More media appearances on health care policy

First, I was quoted in this Denver Post article about a report critical of Health Savings Accounts:

HSAs are an effective way to manage health care costs through the use of high-deductible insurance, said Brian Schwartz, a Boulder engineer who has proposed a free-market insurance initiative to a state commission studying health care reforms.Placing tax-deductible deposits in a health savings account allows individuals to “save money and use it when you really need it,” Schwartz said.

I elaborate on this in a “eLetter” at the Denver Post site:

Health Savings Accounts offer fairness and choice to rich and poor. The tax code’s discounting employer-based insurance is unfair. It ties us to our employer’s expensive non-portable policies and hence limits insurance companies’ incentive to satisfy patients.Imagine you want a more economical insurance plan. A less expensive plan could save you $50 per month, which you could save for medical expenses without your insurance company interfering. But since you’ll be taxed on this investment, you’re left with much less. To avoid this penalty, you’ll probably keep the expensive plan, hence wasting money on premiums instead of saving for medical expenses in the future.

Health Savings Accounts are the first step in eliminating this injustice. If a qualified high-deductible insurance plan is best for you, you can invest income saved on premiums in a tax-free HSA – equivalent to a 401(k) plan for medical expenses.

Since the tax code should not discriminate between money spent on health care or health insurance, HSAs should be available to anyone, regardless of their insurance policy. Further, to free us from our tax-preferred employer-based plans, we should be able to buy health insurance with funds from our Health Savings Accounts.

Michael Cannon at Cato talks about using HSA funds to purchase insurance here and in more detail here.

I was also references in this article about SCHIP (“Medicaid for kids,” get them addicted to government early).

letter: Free markets key to affordable health care

On Monday I had a letter printed in the Rocky Mountain News:

The Blue Ribbon Commission on Health Care Reform has some nerve. Its favorite plans involve funding government programs by taxing you when purchasing snacks, alcohol and cigarettes (“Healthy living may pay off/Sin taxes could fund statewide medical coverage,” Aug. 1). Yet, as shown by FAIR, my proposal at the commission’s Web site, such meddling in our private choices has crippled health-care markets.

First, because the tax code deeply discounts employer-paid insurance, you’re essentially stuck with your employer’s comprehensive plans. These discourage doctors from competing on price and service. As a captive customer, insurers can afford to mistreat you. Changing insurers requires your finding another job or paying taxes on dollars spent on an individual plan.
Second, mandated insurance benefits significantly increase premium costs, hence making it a crime to purchase affordable insurance. Further, ineffective Medicare and Medicaid programs drive up insurance costs.
Instead of further eroding our freedom, the commission should repeal legislation that prevents free markets from delivering affordable, quality health care.

There are many comments on line (see link above).

Having health “insurance” does not guarantee health care

On Monday the Rocky Mountain News published a letter I submitted:

George Swan (Speakout, June 15) erroneously equates medical “coverage” with actual medical care. “Access to a waiting list is not access to health care,” wrote Canadian Chief Justice McLachlin when striking down legislation banning private insurance. As David Hogberg documents in “Health Care, more or less,” patients in Canada, England, and Sweden die or become incurable while waiting months for treatment — despite having “coverage.”

You should have as much choice in health insurance as in car insurance. But tax policy deeply discounts employer-provided insurance, so you’re stuck with your employer’s plans. Insurers are unresponsive to your dissatisfaction, as they know you must quit your job to change providers. A “single-payer” system is worse; with government as a monopolistic insurer, you must move out of state to change providers.

Prescribing “single payer” is like feeding Twinkies to a patient with a heart condition. Let free-markets work by eliminating poisonous laws.

The website allows for comments. They validate Bryan Caplan’s new book, The Myth of the Rational Voter (review in The Economist, podcast) and Mike Huemer’s Why People are Irrational About Politics.

government run medicine treats doctors like vending machines & adult patients like dependent children

So says my letter to the editor in the Denver Post this past Monday:

“Universal” health care

Re: “Patient, take care of thyself,” June 14 Pius Kamau column.

