VACUOUS

Nature and politics abhor a vacuum. In this election the Republicans left one for the Democrats to fill, and fill it they did. When Democrats accused Republicans of gutting the so-called pre-existing condition protections in Obamacare. Republicans offered no push-back to the attack. Instead they parroted that they are for pre-existing protections too. Pre-election polling found that health care was the top issue in the recently concluded campaign. This was especially true of white suburban women, a group Republicans lost by 20 points. Democrats rode this issue to regain control of the House for the first time since 2010.

A pre-existing condition means someone is already sick. To insure is to mitigate against risk – in the case of health care, an expensive illness or accident. By analogy, consider homeowners insurance. If you have a roof that’s about to collapse and you try to buy homeowners insurance, you’re out of luck. Insurers won’t sell you a policy because they know they’ll lose money. That’s a pre-existing condition, a sure loser for an insurance company. Now let’s say the government mandates that insurance companies must issue a homeowners policy to insure all homes in any condition. What will happen? The cost of insurance and everything associated with it will skyrocket for everyone.

With health insurance, we don’t have to guess what might happen if insurers are forced to issue policies to already sick individuals, because it has happened under Obamacare. The main reason for the now-defunct individual mandate, which forced young and healthy people to buy health insurance, was to defray the cost of insuring the sick. The effect of these so-called protections has been disastrous. Insurance companies in the Obamacare exchanges have declined in number every year, and yet again in 2018. Remember the promise that each family would save $2500 in healthcare premiums? According to Health and Human Services (HHS), premiums have doubled since 2013. Doubled. In 2018, costs have risen by 19% for expensive plans and 32% for the cheapest plans. Inflation for all other goods and services is only 2%.

When Democrats attacked, Republicans ran for the tall grass. They allowed Democrats to tout the benefits of pre-existing conditions protection without making them own the terrible price that these protections cost average people. Republicans should have pivoted and attacked, accusing Democrats of wanting to deprive people of healthcare coverage by making health insurance unaffordable. Republicans should have asked: Why should Democrats have any credibility on health care given how they lied to pass it, then badly bungled it? These are arguments that college-educated suburban women would have understood. These arguments might have saved the House. But Republicans would have needed the courage to fight and make a case to a public hungry for leadership.

 

Michael A.Morrongiello, Ph. D.

 

MONOPOLY

MONOPOLY

We used to think that concentrated monopoly power was bad for business, bad for competition and really bad for consumers. The point of monopolies is to eliminate all competition and to fix prices, maximizing profit for the monopoly owners. Merriam Webster defines a monopoly as “exclusive ownership through legal privilege…exclusive possession or control…a commodity controlled by one party.” To prevent monopolistic practices like price-fixing and restraint of trade we passed several antitrust laws, the first of which was the Sherman Antitrust Act of 1890. Its aim was to promote competition, leading to lower prices, better products and services and greater consumer choice, keeping free markets free. Having a monopoly and making a handsome profit was fine, as long as businesses did it by besting their competition.

Now cast your mind to health care, and change the word profit to power. Instead of the filthy-rich monopoly man lighting his big cigars with $50 bills, you have politicians greedy for power and seeking to acquire even more – the power to decide who suffers and who is healed, all to make us beholden to them. This is the essence of so-called single-payer health care. Make no mistake, power is what politicians crave, and they wield it with the same casual ease that we give to changing our socks.

If enacted, single-payer would be the single biggest monopolistic concentration of power in the history of the United States. In its many iterations, single-payer health care is authoritarian (directed from a central authority) and is the very definition of a monopoly (total control over the vast array of products and services that make up health care.) Consider that any single-payer system must control the manufacture of prostheses, drugs, imaging devices, doctors, hospitals and, of course, prices.

Bernie Sanders, the avowed socialist from Vermont, has a plan which outlaws all private insurance – it’s BernieCare or nothing. He wants the secretary of Health and Human Services to establish a “national health budget.” But what happens when a surgical procedure for a painful condition nudges just over the “national health budget?” Oops, sorry – no care for you, madam, and no relief for your pain.

Bernie says we spend too much on health care. Canada spends less per person, he says. But Canadians wait 10 weeks for a referral to a gynecologist, 38 weeks for any kind of joint surgery and 47 weeks for neurosurgery. Why do Canadians wait in pain? Because their government tells them they must.

There is more bad news from the fantasyland that is single-payer health care. The Veterans Administration has been hiring doctors who have had their licenses revoked by their state licensing boards. This is the reality of any government-run system: you don’t get the best, you get who they give you, competent or not.

A review of the NHS (the National Health Service, UK’s government agency in charge of health care) found that NHS cannot meet the growing demands for services. It has gotten so bad that the NHS has been paying people with spare bedrooms to take post-surgical patients into their homes to ease the overcrowding in NHS hospitals.

A recent UK Independent headline blared, “NHS extends suspension of all non-urgent care as doctors warn of winter crisis.” As a result, the NHS “deferred” 55,000 operations. An operation deferred means suffering continued.

The whole point of antitrust legislation outlawing monopolies was to promote competition and provide better service to consumers. A monopoly made by building a better mousetrap comes about through competition and is earned. Single-payer would fall upon us by the exercise of raw political power and the unshakeable belief by elites that they are smarter and more compassionate than we are. It doesn’t matter who has the monopoly, concentrated power is a bad thing.

Monopoly is a game. People pretend to be landowners or railroad barons. A government health care monopoly is no game. Senator John Sherman, author of the law that bears his name, said, “If we will not endure a king as a political power we should not endure a king over the production, transportation and the sale of any necessaries of life.” The title of the autocrat does not matter: Your Highness, Senator, Secretary or Madam President. Because single-payer is a tyranny disguised as compassion. And we, as a free people, deserve better.

Michael A. Morrongiello, Ph. D.