Having practiced medicine for over 30 years, Ron Paul gives his perspective on the past and future of medicine in this country, and the effects of government and special interests on quality, costs and access.
Ron Paul: I’d like to talk a little bit about the medical care crisis that we’re facing. Sometimes I’d like to think that it may be a government crisis rather than a medical care crisis, but we do have a mess in medicine and there is a lot of talk about what’s going on, not only throughout the country but here in Washington.
But first I’d like to describe how I see the problem developing and what has happened. A lot of people are arguing that free markets can’t deliver medical care, which I disagree with and the problems that we face today are not a consequence of the marketplace. They’re a consequence, they’re a failure of the government.
This idea of managed care was introduced during the Nixon years and this was a program designed to force people into medical care and provide PPO and HMOs and tax credits for certain groups and not any others. So we have been enduring managed care over these last 35 to 40 years and what has developed from this has been corporate medicine.
The individuals who were best able to gather up the money passed out by the government and were mandated by the government, they became the chief lobbyists. So the drug companies are lined up, the health insurance companies lined up, the health management companies lined and it turned out that they started running the show and actually made it less efficient.
So there is too much management and at the same time, too much of the money was going into these corporations, which was sort of the middlemen and the patients have suffered, the doctors have become unhappy.
The main complaint I hear is that medical care costs too much. “I can’t afford my insurance”, and there’s a lot of truth to this, but one thing that most people don’t talk about is why are the costs high? Why are the costs of medical care higher than say the cost of bread or computers or television sets or whatever?
The truth is it’s a reaction to government. It’s a reaction to our monetary policy. We do inflate the money supply. We do have price inflation. But prices go up, more so in certain areas that the government gets involved in than in others, so the government is more involved in education and medical care, so you have more inflation there and that is part of the problem.
Over these years, there has been less competition in medicine and that has been gradual over a hundred years or so where people couldn’t enter the medical field without getting all kinds of licenses and protecting special groups. But if there’s more competition and there’s less insurance, actually costs go down.
If you look at some of the procedures provided by the plastic surgeons or the eye surgeons who do keratotomies and they’re not under coverage of the insurance company, those prices actually go down.
We don’t have insurance for medical care. We have distorted that word. Insurance is supposed to measure risk and you’re supposed to buy that protection. So if you want medical insurance, you would be insuring against bad accidents or major surgeries or against cancer or something like that. But today, people expect prepaid services. They want every penny taken care of. They want the drugs paid for and then that invites abuse. When third parties pay the bills, doctors, labs, and hospital, and everybody else, all of a sudden, they charge the most, not the least.
I experienced medicine before they had managed care and patients were always charged the least and nobody went without medical care. The churches and volunteer hospitals and other groups took care of the people, but now, everybody has to have this so-called insurance, which doesn’t do a whole lot more than boost prices and then cause shortages and then there’s a demand for what? For more government and that’s where we are today.
So we’re going from corporate medicine, which was deeply flawed and not working and now, the proposal here is to go to government medicine, which is socialized medicine. This has not really worked well any place else. People, yeah, they surely get care if they want to wait and watch, but today, even and in spite of our shortcomings, people come to this country still for top medical care, but that would soon change if we want to equalize everything by leveling it and making sure that everybody gets poor medicine rather than extra medicine, extra and better medical care.
But we could do better. What we could do is introduce the notion that patients do have rights. Anything that comes out of Washington here, and something will, what we ought to fight for is the fact that we have a choice. We shouldn’t be forced into a program. If the government starts a program, we ought to have the right to opt out of the program.
We should be very generous with tax credits. Give tax credits for the entire amount of money you spend on medical care, so you can be independent. The concept of medical savings account is a good concept and we should promote that and encourage that and we should demand privacy.
I mean, this is one of tools that the government agents always used and they’ve already set the program up. It’s been passed already where there would be essentially no medical privacy. So there’s a lot of things that could be done through the tax code, the tax credit and also protecting the individual’s privacy.
Now, the one other thing that we could do, we could pass legislation that would actually help along these ideas with the problems that we have with malpractice suits. What we ought to do is talk about getting rid of the anti-trust laws against the doctors where they could negotiate with their patients and get the attorneys out of the ball game where you would agree on an arbitration board and get a tax credit for buying an insurance policy like that.
So there are ways you can, through the market place, literally reduce this fear mongering and excessive costs that are involved in litigation against doctors because right now, believe me, if you get a bump on your head, you come to the emergency room because of the third-party payment, we’re fearful as doctors of missing something due to the attorneys. Believe me, you can’t walk out of the emergency room without a $10,000 or $15,000 bill and that is not the way it should be.
There are alternatives. Now, I do want to say that the Campaign for Liberty did such an exceptional job when it came to HR 1207 at the grassroots’ level. So I suspect that the Campaign for Liberty, if they get behind some of this free market approach to medical care, they can do a tremendous job in changing the course here in Washington because right now, we are on a course towards socialized medicine and it doesn’t have to be that way.
I never dreamed we’d see the results that we have seen at the grassroots’ level, which then affected Washington with now over 230 co-sponsors for HR 1207. The same thing could happen with medical care, so I would encourage all who believe in freedom and liberty understand that medicine is no different than any other service. Freedom really works and does a much better job than coercion and just another gigantic government program and socialized medicine can’t work.