Mr. Wow and I Are Both Right: Part One

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I’ve always been a big fan of Mr. Wow. When it comes to personal finance, he’s playing 4D chess while I’m playing checkers. And when it comes to the issue of healthcare, he’s playing 4D chess as well. The few times I’ve talked to him about the issue, he really opened my eyes to the inadequacies of my free-market, laissez-faire policy preferences.

But when it comes to healthcare, I’m not playing checkers either. In other words, I have some legitimate fears about full-blown socialized healthcare, and those fears need to be addressed if we want to live in a free and prosperous country.

Anyway, for the longest time, I wanted to challenge Mr. Wow’s fondness for full-blown socialized healthcare, but I never found the motivation to do so. Then I visited Mr. Wow’s Twitter account last week and my piercing blue eyes landed upon these gut-wrenching tweets:

Now, Mr. Wow’s description of our healthcare system is unquestionably crude—and is hardly becoming of his first-rate mind—but it’s nonetheless true. Our healthcare system is indeed “beyond fucked.” And though I would caution Mr. Wow and other fans of full-blown socialized healthcare that full-blown socialized healthcare is just as inept as ours when it comes to dealing with extreme medical cases like the one highlighted in the above tweets (see here, here, and here), I readily concede that our healthcare system needs a major overhaul. And that’s what I want to address with this post and the next post.

Yep, Mr. Wow has finally roused me to action. There are far too many Liza Scotts in America, and there’s no reason why we can’t craft a healthcare system that is much more humane—and much more affordable. But in order to do that, we first have to dispense with all the rancor and emotion. There are no villains in this lamentable situation. Both sides, whether they approach healthcare with a free-market mindset (me) or a statist mindset (Mr. Wow), have legitimate fears and legitimate means to address those fears. What we have to do, then, is craft a system that respects both sides. And this begins by listing each side’s foremost concerns. Here we go.

Mr. Wow’s Legitimate Fears

Mr. Wow knows personally just how “beyond fucked” our healthcare system is. Some years ago he got hit by a car while bicycling to work. Thankfully, his injuries were minor—just some scrapes and bruises and a mild concussion. But it took him over a year of hell to untangle the jumbled mess of kafkaesque medical bills he received. And he had “excellent” healthcare insurance…and a first-rate mind…and an implacable spirit.

If you wanted to design a healthcare system that rained financial terror upon the humble and the mighty alike, you couldn’t design a healthcare system better than ours. And our healthcare system rains financial terror upon the humble and the mighty alike in three primary ways:

The Cloud of Uncertainty

Imagine you go to your neighborhood car service center for an oil change and no one knows what an oil change costs. You have to call its billing department. Anyway, you call its billing department and a billing rep tells you an oil change is going to cost $35. Fine. You get the oil change and await your bill. One month later, the bill comes and it’s $35. But then ten months after that, another bill arrives. It seems a master mechanic did your oil change and he used synthetic oil. Your oil change wasn’t $35, it was $135, and you now owe the car service center an additional $100.

The insane scenario described above is all too common in the healthcare industry. Doctors and nurses have no idea what anything costs. In order to know what a procedure, surgery, or drug is going to cost you, you have to wrangle the appropriate billing codes out of your provider’s billing department and then relay those codes to your healthcare insurer (if you have one). But even then your healthcare insurer can’t guarantee anything. Go in for a colonoscopy and your in-network doctor happens to be using an out-of-network anesthesiologist that day, and your $2,500 colonoscopy suddenly becomes a $7,500 colonoscopy and you owe the difference.

Price uncertainty is a major problem in our healthcare system, and I completely understand why Mr. Wow and millions of other Americans want to eliminate this nonsense and institute full-blown socialized healthcare. Let one byzantine behemoth (i.e., the federal government) duke it out with another byzantine behemoth (i.e., the healthcare industry) and leave the common man and woman alone.

