Health Care Ramblings

I'm only a month away from being 64-years old. (Remember the Beatles' lyrics, "will you still need me, will you still feed me when I'm 64?")

On the front page of Friday's (7/3/08) Daily Sentinel, there appeared an interesting article titled, "Medicare cuts: Doctors to get 10% less unless Congress acts".

One local doctor, Michael Pramenko, whose personal philosophy presumably leans "left", opined, "People need to put heat on the politicians to fix the bloody system". He seemed to be totally oblivious to the harsh realities of Economics 101, and the fact there is no such thing as "something for nothing". Things are not produced, and problems are not solved by throwing "money" at them. That's simply not the way our cause-and-effect universe functions.

I couldn't suffer either Pramenko's gross ignorance or his poorly-hidden arrogance, so I wrote a 573-word letter to the editor which obviously had little, if any, chance of making the 250-300 word limit of the letters-to-the-editor section.

It didn't make the Daily Sentinel, so I decided to turn it into a blog. Here it is.


With the "slowing" economy, we will all have a chance to reacquaint ourselves with two natural laws of economics which do not depend on collective human opinion or manipulation for their existence and gravitational force: 1) whatever you tax (honesty, ingenuity, productivity, virtue, good health, etc), you will get less of, and 2) whatever you subsidize (dishonesty, apathy, scamming, unproductivity, unwed motherhood, sickness, etc), you will get more of.

Humans, like a dog who knows how to find shade on a sunny day, will tend to naturally channel their labor into whatever pays them the most. If sugar beets have a higher market price than potatoes, then farmers will tend to grow more sugar beets and less potatoes. That is how the cause-and-effect free market (which Nature inherently is) works.

In the long run, an economy cannot work with a non-commodity, debt-based, "legal tender", medium of exchange and everybody competing against everybody else for the governmental power with which to benefit themselves over the "other guy".

Due respect and affection for doctors cannot be allowed to stymie an intellectually honest discussion of empirically observable economics-related realities.

Truth is, the health care industry has led inflation for several decades. This could not have happened without government-granted, market-hating de facto monopolies on access to pain control. Both the medical and legal professions desperately need to be deregulated. New medicines are being held back because "the right people" aren't in control and/or getting "enough" money. Most people already cannot afford the current level of medical prices and fees.

It is impossible for some nebulous, undefined smoke-and-mirrors "system" to fix the problem by throwing more money at doctors, notwithstanding Dr. Mike Pramenko's economics-challenged suggestion to "put heat on the politicians to fix the bloody system". I could make the argument that "fixing the system" means giving me more money and Dr. Pramenko less, instead of the other way around. Exactly where is the "more money" Pramenko wants supposed to come from? Production cannot simply magically appear out of thin air. Somebody has to do the real work of making it. What fairness-based, substantive-due-process compelling government need mandates that it should be the rest of society and not doctors (or lawyers, or any other demographic group) who get to work harder for less money?

The libertarian approach (and in my opinion by far the most logical) would be to abolish the FDA and the so-called "unauthorized practice" of both medicine and law. In addition to the recently recognized individual right to own and bear arms, the individual also has the right to represent himself in court, and the right to "doctor" himself, with equal access to all the same medicines and tools available to commercial doctors. Like increasing our energy competitiveness, this would tend to let health-care prices gravitate toward real, means-tested free-market levels.

Certified doctors would still be in business, because only a fool would try to commit open-heart surgery on himself. And if they should happen to make less money, well, they would still have the option of getting another part time job to help pay for $5/gal (or $10/gal, or $20/gal) gas just like the rest of us mere mortals who are out here in the real world trying to survive (and pay our doctor bills).

Obviously opinions will vary, but not to worry: things are going to get a lot worse before we get natural economics-related realities figured out and they get better!

John Wilkenson Grand Junction


As it happens, after I wrote the blog, a pharmacist friend of mine emailed me and told me he had read my letter in the Free Press. Click here to read that version. I guess the Free Press didn't like my "dog knows how to find shade" paragraph. Maybe too much information. Who knows? One thing I've learned is that most "establishment" newspaper editors have never so much as even heard of ego deficits, much less actually have one. So, if you'd like to get your letters published in their papers, it's often best not to appear too ungrateful by questioning how their editing decisions reflect their personal agenda/s!

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