Stop Killing Me with Your Kindness
July 14, 2005
10:35 a.m., MT

"The uninsured" get a lot of attention in the health care policy debates. We've been trotted out so many times that even a libertarian blogger has begun seriously considering how to work out a single-payer health care system. As one of those uninsured individuals I'd like to use my situation as an example for those who wish to do me the "kindness" of helping me pay for my health care.

Some background: As an individualist-anarchist, I try to avoid supporting the state as much as possible. That means no traditional job for me -- I support myself through freelance work of many types. I won't present numbers to employers or fill out the state's forms so they can steal part of my wages. As you might expect, that severely limits the kinds of work open to me. I'm currently doing decently with my two regular jobs, and have managed to save a small sum toward some freedom-enhancing projects I'd hoped to undertake soon.

From this description of my work situation, it's probably clear that I don't have health insurance. I haven't had it since I realized that the health insurance industry is simply a private means of socializing health care -- albeit one that's much less private than it used to be. What that means, of course, is that I pay for my health care out of my own pocket, all the time. What that means is that I don't often choose to get health care. It's outrageously expensive -- and the service I get is rarely worth the cost in dollars (let alone the time invested into the process).

I have a couple of chronic conditions that require regular medical attention -- mostly to get permission slips (AKA prescriptions) to get the drugs I need to keep them under control. Most people here probably understand that in a genuinely free health-care market, I wouldn't need to pay a gatekeeper to get my drugs, and that the drugs themselves would be cheaper too. What some may not realize is that a nontrivial part of the fees I pay for my medical service go to support that private medical socialism. The costs of increasing paperwork and other regulatory burdens imposed by insurance (often aided by those oh-so-helpful legislators across the land) are transferred to everyone, even those who, like me, do not make use of those "services".

Yesterday I saw a dentist regarding a long-simmering problem. It's a small, private practice -- they accept insurance but ask for full payment at time of service. They also give a discount for cash. (That was a nice surprise; in the last state in which I'd gotten dental services, state law had made such "price discrimination" illegal.) Even so, the cost of having this one problem repaired is going to wipe out the savings I've managed to put together over the past several months. I've other dental needs I'd like to have addressed before it reaches a point where dentures are my only option. And, I've a much more serious breathing problem to attend to. I'll be seeing a university-affiliated specialist for that later this month. (The last time I was in such a place, the office wasn't even equipped to handle any sort of direct payment for services rendered; everything had to be shunted through the records and billing departments. That not only increased my monetary costs, it required more of my time. I'm even more possessive of that commodity than my money, so that didn't sit well with me.)

The costs of regulatory compliance; dealing with Medicare, Medicaid, and other state-run false charity; false scarcity due to market control of goods and services; and often-needless administrative overhead brought on by regulation have all contributed significantly to the huge jump in health care costs in this country. I'm seriously considering having my tooth pulled instead of repaired -- because it would be a lot cheaper. But part of my brain screams What kind of sick system are you in, where it comes to that kind of choice? -- and all I can reply is I don't want to be part of this system!. I have opted out of the socialized medical schemes -- public and private -- as much as I can. Yet I still support them, unwillingly, to some degree by way of higher costs. Those costs have the real effect of limiting the health care I choose to receive. All I want is to pay for the goods and services I receive, plus a reasonable amount for necessary infrastructure and for my providers' profit. What is unreasonable about that?

The blog entry I linked to earlier contains this statement:

This basis of my idea that we should have a single-payer system begins with the idea that everyone should have access to healthcare. I will stop short of calling healthcare a right, but I do believe that the United States and its citizens have a responsibility to provide for the care of all its citizens.

Later, he asks us to agree that it is unacceptable that Americans are "without access to healthcare". I don't agree, and will never agree. An individual who makes an effort to get health care will receive it.