Surgeon Pius Kamau admirably explains that “each man and woman should be responsible for their own health.” Yet, the “universal health care” he advocates as “ideal” erodes this responsibility.

“Universal” health care is a deceptive euphemism for government- controlled medicine. By forcing providers and patients to abide by its prices and rules, government treats doctors like vending machines and adult patients like dependent children. The only thing “universal” about government-run health care is poor quality, low access, and long waiting times. By restricting choice and freedom, authority-driven health care makes government the parent responsible for the health of infantilized adults.

Contrast this with consumer-directed health care, which combines a low-premium, high-deductible insurance policy with a tax-deductible Health Savings Account. Patients self-insure with money invested in HSAs until reaching the deductible, after which the policy’s coverage applies.

Free-market medicine and voluntary charities promote personal responsibility and accessible quality care.

Brian T. Schwartz, Boulder

Will Pirkey of Evergreen responded the next day, claiming that “Our society does not need more personal responsibility, but rather social responsibility.” I wonder where this “social responsibility” comes from, and what actions does it entail. Who determines that, and by what right?

Pirkey continues: “We have the moral and social obligation to ensure every American, rich or poor, gets the care they need without the threat of lifelong debt.” For sake of argument, say this is true. This does not provide an argument for government controlled healthcare. Since it’s had such a poor record, the “moral and social obligation” (or the personal chosen obligation, which is how I see it) compels us to consider that free-markets can provide quality at a good price, just as it does other products and services.

Pirkey also writes: “The personal responsibility argument here is just another sad example of the blame-the-victim public policy and discourse in the United States.” Surely there are victims here – those who cannot afford health care because government policies have driven up the cost.

Two letters in response to my Rocky Mountain News article

The business section of the Denver Rocky Mountain News published two letters in response to my article published there on April 28. Terry W. Donze of Wheat Ridge appreciated my article, so that’s certainly nice to see. According to my web search, he’s a geophysicist with at least one interesting publication.
Micki Amick, the author of the negative letter, seems to have misunderstood my what I was trying to communicate in just 500 words. She writes that

Brian T. Schwartz (“Policies cripple market”) sure is a funny guy for a medical industry lobbyist. He says “health care is so expensive because patients pay so little for it” and calls premiums too cheap.

Well, one correct assertion out of three ain’t bad. I’ll address the other two. So far as I can tell, I’m no medical industry lobbyist. And I’m pretty sure I didn’t write that premiums are “too cheap.” For example:

“costs are exploding for care covered by third parties – insurance, Medicare and Medicaid.”

and

“[T]he tax exemption for employer-paid insurance, mandated insurance benefits and Medicaid … have disfigured real insurance into expensive low-deductible plans that are equivalent to prepaid health care.”

She also misunderstood my critique of guaranteed issue for the business group of one.

Ms. Amick teaches 4th Grade at Aurora Quest Academy, “A Magnet School for Gifted and Talented Students.” (…) Her e-mail address is at the website above. Perhaps I’ll contact her and attempt a constructive dialog.

Government is still hazardous to our health care

Indeed, I am on a roll. Two more letters just today:

1. Rocky Mountain News
Kudos to the Rocky Mountain News editorial board for explaining how “community rating” regulations on health insurance plans drive up premiums and discourage small companies from offering insurance (“Too quick off the mark,” April 10).

I found similar effects when researching my proposal to the Blue Ribbon Commission on Health Care Reform entitled FAIR: Free-markets, Affordability and Individual Rights. Online at the commission’s Web site, it also shows that other state-level mandates such as guaranteed- issue and benefits mandates also increase premium costs and leave many unable to purchase medical insurance.

As does all legislation that violates our rights to freely associate, such as voluntarily contracting with insurance companies, these prohibitive rules are hazardous to our health.

2. Boulder Daily Camera

The government would worsen it

Clay Evans (Insight, April 29) argues that a monopolistic government-run “single-payer” health care system “would almost certainly lower costs.” Government lowers costs? That’s an oxymoron. Like any monopoly, a government-run program lacks incentive to lower costs and provide quality products because its customers cannot leave. Government-run health care lowers costs by rationing, where bureaucrats decide whether you’re important enough to legally receive treatment.