The Ever-Present Threat of Bankruptcy

Some years ago there was a reality tv show called Downsized that followed the Bruces—an Arizona family that got wiped out financially by the housing crash of 2008-09. And I’ll never forget episode two of season two. In this episode, Rex, one of the Bruce children, had an asthma attack and had to be rushed to an emergency room. He was stabilized and remained overnight. And from what I could gather, the doctors first gave him a drug that cleared out his airways, and then they put him on oxygen. The bill for this seemingly ordinary care? An astounding $20,000—and if my memory is correct, the Bruces were on the hook for all of it because their healthcare insurer was refusing to pay (the emergency room may have been “out of network” or the care wasn’t “pre-authorized”).

That same level of care would have probably cost the Bruces $200 had they been vacationing in Mexico when Rex had his asthma attack. I mean, c’mon. How much do an asthma drug and a canister of oxygen cost? Our healthcare system thus hurls two heaping handfuls of monkey-poop at the beleaguered patient: doctors and nurses don’t know what anything costs and any medical intervention—whether invasive and prolonged or trivial and brief—has a serious threat of bankruptcy attached to it.

Again, I completely understand why Mr. Wow and millions of other Americans want full-blown socialized healthcare. That Americans can be bankrupted by an ambulance ride, a generic drug, or a minor medical intervention is insane.

Healthcare Insurance that Prices Out All but the Rich

In the below table, I compare my current healthcare insurance costs to what my healthcare insurance costs would be if I decided to move to Mexico.

And it should be pointed out that I’m extremely healthy. I don’t take any medications, and I haven’t suffered a serious illness since I had pneumonia in the second grade. In fact, I can’t remember the last time I saw a healthcare professional for anything other than a wellness exam.

Now imagine that I’m not extremely healthy. I suffer from type 2 diabetes. How quickly would I rip through my $7,000 deductible? And how much would my annual premium be if I decided to forego a high-deductible plan?

Not surprisingly, the cost of healthcare insurance in America is insane because the cost of healthcare in America is insane. And there’s no way the typical American outside the employer-provided healthcare ecosystem can shoulder the burden of healthcare insurance. Absent Medicare, Medicaid, CHIP, and Obamacare, 148 million Americans would be—in the words of Mr. Wow—”beyond fucked.” They might be able to afford healthcare insurance if the monthly premium for an individual were $142 per month (à la Mexico). But in order for the monthly premium to be that low, the deductible would probably need to be around $15,000.

Healthcare insurance that can only be affordable when coupled with a monstrous deductible ain’t healthcare insurance—at least not in a country where a large swath of the citizenry doesn’t have the savings to handle a $400 emergency. So can I really fault Mr. Wow and millions of other Americans for wanting full-blown socialized healthcare when the alternative free-market “solution”—affordable insurance premiums with unaffordable deductibles—is a cruel joke?

My Legitimate Fears

If all you want out of life is to eat, sleep, watch Netflix, and rut, freedom isn’t a paramount concern. Those base desires can be satisfied in any political environment—even in a wretched, totalitarian state such as North Korea. But if you want more out of life—that is, if you want to speak your mind, challenge the status quo, and pursue your god-given talents to the greatest extent possible, freedom is pretty damn important. And that’s why I’m instinctively repulsed by full-blown socialized healthcare. Full-blown socialized healthcare = less freedom = harder to speak your mind, harder to challenge the status quo, and harder to pursue your god-given talents to the greatest extent possible. Let’s see how.

Infidelity to the Constitution

Our Constitution is the guardrails of freedom. It identifies the key components of freedom, and it establishes a system of government that makes it very difficult for the politically strong to wrest those key components from the politically weak.

But here’s the rub. Our Constitution can only safeguard freedom to the extent we abide by its guardrails. We abide by its guardrails, freedom will flourish. We ignore its guardrails—and we find one “penumbra” after another in our Constitution that allows us to break the chains of limited government and flout the sanctity of inalienable rights—freedom will die.