I suspect that many uninsured people face the same choices I've described from my own situation. Not having cash in hand, and not seeing a way to cover the anticipated costs, they choose to do without medical care. They -- like me -- don't want to be a burden on someone else. Because I haven't been able to pay for treatment, I've let my breathing problems escalate, to the point where I really don't have the choice to ignore them any longer. The knowledge of increasing problems and the knowledge that it will likely take me years to pay off the treatment bills that accrue (and thereby delay other projects) have been a significant source of stress and preoccupation for me, especially over the past few months. And you, my supposed pro-freedom colleague, want me to further subsidize others' care? I'm trying to create and sustain a more freedom-enhancing life for myself, and you're asking me to shell out for others, some of whom would as soon rob me directly for my money? At least they'd be going about it more honestly.

Any system where all are asked to provide for all is pure socialism. The only "single-payer" program I will embrace is one where I, and I alone, am responsible for paying my own way, as well as that of any individual I've chosen to support. Those of you who advocate any other sort of single-payer system for anything may think you're doing people like me a kindness, but it's anything but. You're killing me with your kindness.

Sunni

Comments: 13 people have spoken!

On Thursday, July 14th, at approximately 12:28 p.m. Mountain time, Cat said:

What an *excellent* post, Sunni! Right on. I have health insurance, and it's a bad joke... I'd be much happier with free market medicine, none of this "gatekeeper" crap.

The whole gatekeeper idea makes me think of those little gates for doorways so children can't leave the room... it's pretty scary to think there are "libertarians" who WANT that sort of "treatment" for everybody. Keeper, gate thyself?

On Thursday, July 14th, at approximately 1:17 p.m. Mountain time, Stephen Campbell said:

Hi Sunni....enjoying your Blog for the first time.

In re your comment: "Not having cash in hand, and not seeing a way to cover the anticipated costs, they choose to do without medical care. They -- like me -- don't want to be a burden on someone else."

I wonder how many of the uninsured have cable TV, PS2s, cell phones, and (while we're at it) central airconditioning and other luxuries? That is, how many of the uninsured are uninsured because of lifestyle choices however unwise such choices may be?

I'd be really curious to know more about the quality of life of all those uninsured out there, and whether they could find room for health insurance in their budgets if insurance were more of a priority than, say, a monthly trip to the shopping mall.

Cheers

On Thursday, July 14th, at approximately 2:34 p.m. Mountain time, Pat said:

Memo to Campbell:

Health Insurance: No
Cable TV: No
PS2: No
Cell phone: Yes (no line phone)
Central air: No (only window fans -- barely adequate in this DAMNABLE humidity)

I do have a radio though, and computer with broadband, which are my only accesses to the world. Is that a luxury?

On Thursday, July 14th, at approximately 2:46 p.m. Mountain time, Pat said:

P.S: I just spent $379 for eye exam, treatment, and new glasses, after taking $30 off for cash -- THAT was a necessity.

As Thomas Sowell said, "Reality is not an option."

On Thursday, July 14th, at approximately 4:35 p.m. Mountain time, Jacqueline said:

I've read that many people find the expense of a trip to Costa Rica to have dental work done there to be less expensive then staying here for it.

In a couple months I will hopefully be set up with a guest room!

On Thursday, July 14th, at approximately 4:41 p.m. Mountain time, Jacqueline said:

You can probably get your non-emergency medical care done much less expensively too - check ticket prices to SJO, flexible dates, from Seattle you can find tickets for under $300, for example.

On Thursday, July 14th, at approximately 5:54 p.m. Mountain time, Sunni said:

Hi, Stephen, and welcome. I gotta admit, I'm failing to see the connection you're trying to make. Are you saying that if a person doesn't automatically get health insurance through his employer, and he decides not to buy a policy himself, he shouldn't use that money in ways he might enjoy, or that someone else might view as "less worthy"? Why is it anyone else's business? (For the record, I don't even know what "PS2" refers to.)

Pat, your situation sounds pretty similar to mine. And even though reality bites sometimes, it's still better than the alternatives.

