costs. All of these taxes, drive up the cost of drugs, medical devices, and insurance. This is completely contradictory to what politicians say their goal is. Then again, maybe we just have their goals wrong. I’m guessing they know this, and in a few years they’ll come back and say, “See, the free market isn’t working. We now have to step in and take more control to bring these costs down.” If these taxes can’t be passed on to the consumer by some other legislation, the companies will not be able to meet their profit goals. If they cannot reach their profit goals, they will not make the products. Without the product, supply diminishes even more and drives up costs. So, you either have costs driven up by government induced cost burdens on the medical companies or you have costs driven up by a shrinkage in supply. Pick your poison!

The last one is just perfect. The government loves us so much that they want to make it more expensive if you have very high medical bills. If you have very high medical bills, chances are you are disabled or have a child that has a disability. Don’t worry the government is so compassionate, that is going to make you spend 10% of your income instead of 7.5% before you can get a tax deduction on it. Aww, they are so caring.

Hopefully, if you made it through this blog without vomiting, you see the that government is not trying to help people. They are setting up taxes and other penalties so later all the government zombies come back begging the government for more help. Of course, the government will gladly help out again until they get a nationalized health care system.