Full-blown socialized healthcare makes a mockery of one of the most important guardrails in our Constitution. Nowhere in Article One, Section Eight of the Constitution is Congress granted the power to provide healthcare. Medicare, Medicaid, CHIP, and Obamacare are blatantly unconstitutional. And so too is full-blown socialized healthcare.

Now I’m not saying the federal government shouldn’t provide healthcare. I actually think it should. But if we want the federal government to provide healthcare, we should amend the Constitution accordingly. Infidelity begets infidelity. And that’s the problem. We’ve become way too cavalier when it comes to honoring the chains our Constitution places on expansive government. And we’ve become way too cavalier when it comes to honoring the sanctity our Constitution reserves for inalienable rights—”diversity”, “equity,” and “inclusion” at the expense of such vital liberties as free speech, due process, and equal protection of the law are all the rage these days.

It doesn’t take a rocket scientist to see the threat posed by full-blown socialized healthcare and our growing infidelity to the Constitution. Our woke overlords have no problem de-platforming, de-banking, de-schooling, and de-employing those who run afoul of woke commandments and sensibilities. And this tyrannical impulse of theirs will not disappear with the introduction of full-blown socialized healthcare. It will only get worse. If “fascists” (i.e., those who disagree with our woke overlords) can be de-platformed, de-banked, de-schooled, and de-employed, they can certainly be de-healthcared.

And lest you think I’m being overwrought, that our woke overlords would never weaponize full-blown socialized healthcare against their unwoke “uppity” brethren, think again:*

• Racist Hospital Will Prioritize White Patients Last
• GOP Governor Announces Policy Barring White People Only from COVID Vaccine in Insanely Illegal Act
• CDC Says Non-White People Get Vaccine First, Professor Slammed for Saying Let Older Whites Die
• NYT Article Says Don’t Give Elderly Vaccine, They Are White and Should Die to Level the Playing Field
• Leftist Doctor Says She Doesn’t Want White People to Make COVID Vaccine Because Social Justice
• The American Psychological Association Has Gone Full Woke, Psychology Is a Tool of White Supremacy
• Shocking Film Shows Medical Transition of Children
• Doctors Can Lose Their Licenses for Questioning Trans
• Trans “Chest Feeding” Is the New “Breast Feeding” in Woke Hospitals
• “Jumping the Shark” with the New England Journal of Medicine

* Quick aside: It should be pointed out that our woke overlords (i.e., big-government disciples who are hostile to the inalienable rights of whites and freedomists, and are commonly referred to as “progressives”) don’t have a monopoly on evil. Had full-blown socialized healthcare been around in the 1940s and 1950s, for instance, it’s safe to say that our unconscious overlords at that time (i.e., small-government disciples who were hostile to the inalienable rights of blacks and communists, and are commonly referred to as “conservatives”) would have weaponized full-blown socialized healthcare against blacks and communists. 

Paycheck Slavery

Imagine this scenario: the government has an unlimited right to tax your income and it acts on this right. Seventy to eighty percent of your paycheck is whisked away by the taxman.

Now a question: What is the material difference between being a slave and the government taking 70 to 80 percent of your income? Nothing. You sweat and toil and earn bread, and someone else gets to decide who eats that bread.

The effective tax rate for all levels of government in America today is far short of 70 to 80 percent. But for many well-to-do Americans, it’s in the 40 to 50 percent range. And there are no constitutional protections against that effective tax rate becoming even more onerous and less discriminatory. If 51 percent of the electorate want paycheck slavery for everyone, the other 49 percent will just have to accept the involuntary servitude imposed upon them.

To be truly free, some things should never be subject to the whims of voters and politicians. Voters and politicians, for instance, shouldn’t have the right to create a two-tier system of citizenship and then bar second-class citizens from riding in the front of the bus, dining in downtown restaurants, and enrolling their kids in the neighborhood’s flagship public schools.