Jacqueline, I've heard that about CR, Mexico, and other countries ... I might do that for some of the other work.

On Thursday, July 14th, at approximately 10:30 p.m. Mountain time, freeman said:

Great post Sunni!

While I can't speak for Stephen, it seems as if his statement falls along the lines of suggesting that many of those people who are uninsured have chosen to acquire all sorts of trivial luxuries and thus have little money left over for insurance. Many of these same people complain that health insurance is so neccessary and so important that there should be a "right" to such service if employers are unwilling to dish it out.

If it's such an important and necessary thing, then why are such people blowing their money on video games (like PS2) and other non-necessary items when they could use their money more wisely by saving and making sure that their medical needs are taken care of first?

I agree that what people spend their money on is none of anyone else's business, but the unwise choices that many make may have much to do with their predicament. Many of these people don't know how to manage their money and are worse off because of it, and then turn around and cry to the government for socialized this and that.

By the way, in addition to not having medical insurance, I also don't have cable TV, video games of any kind, a cell phone, or central air. I may not have any facts to back myself up here, but I'd wager to say that I'm in a serious minority in regards to having no insurance in addition to not having such luxury items. Most people my age (and many don't have insurance) couldn't possibly live without the latest video games and central air and whatnot, which I consider unfortunate.

By the way, one of the best write-ups that I've read on the subject in some time is Kevin Carson's blog post titled The Right to Self Treatment. There are better ways to make sure that people have access to treatment than relying on collectivist non-solutions.

On Friday, July 15th, at approximately 12:48 a.m. Mountain time, Vaughn said:

I think Sunni made good points about the costs of a socialised health care system. Perhaps I should call it the 'health care borg'. Talking about how one apportions for the costs of the current system seems a deviation from the question of what this business of patching people up would be like without the 'gatekeepers'.

I consider health care highly personal and find it ironic that many of these so-called advances in this science are administered in such a highly depersonalising way. Such an intimate thing has become an industry - and it's cradle to grave in its reach.

On Friday, July 15th, at approximately 3:04 a.m. Mountain time, Tom Hanlin said:

Sunni, I seem to recall that there was a recommendation on insurance-free health care on the Claire Wolfe blog a few weeks back. http://clairewolfe.com/blog.html

freeman, central air is not exactly a luxury in the Arizona desert but, perhaps, you live somewhere more temperate.

On Friday, July 15th, at approximately 5:50 a.m. Mountain time, Sunni said:

Tom, if you're referring to SimpleCare, I've known about them for years -- they don't seem to have spread this far east yet.

Freeman, your comments make sense to me. I'm not trying to insinuate that everyone without insurance is like me -- my guess is many haven't given the issues near the amount of thought I have over the years. It's a complicated situation, with a lot of competing goals and desires for those who accept the socialized medicine model.

Thanks, everyone, for your thoughtful contributions!

On Friday, July 15th, at approximately 9:51 a.m. Mountain time, Eric said:

The goal of any change we want to see should be to move healthcare to a situation where the consumer of the product is also the buyer of the product. Which, whether we are talking about "private" health insurance or government programs like Medicaid and Medicare, is not what we have right now. I wouldn't have a real issue with private health insurance IF the individual can voluntarily choose it. That isn't the situation we have today. My company does allow me to opt out of health insurance (not all do), but my compensation does not go up equal to the cost of that insurance, so it's an economic loss for me to opt out.

The point of all that? Well, a scenario where the consumer was the buyer would work tremendously to change the market cost of healthcare. I wrote my thoughts on the topic a few weeks ago, for what they are worth.

The bottom line? It years to get into the mess we are in, it will take years to fix it. And it will probably require baby steps on the way. But, it can be fixed. It isn't necessary to go to a single payer nationalized system. Nor is it necessary to stick with the status quo.

On Friday, July 15th, at approximately 2:17 p.m. Mountain time, Quincy said:

In defense of Brad, that particularly galling post was written by one of his guest bloggers, not Brad himself.

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