Healthcare – Market Reform

A core problem with the American health care system is that its market is fundamentally flawed. Part of this is due to laws created to provide humanitarian treatment during medical emergencies. In 1986, congress passed the Emergency Medical Treatment and Active Labor Act. Before EMTALA, if you showed up at an emergency room without proof of insurance, you could be turned away. Under this new law, hospitals would be required to provide services no matter the financial status of the patient.

Under EMTALA, there became less of an incentive for people to get insurance since emergency care would always be provided. And since the uninsured will be will be far less likely to pay their bill, someone has to cover these costs which are estimated at 55% of all emergency services. This results in hospitals raising their prices for services, which typically falls on the insured, raising premiums. Thus, you have a perverse incentive for the purchase of health insurance.

A large percentage of the uninsured are young healthy Americans. These individuals would contribute more to insurance revenues rather than costs. Therefore, a possible solution is to require obligatory coverage. By doing so, we expand the risk pool of Americans to lower per capita insurance costs. Since most Americans are now insured, the cost of EMTALA is reduced, which lowers costs across the board. This is a market based approach to the concept of socialized medicine.

There is another positive side effect. Since insurance is mandatory, anyone showing up for treatment without insurance would most like be an undocumented alien. These individuals could be treated and turned over to immigration officials thus easing the loads on ICE. However, it is also likely that illegals would purchase insurance to prevent easy discovery. Either outcome is a net positive for health care.

As a libertarian, the thought of mandated insurance is in exact opposite to my core principles. But the other solution is to turn away people at the hospital that are not insured or don’t have an insurance bond. I’m not sure any libertarian could support that ideal.

Healthcare – Cost Benefit Analysis

People complain about HMO’s and “drive-by medicine.” They say that hospital stays should be longer and more comprehensive. But what happens when the controls are released and the floodgates are open? Let’s say that an indigent mother gives birth to a premature child. We have the medical technology to save the child. But at what cost? $100,000 to $1,000,000 is not uncommon for this type of service today. Perhaps you think it’s ok for the taxpayer to foot this bill at this level. But, what happens when it becomes $10,000,000?

We have not come to the point of accepting that actuarial decisions MUST be part of health care. If you have X dollars to spend and there is a request for $1,000,000 in treatment for a single case, it has to be determined how that money is best spent. A bleeding heart liberal would say the insurance companies make too much profit so make them save everyone. But the insurance companies just pass those costs on to the consumers, which is our current problem.

On a related note, will someone please take Sarah Palin moose hunting and not bring her tired ass back? Her idiocy in blabbering about supposed “Death Panels” was the stupidest thing that a conservative could have done. End of life counseling was the one sound fiscally conservative aspect of the heath care reform bill. But no, politics are more important than real reform.

On the Nature of Human Intelligence

What is the nature of intelligence? Is it just you or the sum of you and any tools you have at your disposal? For the purposes of an IQ test, it would be just the organic part. However, on your job were it really counts, all bets are off. You are allowed any trick in the book to achieve your goal. And in your personal life, you set the rules. I submit that we have already entered the Cyborg age. It may not be exactly what you expected from reading science fiction, but the details are just speed and interface.

The typical techie has some type of wireless Internet access at most times, be it 3G, EVDO or wifi hotspot. With this technology, you are able to access such on-line resources such as Wikipedia, Wolfram Alpha, or the Internet Move Database. If you can access this information at any time and place, doesn’t it make it part your smarts? I mean you can get the information, perhaps not with the speedof Marilyn vos Savant. But you could easily wax her tail with the sheer volume of information available. Who played Lumpy on leave it to Beaver? Suck on that, Marilyn. It’s given that only part of intelligence is pure recall, but it’s an important part. Original and theoretical constructs are key piece of total cranial horsepower. But even each of these are based on a foundation of basic recall.You could argue based on the premise that we have been in the Cybernetic age since the first written word. But I submit that carrying around the Library of Congress is impractical. It is only the confluence of wireless devices and the Internet that finally makes the total of human knowledge available on demand.

There was a time when students weren’t allowed to use calculators during a test. Now its pretty common if not encouraged. And now we are seeing Internet access accepted on tests as well. Thus, the total of the human experience now includes handheld devices.