Consider Medicaid. My proposal to Colorado’s Blue Ribbon Commission on Health Care Reform, Free markets, Affordability and Individual Rights (at the commission’s Web site), documents that Medicaid fails to meet the commission’s criteria for accessible, affordable, and quality health care. And Medicare? The Medicare Payment Advisory Commission reports that Medicare is “largely neutral or negative toward quality …. At times providers are paid even more when quality is worse.” If government can’t provide quality low-cost health care to Medicare and Medicaid enrollees, how can it provide it to the rest of us?

Government meddling in the free market has distorted real health insurance into prepaid health care. This encourages thoughtless over-consumption, increases costs and limits access. It also erodes the doctor-patient relationship by wedging either a government or insurance bureaucracy between them. My proposal outlines how effective health-care reform requires repealing unjust policies that prevent a free market from delivering quality, low-cost health care — just as free markets provide other essential goods and services.

There is no right to health care – Denver Post letter

Another letter:

Letter-writer Pam Lacey writes that “health care should be a right” (April 26 Open Forum). If health care is a “right,” people can claim the time, energy and wisdom of doctors and taxpayers who provide the care, whether the providers consent or not. This turns the providers into indentured servants and violates true individual rights of self-ownership and voluntary association. The U.S. is “the richest country,” as Lacey notes, because its governments have mostly respected individual rights. Lacey wishes to ensure health, housing, food and education. A free market grounded in individual rights best ensures our ability to obtain such values.

While a (relatively) free market in food and housing provides those goods in abundance to rich and poor, the government-run education system fails the poor especially. Last year the American Institutes for Research reported that one in five college students lack basic math skills and half lack complex literacy skills.

If politicians and bureaucrats provide health care by “right” at others’ expense, both our health and our liberty will suffer. For effective and just health care reform, see my proposal, “FAIR: Free-markets, Affordability, and Individual Rights,” at the website of Colorado’s Blue Ribbon Commission on Healthcare Reform.

Rocky Mountain News posts my Guns on Campus on-line comment

I wrote:

Is it fair to report that CU student Matthew Furnish’s “crime” was possession of “deadly weapons” — especially in the caption under his photograph? (News, April 20) Might have “firearms,” used later in the article, been more neutral? How would the News report the life-saving acts of Kenneth Hammond of Ogden, Utah, or assistant principal Joel Myrick of Pearl, Mississippi? Each used a firearm — in a “gun-free zone” — to stop criminals who had opened fire in mall and a school, respectively. Would the News refer to guns as “implements of life-saving self-defense”?

Adults with permits can legally carry concealed firearms in Utah schools and universities, where there have been no mass-killings. In Utah, those sufficiently trained to have conceal-carry permits can deter and heroically stop violent criminals. At CU, they are felons. CU’s prohibition of firearms for self-defense purposes leaves students, staff, and faculty defenseless against deranged school-shooters.

The comments so far have been pretty good.

Health Care Letters to the Editor

The Denver Post published an abridged version of the following letter today. Scroll down on here.

Al Knight (Feb 27) attributes growing health care costs to advances in medical technology. Yet, if this were true, why have cosmetic surgery and corrective eye surgery costs decreased compared to similar services? According to the National Center for Policy Analysis, costs of medical services increased by 77%, almost twice that of the Consumer Price Index between 1992 and 2005. Yet, cosmetic surgery costs increased by just 22% and the cost of corrective eye surgery has actually decreased.

The difference? Customers are prudent when spending their own money, but are big spenders when spending someone else’s. Patients pay for cosmetic and eye surgery themselves, and to attract customers, providers must innovate to both lower costs and improve quality.

Health care costs so much because patients pay so little for it – just 14% out-of-pocket. Tax laws, Medicare, and Medicaid have made health care like a subsidized buffet-style restaurant. Legitimately concerned patients seek expensive MRIs and CAT scans, regardless of their cost and necessity. Yet, the RAND Health Insurance Experiment has shown that high-deductible policies reduce patient spending — with no measurable effect on their health. Policy-makers should repeal laws that discourage such policies and expand access to Health Savings Accounts.

