Forget government involvement. Forget even the insurance companies. Why not return to the traditional purely free market way of seeking and providing health care through direct payment to the doctor for services rendered?
Seems simple, right? Why has this time-honored practice been completely missing from all the discussions by the politicians in Washington? Why haven't Obama, or even the Republicans, mentioned this truly single-payer system?
Out in the Heartland, at least, the people are catching on. In Lakewood, Colorado, Rich Olver has no health insurance, and he wants to keep it that way. Olver pays for all his health care needs with cash. From his editorial in The Denver Post, July 31, "Paying Cash for Health Care:"
As one of the millions of uninsured, I’ve developed the habit of shopping for my medical care. The good news is that there are deep discounts to be had if you can pay at the time you receive care. Nor does cost have much to do with quality of care. Some top doctors give deep discounts for not having to deal with the “medical insurance companies."
While some quacks haven’t figured out that getting paid up front is easier, faster, and in the long run cheaper than waiting 3 to 6 months or never getting reimbursed by said “insurance” companies. (Certainly you’ve noticed that job One at the insurance companies is to NOT pay claims, and they’re just making up reasons to not pay these days)…we uninsured don’t have to pay their exorbitant fees. There is always competition.
These days most of it resides on the internet. Recently my doctor suggested a test. A call to LabCorp, and it priced out to $125 (sorry sir, no discounts for paying cash). But it only took 5 minutes on the internet to find the same test for $49.
From the San Francisco Examiner, Aug. 14:
The Web site Craigslist says overall bartering posts have more than doubled over the past year as the recession took hold.
People who barter for health care say the practice allows them to stretch their resources or receive care they couldn't afford. But bartering can be tricky, and not every health care provider will consider it.
Some doctors are open to bartering directly with patients. Others do their trading through an exchange like ITEX.
Health care bartering has risen dramatically since the recession began, as people lose their health insurance and consumer spending drops, said Allen Zimmelman, a spokesman for the Bellevue, Washington-based trade exchange ITEX Corp.
The article goes on to cite a couple of examples: A woman in rural western Virginia who trades fresh produce from her organic farm to a local doctor to keep her premiums down, and a man in New Jersey who traded his web design services with a dentist for cosmetic repair of a chipped tooth. Continuing:
Josefs, the Web site designer, found quick acceptance for his services. A dentist about an hour from his New Jersey home responded a few days after he posted a notice last year on Craigslist… Josefs had bartered successfully once before — by doing some Web design work for a sushi restaurant he and his wife frequent — and decided to try again. After calling an insurer to make sure his barter partner was an actual dentist, Josefs got about $900 in work in return for designing a Web site for the dental practice.
He and the dentist hashed out a price after Josefs showed some sample Web sites and explained their cost.
And bartering may be bigger than you think. Blogger Dan Clore quotes the San Diego Union-Tribune:
Although bartering is an age-old way of obtaining goods and services that was largely replaced by currency, U.S. businesses have never stopped using it. Bartering among U.S. companies accounts for about $4.3 billion in transactions, according to the National Association of Trade Exchanges.
And as with so many other proposals, it's the libertarians who are out on the forefront of the cash for health services movement.
Columnist Arnold Kling writes at the Library of Economics and Liberty website:
The basic problem that the Democrats have with health care reform is that when it comes to taking our system away from free markets, there is just not that much farther we can go. We already regulate the practice of medicine and allied health services with licensing cartels. We already regulate individual health insurance practically out of existence.
In contrast, there is a lot of room to move health care in the other direction — toward free markets. The only real health care reformers are those of us on the libertarian fringe.
Libertarian candidates are even emphasizing the cash for health services issue in their campaigns. Dr. Tim Nerenz is a Libertarian Party candidate for Congress in Wisconsin. From his campaign website:
The way to fix an economic efficiency problem is to increase choice and competition; add in the component of direct payment for services, and you have a Libertarian health care alternative to government run health care – Medical Choice.
We already pay for many types of health care services directly – optometry, dentistry, chiropractic, many pharmacy products and services, routine office visits, for example. The simple act of paying the entire amount of a service, rather than a tiny co-pay portion, make consumers and providers focus on benefits and costs of health care services, just as they do any other purchase decision.
Hopefully, Libertarian Party candidates such as Dr. Nerenz can push the issue more into the mainstream of American politics. And hopefully, Republicans will be quick enough to adopt this libertarian ideal.
The completely free market alternative of cash and barter could provide a powerful counter balance to the Progressives looking for a complete government takeover.Powered by Sidelines