Humans live in a finite world. The universe may be infinite, but the world of man is finite. There’s only so much stuff. Because there is only so much stuff, there’s always going to be a shortage of the stuff that people tend to like or need. It’s not always a desperate shortage, but there’s never enough so that everyone can take what they want. There’s always going to be one more hand reaching for the last item just after it is gone.
This is a basic axiom of life and one of the foundation truths of economics. It’s even a foundation truth of communism, which assumes scarcity can only be mitigated, but never fully eliminated, by the elimination of profit. Economists of all stripes work from the assumption that scarcity is an immutable fact of the human condition. The question they wrestle with is how to increase supply and distribute the results.
What this means is that all goods and services must be rationed. Since there’s never enough to meet the maximum demand, there has to be some way to say “no” to people demanding the goods or services. The most common way to do this is price. The poor guy who wants a Mercedes is told he cannot have a Mercedes by the big numbers on the price tag. This is how the supply of luxury cars is rationed.
The other way to ration goods and services is for men with guns to take control of the supply and create rules for who can and who cannot have access to the stuff. Rocket propelled grenades are not very expensive. An RPG can be had for around $500 and the rounds are about $100. The government, at least in America, controls the supply of RPG’s and determines who can have them. In other words, the government rations the supply of RPG’s in America.
This is an iron law of economics. All goods and services are rationed. This is true for health care too. There are no exceptions to this law. Thus, the First Truth of Health Care: No health care plan or system can ever be taken seriously unless it addresses, up front, how it will say “No, you cannot have it” to people who want it. At some point, someone has to tell the patient they cannot have whatever it is they want or need.
In America, rationing is mostly done by price, but increasingly the state is taking over this role. In Britain, most people are denied services by the long lines for those services. The long wait times for basic services is a form of rationing. If you can deliver X per day and the demand is for 2X, you solve this by giving people numbers and having them wait a long time until their number is called. This is socialized medicine in nutshell.
The fact is, most people could pay out of pocket, for their health services. It is only when poor people get old or have accidents when they need someone to pay for their medical care. Most middle-class people should be able to put away a little every payday to reserve for their later years. That is, if they were not being taxed into poverty by the current system in America that has seen prices rise five times the inflation rate.
Thus, the Second Truth of Health Care: The current insurance model is just a wealth transfer from the middle-class to the health care industry, in order to cover the cost of poor people and the metastasizing layer of people who live off the system. Those is really just a tax. Most people use about 5% of their plan for themselves, the rest is used to pay for poor people and the army of people who work in the system.
That’s the thing politicians never want to discuss, which is the whole reason they are talking about health care in the first place. How does a modern society pay for the poor, who cannot afford needed medical services? How to we address the free riders on the system? More important, how much are we willing to pay for the health services to the poor? There’s a limit to all of this and that’s the question that always has to be answered.
Of course, one of the paradoxes of modern life is that you can get very rich off the poor, which is why liquor stores and furniture rental shops dot the ghetto. In the social welfare game, the point is to lay a massive guilt trip on the public, and grease the right political palms, in order to get the middle class to look the other way as their money is siphoned off for one program or another for the poor, always administered by a rich guy coincidentally.
Thus, the Third Truth of Health Care: Health services are a massive skimming operation. Today, the one area of the economy that “grows” is the health care industry. Every year, more and more people pile into that wagon, mostly in administrative roles. The number of nurses and doctors does not grow very much, but the number of bureaucrats grows like a weed.
Then you have the pill makers, machine makers, research people and lawyers. There are always lots and lots of lawyers. The health care industry is massive and government dependent. It’s why rub rooms are now called message therapy centers. They are angling to get it on the racket, by having their service declared an essential health care service. That way, you will be paying for some guy to get a happy ending.
That’s why reforming health care has become an impossibility. As soon as anyone makes any noises about fixing the system, the army of lobbyists, hired by every vested interest, shows up to bury the reformers. If they are not able to kill the idea of reform entirely, they set about corrupting it into another grift that their clients can use to get a free shot at your wallet. The only people not represented in these efforts are the voters. They get no say.
This is the main reason Trump’s efforts to address the problems of ObamaCare failed last week. What Ryan and the other crooks in the GOP were hoping to do is pass a bill that made it easier for their paymasters to skim money from the rate payers, while providing fewer services. Ryan’s bill was just an attempt to help the people feeding at the trough get a little fatter off the middle-class. Its failure suggests we have reached the end phase.
Talk to anyone responsible for paying health insurance premiums and they will tell you that the rates are reaching the point where they cannot be paid. When premiums are going up by multiples of inflation, there can be only one result. Once rates pass a certain level, people stop paying those premiums. You get black markets, non-compliance and a system that can only persist through brute coercion. Soon after you get collapse.