The Humble Libertarian

Mind your business.



Monday, September 25, 2017

America, It's Time to Admit That Washington Cannot Be Trusted to Help Us with Our Health Care




And look for disruptive Silicon Valley entrepreneurship-- and private charity-- to make health care amazingly more affordable instead...

While taking better care of us than ever.


But before looking at how this can happen in our lifetimes and why it probably will...

Let's start with why it's time to admit Washington cannot be trusted to help us with our health care.

(If it's not already obvious by now.)




Politicizing Health Care and Health Insurance

Something seems wrong to many people about treating health care as a product and charging for it.

That's because the people who want or need health care are basically in some kind of trouble.

Many consumer products solve small problems like inconveniences or mild discomforts.

But health care products and services often address very serious problems and major tragedies.

To many people "commoditizing" health care by treating it like a product and seeking profits for solving these major problems people have... seems evil.

But it's not evil if it actually makes health care more affordable, more available, and better all the time.

If we really care about people, then we will have this discussion in terms of the real, actual consequences of policies.

Not uninformed moralizing.

And the consequences of politicizing health care by making it into something Congress and the White House are responsible for have been a disaster.


Two facts to remember here:


1) Health care and insurance have been firmly in the hands of Washington politicians and regulators for half a century now.

So what we have today is not the result of commoditizing health care or insurance, but the result of politicizing it.


2) And what we have today is:

Staggeringly high costs for health care and health insurance, and restricted access to health care products and services.

And astoundingly high levels of dissatisfaction with the health care industry...

In an August 2016 Gallup survey of American views toward various business sectors, Americans generally had the most negative overall view of the federal government, followed by the pharmaceutical industry, and the health care industry.


So it's easy to see why Washington cannot be trusted any longer to help Americans with our health care.

The federal government has had the health care and insurance industry firmly in hand for half a century, and has been heavily involved in shaping the sector into what it is today for a century now.

And the result is health care prices have spiraled out of control and Americans have the most negative overall view of this sector out of any major sector in America, other than the United States government itself!



Just the last decade of Washington managing our health care and insurance industry should be enough to know that we cannot and should not count on the United States to help Americans with our health care.

ObamaCare was officially titled:

"The Affordable Care Act"

And in a short amount of time it has made health care much less affordable. Ironic, isn't it?

Under the "Affordable" Care Act:

-Health care prices have gone up dramatically.

-Health insurance premiums are getting ridiculous.

-Deductibles are absolutely insane.

Ballooning health care costs are also a big reason why American workers can't seem to get a raise these days.


And people who are getting their costs subsidized to help with the price have no sense of security at all about the future of their health care as the Republican controlled Congress and White House push for their own health care reform legislation.

That's the unavoidable danger our health care needs are in as long as health care is politicized, especially as partisan fighting becomes more polarized and extreme.

Even the most ideal situation for any given person is never safe from being changed as soon as Congress or the White House flips back to the other party and they start fooling around with health care some more.


Washington's partisan politics are too unstable and too distorted by perverse incentives for something as vital as our health care to be entrusted to the management of politicians and federal regulators.

The United States government cannot be trusted to either want to or be able to make sure Americans have the most affordable and best health care possible.



A libertarian health care plan


But if you're still wondering what a libertarian health care plan would look like and still worrying that it would commoditize health care...

Let me suggest that politicizing health care also commoditizes it (even more than free markets).

Do you think under federal control, the health care and insurance sector aren't hoarding massive profits from all these sky high prices and limited supply?



Any good or service that people value is a commodity...

The question is do we want this one to be a political commodity or a market commodity?

At this point what more do we need to see to know that as a political commodity, the supply of health care will be restricted and the prices will keep getting higher?

Under Washington's management, the health care industry is a federally protected monopoly.


Washington keeps the supply of doctors and health services legally restricted so the industry can make unfair profits on the artificial scarcity of these highly valued and much needed services.

Now that's evil.

It's like the diamond sector artificially keeping the supply of diamonds low so they can charge unfair prices for diamonds and make enormous profits.

Except diamonds are a luxury that look pretty and health care is something many people are desperate for when they need it.


The United States federal government has an uncanny record of saying it must intervene to make something more available to society and then making it less available and more expensive.

When it got involved in "making housing more available" through Fannie Mae and Freddie Mac, it drove up housing prices and created the housing bubble that crashed the economy in 2007.

A lot of people lost their homes and a lot of people lost their jobs. Meanwhile Wall Street and major insurance companies scooped up lifetime fortunes as prices rose, and when they came crashing down, Congress made sure their losses "trickled down" to the rest of us.


Interestingly both presidential candidates at the time (Obama and McCain) were U.S. senators and both voted for the Wall Street bailout.

The stalled economy was hard-hitting for college graduates at the time, another group of hapless victims of Washington's uncanny ability to drive up prices.

In their case, the federal government undertook policies for decades to make a college education more available, and sure enough, drove up the prices of a college education and created soaring tuitions that made it impossible for many to go to college without racking up massive amounts of debt.

Many of these universities have made record profits raking in tens of thousands of dollars per student, and sending graduates off to work in coffee shops.


The federal government has an uncanny record of making political commodities more expensive.

But Silicon Valley companies have an uncanny ability to make market commodities much less expensive, while vastly improving them at the same time!

