The government’s subsidy of the corn industry has been well documented as having contributed to the excessive consumption of corn and the resulting negative impact on Americans health (i.e. high fructose corn syrup). It doesn’t matter how much we eliminate taxes or regulatory restrictions because if more people are getting diabetes and heart disease then those costs will be transferred to everyone in their insurance pool. The whole insurance model is like fractional reserve banking and right now more money is going out because of our health crisis than going in. As a side note, sugar cane isn’t as bad and as we have seen in Brazil it has better potential for biofuel, but because of state price controls sugar has been dropped in favor of corn.

The licensing scheme created by the state through what we know as the American Medical Association (AMA) is so atrocious with their deliberate capping of licenses they give to doctors, nurses and schools. With to few doctors we are going to be like Canada and have increasing lines and they’ll have to rush us through like cattle due to the overwhelming doctor to patient ratio on rise.

Lastly, how do you propose limiting malpractice awards? I hear the Neocons promote this all the time but it sounds like it would involve alot of government involvement and really serve to protect the insurance companies.

First off, you say “If you assume that most or all of the features of our current health care system should be treated as given, the trilemma really does seem irresolvable”. It seems at first sight as though many countries at least apparently similar to the US (such as my native Britain) provide everyone with free healthcare and spend less of GDP on it. And my impression as a patient has never been that of being ‘less free’ or having less choice – I can go private if I really want to.

So I’m interested in why you don’t think this is possible in the US (or why you think it’s undesirable).

Secondly, you talk about getting rid of all licensing. I’m not well-read on market varieties of socialism, but I wonder what replaces them? Because, I as a consumer usually don’t have the knowledge or time to inform myself enough to make educated choices between different drugs, at least just as an individual. I’m sceptical of market solutions to this (which isn’t to say in favour of state solutions) since markets, as I understand it, work on the assumption of decent information on all sides. With health that seems very far from reality.

Also, thirdly, what happens if someone doesn’t buy insurance (you seem to be against making this compulsory?) and then gets seriously ill? Whether they were foolish to do so or not, presumably they receive treatment?

Until insurance company shareholders become personally financially responsible for the care, or lack thereof, provided to policy holders (or policy holders conveniently dropped when they get sick), let’s not behave that they have a liberty interest in this debate (even if they leave $50 on our night stand).

While the other issues have liberty implications, the real issue in the current debate is about the insurance monopolies and how they are regulated.

I am all in favor of abolition, however this is not the time for that and it would never be accepted by the rank and file. Unitl workers actually control and own their employers and mandate the hiring of doctors and the inclusion of medical facilities in their operations, we will have the problem of third party payers – just like as long as people seek third party financing for homes and for stocks we will have finanical slavery.

It is possible to live without poverty and government, but it takes solidarity to get there.

I am, of course, never defensive. But, if I were, I’d say that I neglected to highlight this crucial point because the restrictions you’re thinking of depend on the FDA approval process, which I’ve proposed eliminating, and on the availability of an identifiable group of state-approved physicians able to authorize another group of state-approved pharmacists to release particular drugs, which clearly wouldn’t be a feature of the model I’ve described here.

Thanks for the kind words.

I would also mention restrictions placed upon the individual about how they choose to medicate themselves. The obvious example being the use of marijuana, though other restrictions include the need for a pescription from a doctor to obtain drugs you wish to use among others. The end effect of these restrictions is to restrict the choice of the individual in deciding how best to meet his/her medical needs as well as increasing the overall medical costs an individual must bear.

Great post by the way.