For the last eight years I've held that, if a group of people engaged in a serious conversation about free market health care reform, that group of people could have a decisive effect on the heatlh care debate.
I've been been perplexed by the unwillingness of Conservatives to discuss free market reforms and had given up on the GOP.
However, I was delighted to hear Doctor Ben Carson mention the words "Health Empowerment Account" before the moderator cut him offer and diverted to less pressing concerns.
I was astounded. A word about free market health care reform was spoken in public and, just maybe, some people somewhere started thinking about the issue.
Maybe some people asked themselves: "What is a Health Empowerment Account"?
- How can an account empower people?
- How is a "health empowerment account" different than a "health savings account"?
- Why did the moderator cut Ben Carson off?
- Why haven't any other conservatives discussed free market health care reforms in the last eight years?
I actually do have answers to the questions above. Let's answer the easy questions first. Going in reverse order:
4) The moderator cut off Ben Carson because conservatives (and members of the GOP Establishment) do not want the American people to discuss free marketh health care reform.
3) Conservatives don't want Americans to discuss free market health care reform because true free market reforms would hurt the insurance industry.
Conservative opposition to free market reform is itself a very interesting story. For this paragraph I will simply state that Conservative think tanks are often funded by insurance and the goals of Conservatism and Big Insurance companies are closely aligned.
This thing we call ObamaCare (PPACA) is a network of state run health exchanges. The structure for the health exchanges was created by a Conservative group called "The Heritage Foundation." The basic idea is that the industry could improve coverage if the state were to combine insurance mandates with regulations that forced insurance companies to provide coverage for pre-existing conditions.
The Heritage Foundation believed that insurance mandates might help it achieve a variety of conservative social goals. After all, the group that controls access to health care can control the people.
2) Conservative have a long history of passing legislation that benefits insurance companies. The system of Health Savings Accounts is a prime example.
The HSA program gives a tax credit for money put aside in a "Health Savings Account." My first observation is that only people with large incomes benefit from the tax credit.
An HSA is usually given in conjunction with high deductible insurance policy. The high deductible frees insurance companies from having to process small claims for day to day care.
The pernicious effect of the HSA is that only upper income employees benefit from the tax credits. Lower income workers simply receive health coverage with high deductibles which they cannot afford to pay. While it is true that low income workers with no children and no health expenses can benefit from an HSA, the HSA model artificially decreases the income of low income with children and those with health expenses.
The HSA model was created by the insurance industry as an add on to insurance to benefit insurance and people in upper management. The fact that one model built around savings benefits the rich does not mean that all models will benefit the rich.
1) This is why I was excited to hear Ben Carson mention the words "Health Empowerment Accounts" during a public debate.
I believe strongly that, if one built the health care system around a health account that one could create a system that empowered people to take control of their health.
I am not an expert on the Ben Carson plan. Okay, the only thing I know about the Carson plan is that it starts by giving each person an account that is used to track their personal health savings and expenses.
I know that this statement will sound weird at first. But this simple step of giving people an account to track their savings and expenses would fundamentally change health care in America.
The current health care system is built on a collectivist model. In the current system, health care is provided at a group level through insurance companies. Insurance companies collect premiums for care to build a health care pool. The insurance company tracks the expenses of the pools and the wealthy investors speculate on the pool. Claims adjusters within the pool determine who receives care and when.
For more information on the philosophical model behind insurance. I suggest reading a rather dense tome titled "Das Kapital" by a nineteenth century thinker named Karl Marx. (I never really understood insurance before I read this work by Marx who could rightfully be considered the founder of modern insurance).
And yes, I did just state that employer based healthc are is socialization of health care at the corporate level. From a mathematical point of view, there is little difference between health care collectivized at the employer level and health care collectivized at the state level.
The most direct path to breaking apart a collectivized system is simply to start tracking expenses at the individual level.
The money for health care could still be in a pool. The simple fact that the system is tracking the health of individual people and not collective health would fundamentally change the system.
The simple fact that individual accounts would allow individuals to start seeing their health as their concern would dramatically change the health care system and health in this nation.
I admit, I am part of that radical fringe who wants America to take the anti-social step of removing some of the money from insurance pools and giving individuals greater direct control over their health care dollars.
Like other free marketeers, I have a tendency to jump of ahead of myself and start talking about how our society would appear if there was a more equitable distribution of capital. (Hint there would be more small businesses, less big businesses, a more equitable distribution of income, and healthier people.
People are so cowed by big insurance that, at this point in time, people are in capable of imagining health care without huge pools.
But, if they had direct access to information about their personal health, people would start to realize that they would be better off with direct control of their health care dollars.
Anyway, I was really excited to hear Ben Carson say the word "Health Empower Account" on the TV set before being cut off by the moderator.
My head has been spinning with all of the possibilities that could take place if there were people brave enough to talk about free market health care reform.
Now, both Ben Carson and Rand Paul seem to be out of the running for this presidential race. None of the other GOP candidates seem to have any interest in free market health care reform.
I can't imagine a debate about free market health care reform taking place in this political cycle; So, I admit I am somewhat at a loss as to where we should take this debate.
Dr. Carson's system of "Health Empowerment Accounts" would go a long way to restoring freedom in America. I think what we have to do is discuss why recording health information on an individual basis would change health care and work to differentiate this idea from Health Savings Accounts. Above all, those seeking to advance free market reforms have to counter this fiction that Conservatives support free market reforms, when the truth is that conservatives actively silence discussion of such reforms at every step. Just hearing a person mention a word in a debate before being silenced should be enough. But I can't figure out where to proceed with that.