More DMVs, please

Who are these people that go to the Department of Motor Vehicles to get their driver's license renewed and say "Oh yea, that's how I want my doctor visit to be."?

Or someone who has the pleasure of dealing with the IRS and concludes "Yep, I want to go through that to get my pacemaker approved."?

The pat objection to today's health care system is that it's too "profit driven" and not "caring" enough. Capitalism doesn't work for medicine (as if the reformers approve of capitalism anywhere else). Well, being "profit driven" can be accused of a lot of things, but failing to reduce costs is not one of them. And Amtrak is not profit driven . . . exactly how "caring" would you say it is?

The truth is, today's health care system is not capitalist (meaning, it is not a free market). This is true for at least 3 reasons:

1) The American Medical Association (AMA) controls the quantity and type of physicians that exist on the supply side of the market. They have successfully directed legislation to the point that it is illegal to establish a competitive entity. It's like creating a legal monopoly that controls the number of grocery stores . . . think how expensive your food would be.

This fact also limits the types of physicians out there. Today it is illegal for someone to open a wart removal clinic without going through the AMA required process of education and certification, becoming at least a general physician. You can't just go to a 2 year school to learn all about warts and how to remove them and then open an office. Those against free markets say that a highly educated doctor should do it because it might be skin cancer or some other serious condition. But, you can go to the drug store and buy a wart removal product that freezes them off. I doubt the checkout boy at the Walgreens is an expert in melanoma. As always, the perfect is the enemy of the good. A lot of people could be served by an array of low cost health practitioners, but the government, driven by the AMA, won't let it happen.

2) Health benefits from your employer are not taxed like regular income. This has created a culture of special treatment of benefits that raise costs. For example, does it really make sense for your health insurance provider to pay for your annual checkup? This is like your auto insurance company paying for your oil change. Sure, it sounds great, but why do I need to pay someone to pay my bill for me? It just raises cost. There's no such thing as a free lunch, so that perk of not having to pay for your oil change would only raise your auto insurance rate and lighten your wallet more than if you had just paid it yourself.

Treating health benefits like regular income would, among other things, have the effect of returning insurance to its proper place . . . as insurance. Just like home, life, auto, fire, flood, theft and locust insurance, it only kicks in when something bad happens. Otherwise, you pay out of your pocket to get through life. Watch how costs go down and how you think twice about going to the family doctor for a simple cough or sore throat if it's coming out of your pocket.

3) Malpractice suits are unpredictable (hence, unacceptable) sources of risk for physicians, therefore enormous amounts of wasted resources are spent to avoid putting one's career in the hands on 12 jurors, each of which sees a doctor as insensitive, overpaid and too tan. The amount of money taken out of the health care system and put in the hands of trial lawyers, insurance salesmen, accountants and, of course, harmed patients is staggering. Beyond belief staggering.

A government that allows such a system to persist must be one run by trial lawyers. Contract law is perfectly capable of handling any eventualities that may result when a human doctor treats a human patient. Simply put a price on whatever may occur in advance, in writing and make it part of what motivates you choose one doctor over another. If one doctor will pay you $2 million dollars if he accidentally misdiagnoses your heart condition and another will pay you $4 million, maybe the second doctor has a little more confidence in his skills. Or maybe the first doctor's fees are lower because he's not running every test under the sun. In any case, you now have information you can use to choose your doctor.

(Note: Doctors having different business models and for folks to choose their physician based on such things is distasteful to some people. I respect that. OK, no I don't. Grow up.)

So, instead of letting capitalism do what it's always done (maximizing efficiency and innovation) we're going to put the government in charge of our health care system, undoubtedly dooming us with what it has always done (maximizing bureaucracy and stagnation).

This brings us to a troublesome reality in the health care debate: it's not about health care. The motivation for these reformers is not to improve the system or to make it more efficient. The real goal, as is their goal in so many things, is to tear down the rich vs poor class structure. Everyone should get the same . . . fill in the blank: health care, education, housing, retirement, food, car, vacation, wardrobe, cell phone . . . the list is all encompassing. It's a classic socialist dogma that no man deserves a better life than another, despite how hard he worked or the risks he took. Anyone who lives well is doing so at the expense of another and should therefore not be allowed to do so.

(Challenge to the reformers reading this: Be honest, in your heart of hearts, this is your deepest motivation, isn't it? Take a minute and tell the truth.)

Ending these blogs on a positive note these days is difficult. Look around and it's clear the direction we're headed. But, at least your doctor and the DMV can use the same eye chart equipment. That'll save some money, right?