Saturday, January 5, 2019

Imagine if We Paid for Food like We Do Healthcare

That's the provocative title of an article on Libertarianism.Org and reprinted by FEE (the Foundation for Economic Education).  The article is by Dr. Ryan Neuhofel, DO, MPH, a board-certified family physician in Lawrence, KS. As he puts it:
Imagine if you purchased food like most Americans obtained healthcare.

No, I really want you to try to envision it…


I am a family physician whose father worked in a grocery store and I enjoy eating at Mexican restaurants immensely, so maybe I can help:
I think most of us have some inkling of how screwed up the health care system is in this country, but Dr. Neuhofel puts together a world in which Food is paid for with a system just that screwed up.  Perhaps it's the "after" state for whose who argue that food is a basic human right.  I can't say I was really surprised by anything, but he did a good job of creating a parallel universe populated with a "Green Cross Green Shield (GCGS) Bronze-Select food plan" and an Affordable Sustenance Act (a.k.a. ASA, or “Obamafood”).  Instead of Costco, BJ's Wholesale Club, Amazon, Walmart and dozens of other companies competing to see who can provide a better price per pound or better quality food to get your business, this parallel universe features giant Food Plan providers and (of course) the totally destroying the market incentive to provide better food at lower prices.

I really recommend you read the whole thing, but as I usually do, I'm going to grab a few excerpts to whet your appetite.
Thankfully, your new Green Cross Green Shield (GCGS) Bronze-Select food plan is a benefit provided by your new employer. There is some payroll deduction stuff that you don’t quite understand yet. Most of the plan’s $680 monthly premium is hidden from you and drastically reduces your wages. Still, you are happy that your food plan costs only (as far as you know) $123 per paycheck.
Worried that you won’t be able to afford everything on your list, you cross off any special items and opt only for the basics. As you scurry up and down the aisles, you see there are no prices listed on anything, nor labels telling you what is a Bronze-Select item. You suspect the delicatessen with your favorite cheeses is off limits because of the large “included with United Food Platinum-Plus” sign above it but with no mention of Green Cross Green Shield. Remembering that eggs are included as a “free” GCGS wellness benefit you get 3 dozen of those—even though you don’t really need any right now.
During check-out, the cashier rings up the items and asks you for a $30 copay. You are given a 6-page receipt with indecipherable codes and then asked to sign a few other forms because some of your items will be billed to you later.

As you drive home, you remember that your monthly food deductible is $250 and you hope that the balance of the bill isn’t overly expensive. (Several months in the future you get a bill for $276 from FoodMart. Although vaguely suspicious that you’ve been taken advantage of somehow, you are happy that you got a big discount on your $18 box of Tasty Flakes cereal and have now reached your deductible.)
Upon checkout, you present the waiter your GCGS card, and you are asked to pay a $10 copay. (The billing statement weeks later reveals that the “plan discount” did reduce the initial charge from $64 to $37 and that GCGS paid Burrito King another $27 a few months later which got applied to your deductible.) You question how a simple burrito can cost $37, but nobody, including the majority of food policy experts, knows exactly why.
Politicians, regardless of their ideology and grandstanding, are lobbied heavily by a swamp of power players to preserve the status quo. Understandably, most Americans are fed up with all of this, and an increasing number now believe the only solution is a national, federally-administered “single food plan.”
As always, the thing that boggles my mind is those people arguing for a "single payer food plan" are begging the ones who screwed up the existing system to "do it again, only harder".  Whenever there's some sort of corruption found where some industry lobbies the Feds for giveaways, they pounce on the private sector guys and totally ignore the  If someone bribes a legislator, they've both committed a crime.  


  1. I know that most folks don't have any idea how screwed up the healthcare system is. My first question is why can't Congress just say "Ooops, we screwed up, so we will repeal it and go back to what was available previously." And if they say that in say January/beginning of February, the insurance companies will be able to get some insurance lines set back up. I am sure that somewhere, some insurance company has a record of what they offered 10-12 years ago. Now that the economy is improving, more folks are working, and rolling back Obamacare should help immensely. Not very many people were helped (remember the original goal was to get insurance for folks who couldn't afford it?) Now, no one can afford it, even if you can afford the premium, you certainly can't afford to use it as the deductible and other fees will begger you.

