Role of Government: A Fundamental Philosophy

I would describe my political philosophy as relentlessly individualistic. I believe that individuals, given the proper information, can always make a better decision for their own welfare than the government can make for them. This leads me to be a conservative, small-government, personal responsibility, free-market type fellow.

I know this is not about local issues, per se. I am going to use the following letter to the editor of The Capital to display my point, then I will attempt to relate that point to the local issues.

Keep reading below the fold. Crossposted.

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Regarding the Walter Williams column headlined “Socialized medicine won’t work.”

I agree with Walter Williams nearly 100% of the time. I cannot recall a disagreement I have ever had with him. You had better be on to something.

The motives of executives of insurance companies, health maintenance organizations and the like are to maximize profit and minimize cost. To survive, profit-driven businesses like food markets and computer manufacturers must deliver products and services that are competitive in price and quality.

I am with you so far. Do I sense a “but” coming?

But the bottom-line philosophy doesn’t work so well in health care.

Yes I do. And, you are incorrect, the concept works perfectly well, as you will prove later in your own letter.

It is not uncommon for coverage of a procedure to be denied even if a doctor deems it necessary for the health of the patient. And the decision may be made by someone who is not even a doctor.

Let me make the first mega-important assertion of this post. The health care system is inefficient because there are people who make decisions other than YOU and YOUR DOCTOR. Think about it….if you buy a computer, or food from a market, you give your money directly to the person who made the computer or grew the food. The fact that you make a purchase conveys, via the price system of a free market, that you are satisfied with the people that you bought the things from and that their products provide a value to you as compared with another alternative.

Now think about health insurance. You pay your premiums every month, and then you have nothing to worry about. Except for your deductible, you don’t have to pay at all when you receive medical treatment. So you get medical treatment all the time, which drives up the cost of insurance. Doctors–same thing. They get paid by the insurance company. So, when they treat you, they are not concerned about your financial situation at all (as long as you have insurance). The point is, doctors and patients have no incentive to negotiate and do not face normal free market forces that ensure efficiency, because there is a third party involved.

Whenever you lose accountability like this, things go to hell. Consider schools. If you paid a school directly, I promise you that school would be damn good at what they do. Otherwise, you would take your kid out of that school and pay another school. Instead, we pay taxes to the county, then the county gives money to the school board, then the school board gives it to the schools. And what is the result? Everybody complains about the schools.

People who have no health coverage go to emergency rooms, which are required to treat them. This is probably more costly than health insurance.

Clearly. If emergency rooms were cheaper then insurance than nobody would get insurance.

Newsweek (July 30) reported that “the United States spent 15.3% of GDP on health care (Medicare) for some of us. France spent 10.7% and covered everyone.” And other European countries with universal health care spent less than France! Other objections to universal health care are debunked in that article.

First of all, friend, if you like Europe so much you can go live there. (Disclaimer: This line is required by the Republican National Committee as the standard response to comparisons with other countries. We can now continue our discussion.)

Let’s start with other European countries. Britain has the largest health care system in the world. In fact, it’s health care system is the third largest employer in the world–behind only the railway systems of China and India. And what do they get for their great system? Rationing of service, low quality doctors, and poor results.

And what about health care in France? Everybody gets it, but at the expense of the economy. Higher taxes, especially employment taxes, cause higher unemployment and contribute to a per capita GDP in France some 40%-50% lower than here in this fine land. I would rather make 40-50% more money, and spend it buying my own health insurance (or paying my own doctors directly). I know it’s cliche to say ‘if you don’t like it here move’, but in actuality if you favor heavy government involvement to fulfill social goals, then this is probably not the place for you. (Although, you may want to stick around to see who gets elected President.)

However, you are correct that France has a highly rated health care system. So why is this? Well, doctors in France insist on retaining all the decisions concerning whether or not a treatment is administered, and the Medicare system there is very streamlined so filling out claims is very easy. In other words, they kept the good stuff and reduced the BS! And in the opinion of this blog, BS reduction is next to Godliness, as the saying goes.

Our government is inefficiently administering Medicare.

Agreed….you have a chance to redeem yourself and bring this one home….

Efficiently managed universal coverage via a Medicare-type coverage might allow extending coverage to all citizens at at reasonable cost, if our inept government would swallow its pride and see how other countries do it.

You blew it. First of all, AP doubts that the government can efficiently manage anything. If you want an example of this, look what happened when the Annapolis city government tried to enter the landlord business at the Market House. If you want another example, read anything else about any government, anywhere.

Second of all, this is just a difference in philosophy. Here is what you say:

Problem: Government mis-manages health care. Government is inept.
Solution: Do what France does to make our government less inept.

And here is what I would say:
Problem: Government…………….inept.
Solution: Don’t let the government run this activity. Find a private market solution.

There are all manner of subsidies and tax breaks afforded to corporations, farmers, and the dairy industry. So why not help the helpless as well as the wealthy?
BARRY FLIEDER, Annapolis

Again, terrible. You say help everybody, whereas conservatives would say help nobody. It sounds mean, but in the long run everybody is better off: there is no time wasted by politicians trying to figure out which people to help (because if you help one special interest group there are like 3 ka-billion more that want handouts), and you eliminate the equity problem that we have now from our (everyone’s) taxes being taken and given out to particular industries (not everyone.)

So, how does this relate to Annapolis? Frankly, I don’t remember everything I wanted to say about this. You see, I started this post yesterday, then drove to Ocean City for a bachelor party type event, and am continuing this post today. Sufficent to say I am working with fewer brain cells today than I was yesterday. (Do they re-grow?)

I suppose my main points as they relate to our city are role of government and accountability. I don’t believe the government should be ever-reaching into our lives. I don’t believe they should be spending our money on ‘economic development’. I don’t think they should be apologizing for slavery. As Ronald Regan said, government should be funded through the strength of the people.

(Disclaimer #2: The above Ronald Regan quote is only marginally relevant, but was used to fulfill another Republican National Committee Mandate.)

And for accountability–follow the money, as they say. Any time the government becomes the middle man between us and our money, we lose accountability and we cannot control what happens to us (at least to the same degree). So we need to make sure, when the city takes our money, that they are using it correctly.

Man, I hope the coffee is ready……..