Earlier in the week I submitted the following letter to the Denver Rocky Mountain News. It has yet to be published.

“My family is a victim,” said a protester calling for more government meddling in health care (Dozens rally for lower health-care costs, Feb 26.) Indeed, we are all victims — of destructive government policies that inflate costs, limit accessibility, and cripple technological advancement.According to the Council for Affordable Health Insurance, government insurance mandates boost policy costs between 20 and 45 percent.” Economist Chris Conover found that health-care industry “regulation” has caused chaos: it costs each household $1500 and is responsible for one-sixth of the daily uninsured.

Health insurance does not guarantee health care. Says Canadian Medical Association President Brian Day: “dogs can get a hip replacement in under a week,” while “humans can wait two to three years.” (The free-market cares for the dogs.) The Fraser Institute found that on average, Canadians wait more than 17 weeks to see a specialist. As Lindsay McCreith knows, brain tumors move faster than bureaucracy. Instead of waiting eight months for “universal care,” McCreith went to New York for life-saving diagnosis and surgery, and is suing the Ontario Provincial government for damages.

If the 20th Century Communism has taught us anything, it’s that government controlled economies result in poverty, stagnation, and misery. Let this be a warning: Government is hazardous to our health care.

Who Really Cares?

This week’s Boulder Weekly published my letter to the editor about the book Who Really Cares and an article a columnist had written about it. Here’s a link to the print version and the text of the letter:

Wayne’s wasted chance

I was quite disappointed in Wayne Laugesen’s recent article (“Jesusland,” Wayne’s Word, Dec. 28) about the book Who Really Cares: America’s Charity Divide, by Professor Arthur Brooks of Syracuse University. The author’s website summarizes: “Approximately three-quarters of Americans give their time and money to various charities, churches, and causes…Why has America split into two nations: givers and non-givers? Arthur Brooks, a top scholar of economics and public policy…demonstrates conclusively that conservatives really are compassionate—far more compassionate than their liberal foes. Strong families, church attendance, earned income (as opposed to state-subsidized income), and the belief that individuals, not government, offer the best solution to social ills.”

Wayne has often defended individual freedom and free-market policies, and exposed government folly and abuse of power. His explanation of Brooks’s findings could have continued this. Wayne could have mentioned the obvious: that “progressives” worship at the altar of compulsory government charities, and then exposed their moral bankruptcy, hypocrisy and destructiveness. He could have shown how government charities unfairly crowd out voluntarily-funded ones, how they are unaccountable because tax laws compel us to donate and how spending other people’s money is not compassionate, but intolerant and arrogant. He could have mentioned relevant scholarship such as David Beito’s From Mutual Aid to the Welfare State or Marvin Olasky’s The Tragedy of American Compassion. That is, he could have explained how compulsory charity is neither a moral nor effective way to solve social problems. Yet, Wayne chose not to do this.

He had ethics, economics and history on his side—not to mention several column-inches to showcase his writing talents—to influence public opinion and be a force for positive change. Instead, his “explanation” employed blatantly fallacious non sequiturs to insult secular non-believers, a good part of his audience. (For an elegant refutation, see Kent Northcote’s letter in the Jan. 4 issue.) A left-wing secular friend of mine regularly reads Andrew Sullivan, a conservative Roman Catholic who refrains from such inflammatory ad hominem attacks. After reading Wayne’s Ann Coulter-like rant, I doubt my friend would give Wayne a second chance.

Wayne: What is the purpose of your writing? Is it to persuade people that more individual freedom—not Big Government—will promote peace, wealth and justice? Or is it to insult your readers, court angry letters, turn people off to your ideas and consequently become an enemy to the values you profess to advocate?

Brian Schwartz/Boulder

I’m glad they printed it, but the four letters supporting a minimum wage are so poorly argued, I suspect that this newspaper will print anything. This reminds me of research on how biased and irrational people are when advocating public policy. Arnold Kling (Yes, that Swarthmore guy, what’s that I feel “school pride”??) has a good article on it, though TCSDaily is down as I write this.