In 2009 one blogger tallied up the cost of 23 different devices and several pounds worth of gear that had been replaced by a single iPhone:

"I started thinking about what a converged device the iPhone is and compiled this impressive list of devices I used to carry that are now replaced by my iPhone. This is an unprecedented level of convergence if you ask me. A quick informal tally shows that the iPhone is replacing $2700.00 dollars worth of equipment and several pounds worth of gear."

There are plenty of people around today who remember when computers used to be so expensive that only big corporations and universities had them, so inefficient that they filled up an entire large room, and so weak that they couldn't match the power of a high schooler's $80 graphing calculator today.

But in an astonishingly short amount of time, computers have become a million times cheaper, smaller, and more powerful, so that now just about everyone in America gets a new incredibly powerful smart phone every couple years.


Just imagine what could happen if Silicon Valley brought its disruptive powers to bear on health care products and services. Imagine health care prices going down as much as the price of digital computation has gone down from the 1950s to the present!

Even more exciting: imagine health care that is more powerful and capable than today's health care on the same order of magnitude that today's iPhone's are an improvement over 1950s computers!

We are already seeing the beginnings of this seismic shift as medical technology becomes an information technology, grafting its rate of advancement right onto the wave of exponential advancement happening in digital computation.


Because the rate of advancement in digital computation is exponential, it will take much less time than it did to go from IBM mainframes to the iPhone for it to go from the iPhone to a device that is a million times smaller again, and a million times more powerful, and a million times more affordable.

Think about that for a moment. The implications of this are absolutely cosmic in scope. An average human red blood cell is 8 ┬Ám (micrometers) wide, which is 0.0008 centimeters. So something a million times smaller than an iPhone (13.8 cm in height) would be 0.0000138 cm wide, much smaller than a red blood cell.

And with a million times more power! We're talking about devices that will be able to replace your red blood cells and deliver oxygen better and more reliably, that will be able to replace your immune cells and fight cancer and disease with godlike results.


I can hear some of you thinking:

No way. Isn't there a hard limit to miniaturization that we'll bump into way before then?

Google's Chief of Engineering, Ray Kurzweil, a veritable Isaac Newton of our age, says "Nope."

You'll see.

The kind of changes that will result from this "technological singularity" are so cosmic in scale that you can think of it as a rupture in the very fabric of human civilization and the universe as we know it, tantamount to the creation of a new universe altogether.


So this discussion has gotten a lot bigger than health care, although the absolute perfection of health care to the point of ending disease and achieving human immortality is no small implication of the blinding pace of technological advancements happening.

But between now and that point (which Kurzweil estimates to be just a couple decades from now) tech entrepreneurship will drastically bring down the price of health care while improving its quality by solving problems at an amazing pace and spilling like an ocean over every barrier and through every crack of the Washington regulatory regime to give the market what it demands at a competitive price.


Take the case of Uber, which is relevant in more than one way to this discussion. The taxi industry in many major U.S. cities was a protected monopoly just like the health care industry has been, and thus taxi services were overpriced and consumers were under serviced.

The industry was heavily regulated by cities, which would give out a limited number of expensive licenses (in New York City for instance they're called "medallions") to provide taxi services to the public.

The result was not enough taxi cabs to supply consumer needs, really high prices, and a stagnant industry that didn't have any sense of urgency for catering to consumers and improving their service.

Along came Uber with the Silicon Valley mindset of innovation and creative problem solving using all the new tools that are available to us in the 21st century, and disrupted the stagnant taxi industry by offering a better service at a more competitive price.

Their technological platform made it easy to work for them or hire one of their workers. With a tap on the phone, consumers could hail a ride from anywhere. It was simple. It was brilliant. It was beautiful.


The stagnant, government-regulated and protected taxi monopoly just sat there and watched Uber disrupt and destroy its monopoly completely with a better service, despite the taxi cartel's legal protections.

The media and the taxi lobby complained that Uber was "breaking the rules."

And consumers just kept pulling out their phones and giving Uber their money by the billions of dollars, voting with their wallets for less regulation, lower costs, more availability, and better service.

It was a revolution without blood, anger, fighting, or even intentional political agitation.

Technology just made it possible for someone to provide a better taxi service, and the government's monopolistic regulatory barriers couldn't stop it.

Some things are too beautiful for words.


Well expect to see it happen to the stagnant, government-regulated health care monopoly in the United States as well, just one bloodless coup after another, as technological advancements and brilliant entrepreneurs start providing quality services people need, at a reasonable price, outside the federal regulatory paradigm, and within the paradigm of the digital marketplace. It's going to be sweet.

Uber itself is one example of how this is going to go down. People are hailing an Uber instead of calling an ambulance to take them to the emergency room in increasing numbers because it's so much more affordable and even likely to get them to the emergency room faster than the ambulance.

It's a very short step from here to Uber providing an "Uber White" service. People can see how near one is to them, get an estimate in advance of what their cost would be, and hail an "Uber White" car with an Uber employee who has completed First Aid and CPR training and keeps their certifications up to date to drive for Uber White. The requirements would be simple and make sense. They would be written by a savvy tech company, for its paying customers, not by lobbyists for an entrenched industry cartel.

I'm not advocating for this kind of smooth revolution in health care services in America, although I do welcome it. I'm just saying this is what's going to happen next among other things. Expect it.

But if you do want to help get it here faster, please spread the idea by sharing this post.



The more interest and buzz the hive mind shows in this, the more startups and established tech companies will be encouraged by the possibilities to start helping us out here. Because God knows Washington won't.


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