The Virginia house, with bipartisan support, passed Senate Bill 417 which legislatively pushes back against a federally instituted individual insurance mandate.  It is legally protecting the right of Virginia residents from being forced to purchase health insurance.

You can find the text of the bill, which Governor McDonnell is now expected to sign into law here, and more about national efforts to protect health care freedom through states acting under the 10^th amendment here.

We applaud these efforts because they will also protect our members’ right to use non-insurance options like health care sharing .  Americans need to have freedom of choice in their health care solutions, rather than a one-size-fits-all approach that will limit innovation and liberty.

Even before an array of national groups and taxpayers mounted a brave and seemingly unwinnable challenge to nationalized health insurance, an Arizona doctor began the fight to strengthen protection for health care freedom at the state level.  Three years later, his idea has spread like wildfire.

The Goldwater Institute has a great writeup on one doctor who started the health care freedom efforts that led to the Arizona ballot initiative and now the Virginia Senate passing the recent bill I mentioned last week.

Health care reform legislation at the federal level includes an individual mandate that would require all U.S. citizens to buy health insurance or face fines.

The Freedom of Choice in Health Care Act, which would release residents of a state from such a mandate, has already been filed or prefiled in 30 states. A question on whether to guarantee freedom of choice will be on Arizona’s ballot this fall, and lawmakers in five more states have announced their intentions to file the legislation. A citizen-led initiative has also been announced in Colorado.

It’s encouraging to see state legislatures pushing back against a one-size-fits-all approach to health reform. When a patient is freed up to choose providers, to choose the design of his own health care methods, at that point there is better health care and better cost.

We applaud the legislators standing up for freedom rather than a centrally controlled choice.

The states in which the Freedom of Choice in Health Care Act, promoted by the American Legislative Exchange Commission, has been introduced to release residents from an individual mandate are Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Virginia, Washington, West Virginia, and Wyoming.

States in which legislators are considering introducing the act are Kansas, Montana, North Carolina, Rhode Island, and Utah.

Thirty-Nine Fallacies About Health Care
1. “The quality of health care in America is ranked lower than 36 other countries.”

When you hear this, always ask, “Ranked by whom and how?” In 2000 United Nations bureaucrats at the World Health Organization sent a survey to “officials and experts” selected by the U.N. Why should we be surprised to learn that government “officials and experts” in France thought that their government-run health care system was the best in the world? The scoring of these surveys also made them meaningless. For example, 25 percent of the scoring was weighted based on the assessment of how “fair” the financing was in each country. For “fair,” read socialist—the list was largely a ranking of how socialist each country’s system is.

Richard Ralston has written 39 publicly repeated fallacies about health care, linked to above.   It’s worth a read, whether you’re for or against the current reform bills.

This morning while on the radio I got a question, as time was running out, related to the Canadian health care system.  The caller asked why I didn’t believe the Candian system to be successful when Canadians, on average, live longer and have lower infant mortality rates.

Leaving mortality rates (which are manipulated often, btw, see article here) aside for a moent, I briefly answered that statistics are difficult things.  Life expectancy, though, is decidedly not a function of the health care system.  There are hundreds of societal and cultural factors that have much greater impact on life expectancy than the health care system.  Americans drive more, for example, and auto deaths in the US are much higher than in Canada.

As this article notes, if you want to see the impact of the health care system on life expectancy, you need to look at cases where the delivery system can save/not save lives.  One important area here is cancer survival rates, which are highest in the US of all developed countries.  A US citizen, contracting cancer, has a much higher survival rate than a Canadian in the same scenario.

The sad part is that proponents of a single payer system should know that these statistics are misleading, and that health care delivery is only one of many components of life expectancy, but they continue to use the statistic  to convince the public that major reform is necessary.  This type of one sided, uncritical use of statistics needs to be examined.  If we are to seriously look at what needs to be fixed in our health care delivery systems, we need to move past misleading stats and actually examine the problems and solutions, not look for statistics that support our predetermined solutions.

And even if (and it’s not the case) the government taking over the health care system would increase life expectancy, is a small increase in the average life span worth a huge sacrifice in personal liberty?  Because remember, average life span is just that, average.  It does not mean that some individuals (the ones with liberty) don’t have shorter lives under the new system.  And the system with the greatest liberty, in the long run, will be that which produces the greatest lives.

UPDATE:  found another post today dealing with life expectancy and statistics that bears reading.   Read it here.