Well, the same goes for taxation. Voters and politicians shouldn’t have an unlimited right to tax. Having that power invites tyranny. Democratic control of your paycheck is democratic control of your values. “We’ll tell you what you shall buy with your sweat and toil.” And once the majority has enough control over your paycheck and values, it has effectively rendered your most valuable possession—your mind—useless. After all, what’s the point of having a mind—”of dreaming things that never were and saying why not”—when confiscatory taxation makes sure you don’t have any money to act on your dreams?

Full-blown socialized healthcare will just advance the onset of paycheck slavery. And I don’t care if it’s for a good cause. Defense is a good cause too. Does that then mean we should all welcome being turned into slaves for the military-industrial complex? Hell no. I don’t want to be a slave to the military-industrial complex. And I don’t want to be a slave to the healthcare-industrial complex either.

ISIS

Whenever you remove competition from human affairs, you remove accountability. And whenever you remove accountability (i.e., the ability to lose or be hurt), you invite ISIS: incompetency, sloth, inefficiency, and stagnation.

I know well the horror of ISIS. For 21 years I worked for a highway department on Long Island. And because we had a monopoly on road maintenance and a coerced clientele—the taxpayers by law had to pay for our service—it was impossible for us to lose or be hurt. We got our cut of property taxes whether we provided excellent service or not.

Now a question: If pursuing excellence in anything is hard, including something as mundane as road maintenance, how likely do use suppose my fellow highway employees and I pursued excellence when we knew full-well that our livelihoods didn’t depend on pursuing excellence? If you said “very unlikely,” go straight to the head of the class. In a word, we were bums. In fact, our total compensation was so disconnected from the amount of effort we exerted, we commonly referred to our jobs as “high-class welfare.”

Here, then, is how the horror of ISIS manifested itself in my little corner of government:

Incompetency: Very few of my co-workers were competent in their jobs. And it’s not because they lacked the innate ability to be competent. It was uncanny how many of my co-workers were total boobs on the job but total crackerjacks off the job in whatever avocation moved them—playing softball, jamming in a rock band, running a landscaping business, etc.

Sloth: During the typical workday, the typical highway employee gave the taxpayer about two hours of moderately conscientious work.

Inefficiency: Why have three two-man crews filling potholes when you can have one six-man crew filling potholes? It’s much more fun when you have five guys standing around and cracking jokes while one guy works.

Stagnation: Nothing changed. When I first began my government career, the typical highway employee gave the taxpayer about two hours of moderately conscientious work during the typical workday. And when I ended my government career 21 years later, the typical highway employee gave the taxpayer about two hours of moderately conscientious work during the typical workday.

And this is probably the main reason why our healthcare system is “beyond fucked.” We’ve removed too much competition and accountability and invited too much ISIS.

Now I’m not saying the incompetency and sloth components of ISIS are currently marring our healthcare system. The typical doctor or nurse is still very competent* and still very industrious. But the inefficiency and stagnation components of ISIS certainly are marring our healthcare system. You see it in administrative bloat, you see it in the practice of defensive medicine, you see it in the needlessly restrictive licensing laws that determine what healthcare professionals can provide what care, you see it in the growing popularity of medical tourism, you see it in the steadfast resistance of doctors, hospitals, and pharmaceutical companies to any reforms that would make healthcare prices more transparent and encourage patients to comparison shop, and you see it, above all, in healthcare costs that make us the laughingstock of the developed world.

* Quick aside: Even though I still have a lot of faith in our country’s doctors, the complicity of our doctors in effecting our opioid crisis does give me pause. Perhaps decades of ever-decreasing competition and accountability are finally starting to put doctor competency in harm’s way.

Crafting a System that Addresses both Sets of Fears

Okay, groovy freedomist, there you have it. I think I’ve done a masterful job of outlining the healthcare-related fears of me and Mr. Wow. The real trick, however, will be crafting a healthcare system that adequately addresses both sets of fears. Can it be done? I think so. But you’ll have to wait for Part Two to see how. Cheers.