Healthcare and Public Policy

Providing healthcare, along with many other sectors of our economy, is increasingly being considered a public good, like a public utility. If, for example, the financial system is so critical to the public welfare, why should it be subjected to a cycle of boom and bust that is inimical to that welfare generally as long as it remains in the private domain of the power structure where it has demonstrated the model of inefficiency and corruption, providing the lowest quality at the highest possible cost.

Bifurcation of the power strucutre into the domains of public and private is supposed to allow for a pluralistic efficacy. In some cases, goods and services are to be determined best provided in the private sector, some in the public. Failure in the private sector tends to force an enterprise into the public domain, if not in whole, in part by regulation of public enterprise--government. So we see that the conservative argument that "government does not produce anything...it is the model of inefficiency" is merely a "belief" proffered as an absolute truth (a guiding principle) that is nothing but sophistry that identifies their self-interest with the general welfare. It is the rhetorical stock-in-trade of the conservative element and is completely, empirically, disconfirmed by the evidence.

So it is with the healthcare system residing in the private sector. It is a model of inefficiency, and where it intersects with the public sector, it is a model of racketeering, fraud and corruption, just like the financial system. While medical doctors, for example, gain the public's confidence as the keepers of the public health, they at the same time bilk the public coffers (the tax base) with fraudulent and abusive pricing practices that only Enron could rival. This, of course, explains the byzantine regulatory scheme of Tom Daschle, for example. Complex schemes provide the opportunity for the abuse it is supposed to prevent, like the tax code, and that would explain how Daschle, and many others like him, can be both industry-friendly and keeper of the public trust (see the article, "Restructuring the Elements of Power" at griffithlighton.blogspot.com).

The remedy for the tendency to engineer complex schemes and organizational public/private technologies is a free market system, falsely discredited by the partisan, duopolistic, politics of the power structure that allows industries and markets to consolidate, defeating its operational utility.

A doctor should become wealthy because the public prefers that doctor over others, not because there are not enough doctors as per the entrance requirements of the AMA, its medical procedures, or its billing practices. The AMA is operating with the classic model of early 20th Century capitalism in which unscrupulous businessmen monopolized industries and markets in the name of free enterprise and free-market economics only to render its operation null and void. Only the most unscrupulous were the fittest to survive, or rewarded with a profitable measure of success.

The Standard Oil Trust Corporation became the model of uncivil behavior and economic inefficiency because it defeated the utility of free-market economics. Practitioners of organizing economic trusts became the criminal element of a civil society, and medical doctors should be no exception because they swear a hippocratic oath of doing no harm.

Anti-trust laws were enacted to control the tendency of organizing capital so that producers could tyrannize consumers by dictating the marketplace, consolidate the capital, and power. A significant part of that legal remedy was allowed to be dismissed by the Clinton Administration with the result of letting the financial sector both horizontally and vertically integrate. The result of this false two-party system of practical governance was catastrophic! Liberals and conservatives, by the evidence to date, work against each other in a bivariate--binary--system of false opposition and cooperation to produce the status quo of power. Allowing this realpolitique to continue--allowing bipartisanship to masquerade as nonpartisanship--should be at the very top of our list of things NOT to do!

The advocates of organizing to consolidate power either public or private should exist at the fringe of the power structure. Consolidation of power will be abusive! A government that acts to ensure a free and unconsolidated marketplace in priority is a government that governs least because the free market takes care of keeping everybody accountable by direct participation (Democracy with a BIG "D") and controls prices with a plurality of easily accessible capital and markets.

Doctors claim their incomes are high because they have the special knowlege to keep the public health. The free market dictates that a high income will draw enough practitioners into the profession to equilibriate the cost of healthcare so that everyone can afford it--so that it is in adequate supply. The only reason it will not be in adequate supply would be a barrier-to-entry into the profession and, consequently, a cost-barrier to "acquiring" healthcare (what is reasonably to be considered a "requirement"). The final result of "rigging the market" (defeating the economics of a free market) is the lowest quality at the highest possible cost. It is the model of inefficiency, and organizing it into the public sector, so-called "socializing" it, without trust-busting the AMA just jumps it from the frying pan to the fire. The organized utility of bifurcating the power structure to preserve the status quo, the class distinction of have and have not (Hamiltonianism), will be very elegantly applied and accomplished.

The formula for providing healthcare is the formula for economic health: adequate income and controlling costs. It is what a free-market economy provides through pluralistic means.

The way the healthcare sector is organized now, we have the high cost rendering incomes inadequate--it is deflationary. The SCHIP legislation is just a reinvention of the status quo, financing extension of coverage through a regressive tax burden, a deflationary tax policy. It does not fit the formula for economic health: it despoils income and, rather than controlling costs, it provides public funding for price increases. The public/private mix is a false pluralism of power. It provides less an efficiency for public welfare than for a consolidation of power for private profit (a consolidation of private property--Hamiltonianism).

Pluralism provides. Consolidation deprives. Despite all the rhetoric and promise, consolidation of power always proves corrupt and inefficient. Pluralism always proves an efficiency of costs and effectiveness with the highest degree of accountability, which is why the most unscrupulous among us will always try to organize to defeat it without prohibition. The healthcare sector is no exception.

In terms of economic health, the medical profession is overfed and its patients are undernourished.