A Libertarian approach to health care ‘reform’ OR I Can Get It For You Wholesale

I had a physics professor in Brooklyn College who was asked one day about a book entitled, "Physics Made Simple." The question was whether or not physics could indeed be made simple. HIs answer was, "Of course it can be made simple. Just leave out all the hard stuff."

A similar question is often asked about health insurance, i.e. whether it can be made cheap. The answer is, "Of course it can be made cheap. Just leave out all the expensive stuff, like MRI's, coronary artery bypass, etc."

Nevertheless, the good news is that, though good quality health insurance will never be cheap, It can be made cheapER. One of the problems is that each state regulates health insurance differently, requiring a variety of expensive 'mandates' (addiction treatment, chiropractic, etc.) and prohibiting residents who don't want to pay for all the 'bells and whistles' from purchasing insurance in other states.

There is a better way.

I propose that we make the District of Columbia into a health insurance free trade zone, supervised by the Department of Health and Human Services (or maybe another czar or czarina). The Constitution grants Congress the duty to "exercise exclusive Legislation in all cases" over the District. While home rule was granted in 1975, Congress still has final authority.

We should allow any insurance company operating within the District to offer for sale any type of health insurance offering any benefits subject only to the following restrictions:

1) Demonstration of sufficient reserves to pay claims.

2) Benefits and restrictions be clearly spelled out in the policy.

Companies that want to organize and operate as a "Cooperative," fine. Those who want to operate individually, also fine. You want to come here to buy insurance because you can get a better deal? Common' down. Want to keep what you've got? No problem. Isn't that what the President promised?

Not only will this make insurance more affordable, it will also serve as a non-compulsory 'laboratory' for any insurance company with a good idea about how to offer a better product at a more affordable price. All we ask is that you put up your own dough and that you don't lie to us. Isn't that what the American Way was supposed to be all about anyway?

As to the question of a possible illegal preemption of State prerogatives by the Federal government, this will be a question for the lawyers to decide. However, the Constitution's Supremacy Clause addresses this question, "The Laws of the United States [i.e. the Federal government]…shall be the supreme law of the land." Besides, why would the states want to continue mucking around in the insurance business if this were all to work out and the Congress, for once, got it right?

We should also make health insurance deductible for individuals purchasing their own insurance just the way it always has been for those getting their insurance from their employers. Fair is fair.

And, finally, there is the question of tort reform, which might go a long way toward controlling costs. The British, in their inimical fashion, have always regarded as 'eminently sensible' the suggestion of a little known British playwright who proposed over 400 years ago to 'First, shoot all the lawyers.' Personally, I would lean toward the successful-where-it's-been-tried cap on non-economic damages. But this is a subject for another time.

Dr. Finger has been practicing otolaryngology in Brooklyn since the invention of the ear, the nose and the throat. He ran for Congress in 2006 on both the Libertarian and Republican lines and came within 44% of staging a major electoral upset. drstevefinger@aol.com

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