Will Concierge Medicine Solve Our Primary Care Crisis? – Dr. Steven Knope
The reason for the primary care shortage is obvious. Young doctors coming out of medical school will simply not tolerate the abuse from third-party payers and Medicare bureaucrats that their predecessors endured. It’s just not worth it. In reality, most medical students could not even afford to enter primary care, even if they wanted to. Reimbursement for primary care doctors is simply too low to repay the average medical school debt. As one family practice physician said to me this week at the American Association of Family Practice meeting in San Diego, “The only people who are going into primary care medicine now are those with a ‘religious, do-gooder’ mentality, or those at the bottom of the medical school class. You’d have to be an idiot to go into primary care under the current third-party payer system.’” Chew on that one for a while.Concierge medicine and free market forces may right the system over time. As the need for good internists becomes more apparent to the public, the market will force change, as more and more patients become willing to pay primary care physicians for their valuable services. With an increase in demand, more medical students will enter primary care to fill the market need as they realize that they can make a living in primary care medicine. This retooling, however, will take decades to accomplish. In the mean time, patients will suffer. Many will be forced to see nurse practitioners, or physician assistants instead of fully-trained diagnosticians. Even if half of all medical students opted for primary care over the next couple of years, there would be a lead time of 10-15 years before we will have trained enough doctors to take care of our aging population.

Here’s a good post from an author of a book on concierge (or retainer based) medicine, hypothesizing that concierge medicine just might encourage more doctors to try primary care.  He’s not making any predictions, mind you, but this may be one way that young students can see paying off medical school loans while still not flooding the specialist markets.  I think it’s a good theory, and I really like the options this model gives us.  One great feature is a true return to the doctor-patient relationship unencumbered by third party politics.   And something like this combined with an HSA or a HDHP or, even better, a health care sharing ministry could be a way to keep consumers directing their own health care.

Patients ’should not expect NHS to save their life if it costs too much’ – Telegraph
The National Institute for Health and Clinical Guidelines (Nice) has ruled for the first time that saving a life cannot be justified at any cost, in a review of its ethical guidelines.The ruling – made by the board of the controversial organisation – contradicts advice it received from its own ‘Citizens Council’ which offers advice from a representative sample of the general public.

In a market based health care system, each patient can decide on his or her own whether a treatment is too costly to make it worth even saving a life.  Even n a mixed market like the United States, a patient could go and find charitable sources of funds to do something his insurance company wouldn’t pay for (if insured) or the like.

The NHS system has no competitors, and once a ruling is made it cannot be gone around except by traveling to another nation (as many Candians do today).  This is the big risk of government sponsored health care–it leaves no other options and endangers those very vulnerable beginning and end of life decisions.

Yet again how consumer directed systems, like health care sharing ministries, can provide sound principles of care that leave the doctor patient relationship intact, and don’t impose other controls upon personal decisions.

A day in bankruptcy court would make you sick | IndyStar.com | The Indianapolis Star
“More and more of the middle class is finding out that even if they have jobs and insurance, they can be wiped out by medical events that are not even catastrophic,” says Dr. Christopher Stack, a retired orthopedist and co-founder of Hoosiers for a Commonsense Health Plan, the state’s chapter of Physicians for a National Health Program. “You can run up a high five-figure bill real easily.”

Bankruptcy is up, and many of these are these days related to health care costs.  The media would have you think that this is because we don’t have universal coverage–but there we have a doctor admitting that the insured are not immune to the medical debt that plagues manyAmericans.  So even having insurance (or forcing people, as Massachusetts did, to buy it)

Why?  Why is health care so expensive?   When examining price trends you should look at the supply and demand of the product, and the chief buyers and sellers of the product.  Right now the largest purchaser (not the largest consumer, but the payer) of health care services is the federal government.  And because they can, the government fixes their own price for the services they pay for, raising the price for other consumers and lowering the supply, which further raises the price.

This is just one way in which the cost of health care is increased by government involvement.  Other ways include mandated benefits on insurance policies, regulation of health care services, licensing fees, etc.  Over time we’ll be doing in depth examinations of each of these–but the point of linking to this article is to let you know that insurance doesn’t fix health care problems.  And having insurance doesn’t make one immune to rising costs.  And so pursuing non-insurance health care solutions needs to be a part of the picture because it’s no more dangerous than insurance in some cases.

And health care sharing ministries are an important, viable, accessible non-insurance health care solution.

Texas Public Policy Foundation – Commentaries
For those who question the viability of free markets and competition in health care, they need only look at the field of Lasik eye surgery. Because consumers pay the full cost of their procedures, competition has led to lower prices and an abundance of providers.

It look like Texas, where almost 1 in 4 are uninsured, is trying to find a solution to this “problem.”  Ms. Hammonds has some ideas that Texas policy makers should consider, including the examples of how opening the market with less regulation drives costs down rather than up.

Agency expects more to appeal healthcare fee – The Boston Globe
The Commonwealth Health Insurance Connector Authority set aside $3.3 million – nearly 10 percent of its $39 million fiscal 2009 budget, which it finalized yesterday – for the 8,000 appeals the board expects to process. In the year that ended June 30, there were an estimated 2,000 to 2,500 appeals, the board said.

This is the problem with not approaching health care with liberty, charity and faith in balance.  It leaves to forcing people into a particular system, which leads to punishing them for not doing it “right”.  The article goes on to say that the requirements for what is “legitimate” insurance will get harder next year as well, raising the cost even higher, thus raising the stakes for those who would like to try to afford what they say.

Thankfully, health care sharing ministry members have, at present, been granted a regulatory status that fulfulls the intent of the mandate–allowing our members to continue to practice their faith in Massachusetts.  At least for now.