    I have been a nurse for 40years. Never thought I would see the day when I could not afford health insurance. Well, guess what...I did. I keep hoping some doc in my area will open up a concierge practice. There are a few in the country. Pay a flat monthly fee (like $50), get your routine care, your emergency care, medications all covered, with 24 hours access to a doctor. X-rays, lab work, all covered. But no way do I want single payer health care. Just look at the mess the VA is in. And if single payer is so great, then why do Canadians head south for their elective care? Single payer is great if you have the bucks to go outside the system. Health care is not a right, it is a privilege.

    1. ...why can't Congress just say "Ooops, we screwed up, so we will repeal it and go back to what was available previously." What we had before O'care was screwed up, too. O'care took it to whole new levels of screwed up because they designed it to be so bad it drove people to demand government takeover of health care - and apparently succeeded.

      We need drastic market reforms, drastic deregulation, and the regulators supposedly "unscrewing it" will be the very same people, pushed by the very same forces, that screwed it up to start with.

      As Aesop says (1153PM), in plastic surgery, where the vast majority of it isn't covered by the insurance complex, the market works. (See also, my comment) I haven't seen any studies comparing plastic surgery rates where it's mandatory that insurance reimburses (post mastectomy breast reconstruction is one) vs. plastic surgery rates where it's free market only, but I bet I know how that would turn out.

      The author of the piece I linked to, Dr. Neuhofel, is from an organization like that. My former GP, here in small city America, went concierge but not like Dr. Neuhofel's practice. In that case, I was to pay him $150/month (add the same for my wife) PLUS I needed to keep my health insurance mostly because there were things that his service just couldn't do. In the year before that happened, I saw him twice.

      To say "I have a right to health care" is to say I have a right to someone else's knowledge and experience, which is to say I have a right to the very essence of that person; what makes them different from everybody else. Nobody has that right in my book.

  2. Brilliant skewering of reality.

    And everything Suz said.

    If you think health care is expensive now, what until you see what it costs when its ALL GOVERNMENT, ALL THE TIME.

    That's "single payer." Who's the actual "Single payer"?
    Look in your mirror.

    You want the model for rational reform? Look at plastic surgery.
    98% of it isn't covered, so prices are posted, and they're affordable, so average people can get work done.

    No mandates, no insurance companies, no muss, no fuss.

    Pure medical capitalism paid for with fee-for-service.

    Almost like we did this for 3300 years of recorded human history without any help from scammers from government, or insurance companies.

    1. You want the model for rational reform? Look at plastic surgery.
      Same thing with Lasik surgery. I saw a commercial the other night advertising "$300 per eye" for Lasik. I can't say I follow prices, but I think I recall hearing prices over 12 to $1500 about 10 or 15 years ago. Assuming that was both eyes, it's still better than a 50% price reduction.

      For reasons I don't understand, the general public doesn't think that the market forces can work for health care. There are some situations where the market is going to be constrained (you're injured in a car wreck and taken to an ER - not in any condition to check prices and negotiate - or on a trip in another city, and so on), but the market dropped the price of virtually everything else in our lives where government didn't have a thumb on the scales. Why would market forces work for refrigerators, stereos, heaters, air conditioners, furniture, houses, and a virtually endless list, but they can't work for health care?

  3. The Left - including Obama, Pelosi, etc. - wanted to model our health care system on Britain's National Health Service. NHS will not provide dialysis if you are over fifty. If you can't afford to pay for it yourself, you die. Period. In Canada, many people who might have survived their cancer end up dying, because it is months, sometimes over a year, before you can be seen and treatment _started_. Their health care is rationed. There aren't enough resources to provide decent health care. Not enough doctors, nurses, technicians, beds, etc.

    I worked for the VA medical center in Roseburg, Oregon for over eight years. I quit five months short of being able to start drawing my wonderful $300 a month retirement (FERS) because it got so bad I couldn't stand it.

    The directors of the various VAs get bonuses based on how much they "save" from their budgets. Our director routinely scored bonuses of $30,000 to $45,000 a year - by not hiring new staff when our staff retired, quit, transferred to another VA, or were promoted into a "do-nothing" job that gave them plenty of time to do their shopping on duty, go out for a tanning session, etc. Also for not providing things the veterans needed. For example, the soap, shampoo, razors, shaving cream, toothbrushes and toothpaste they got were all donated by local hotels/motels, and by concerned citizen groups. Otherwise they wouldn't have had anything, and a bunch of our veterans were homeless to start with, unable to provide for themselves.

    The vets suffered for it, with waiting months for an appointment, only to be called the day of the appointment and told it was cancelled. Some drove over 100 miles each way, and WEREN'T even told their appointment had been cancelled, that the doctor had called in sick, or otherwise wouldn't be there.

    The last straw for me was when they decided to allow the veterans on the Substance Abuse Unit (drugs and alcohol) to _self-medicate_. Yeah, that's right, they decided to allow them to administer their own drugs - even the vets who were their for abusing their own medications (opioids, tranquilizers, etc.). Nurses like myself who were placed in the position of being responsible for keeping our veterans safe were left hanging. We all told admin it was insane to do that, but they insisted they were "required" because the unit was labeled as a "residential program", so it had to be done as if they were at home. They set it up and labeled it that way on purpose, because it allowed then to cut three or four more staff positions. It didn't matter a tinker's damn to them that some of those veterans would die thanks to the administration's policy.

    My co-workers told me it got even worse in the months and then years after I quit (2008). As much as I wanted to be there for my fellow veterans, I had to go. I truly believe I might have done serious harm to the individuals doing that to our veterans and to staff, had I stayed there much longer.

  4. I am coming around to the idea that the people who obey policies like that deserve nearly as much moral guilt as the people who champion them. Self-defense is not optional for any life form. Innocent people who don't defend themselves are making themselves into logistical material for evil people.

  5. The problem, i.e. the misinformation as I see it is: Our health care is good. What most people mean when they say it is screwed up is the way it is payed for and the regulations around that process. My fear is a single payer system will actually harm our health care NOT what it will do to how it is payed for. Canadians and many people from many other countries come her for health care because our health care is the best. Let's not destroy the quality of our health care in the effort to subsidize it for everyone.

    1. Yes - that bears repeating. The leftist media always conflate these two.

      My tired old song is that "health insurance is not health care" - it's really elementary logic but imagine being on a deserted island - nobody there but you and your volleyball "Wilson" - with an insurance card and plan from "back home" with no doctor on the island. You have health insurance but no health care.

  6. Gun control in California, Connecticut, New Jersey, and Boulder is currently mostly being disobeyed. This doesn't appear to be civil disobedience, which means you surrender to the penalty in order to protest it. Instead this response appears to claim, try it and the hot war starts. Just like a parade is supposed to mean, this group of disciplined people could be carrying rifles instead of signs.

    This same response of mass disobedience also works for doctor control.

  7. NOTHING that the self-serving IDIOTS in Washington do is in the best interest of we the people. Once enough people realize this, they will understand that secession is the answer.

    The A.C.A. will never be repealed. Same with the Patriot Act. I can't think of one single law that the idiots have passed that improved American lives in my lifetime.

    The Beast must be starved. Secession is the answer.

    1. Secession to where, sport?
      Every state has a blue hive, and trading 10 communists 2000 miles away for 2000 communists 10 miles away never works out any better.

      You're out of places to run.
      Dig in for the long fight, or roll over and play dead.

    2. The Beast must be starved. Secession is the answer.

      He said secession, not retreat. Exchange all your paper wealth for coins in your hands, take the license tags off your cars, and stop paying taxes. What are they going to do, make it a felony? [laughter] States always talk about 95% vs. 5% of population, because that's the only ratio where they can win. Blue hives are a liability, not an asset.

  8. Local, Local, Local. Imagine no flow of taxes out of the state you live in to the Imperial Communists in Washington. Imagine they shut off the "services" to your local communist blue hive. If the blue hive is to survive, it must swarm to a commie-friendly state. Local problem solved.

    Or, if it must be, the long fight occurs around the hive (in your state), which is a much shorter walk. BTW, Aesop, your math skills are lacking if you think there are less reds in Washington, than your state capitol. Heh.

    1. Imagine no flow of taxes at all, not even to the imperial Communists on your local city council. How then will government tapeworms get their salaries paid? The firemen can go back to selling subscriptions like they used to. The ambulance drivers can bill patients. Teachers can charge parents tuition to learn which pronoun to scream at the invader in the bathroom.