I don’t know enough to say how much the drug companies themselves might have manipulated British policy. But as one who now earns his bread consulting with biotech companies (mainly on R&D matters rather than on policy, to be sure), I am confident in saying that we should not rely on industry to even recognize what’s going on politically, let alone to lead us out of the wilderness. We the people are going to have to monitor this, and do something about it if necessary.

Rich

I think so, too.
On the bright side, if “the plan” is actually to Trojan Horse in a “literally single-payer” system (which, it might not be. It might not ever have been anyone’s plan. When it comes to liars, one can never be too sure who, exactly, is being duped…), the drug companies will probably help us out with illuminating the problems with that.

I think it might have been the work of the drug companies that got those tyrannical laws repealed in the UK?

I am being very serious when I say that I am very glad that you and other progressives who are regular folks feel this way. Because (as I have elaborated upon at length) your elites do not. So please watch out for it, and when you see it (as you will), I hope you will join us non-progressives in fighting this particular aspect of the healthcare system.

If we Americans can agree on this one point, I am confident we can work out the rest in a civil manner.

Rich

Of course, just because we Joe Schmoe progressives feel that way doesn’t mean the “progressive elite” strategists and decision makers would think the same way. And it’s not like those “think tank” types would be forthcoming (with anyone besides their political elite friends) with their plans and strategies, either. For that reason, it’s definitely something to watch out for.

Fundamentally I agree with you. And most of the Progressives, including, I think, Mr. Obama, would dearly love to see a single-payer system. But keeping the insurance companies around in a diminished capacity nonetheless has certain advantages for them, which I will discuss in a later post in this series. Basically, it would be an advantage to the Progressives to keep the evil (but castrated) insurance companies around so there’s someone to blame when the whole mess gets really ugly. For instance, don’t you think the Feds were happy to have private mortgage companies around to distract attention from Fannie and Freddie over the last 2 years?

Also, I will take this opportunity to remind readers about another bugaboo of mine. Which is, under any single-payer system, the ability of individuals to spend their own money on their own healthcare must be forcibly restricted. Otherwise, that would be two payers.

Rich

Because the average monthly payments made by subscribers (premiums) is rapidly overtaking the average expenditures made by the insurance companies – despite all the legitimate and illegitimate cost-savings measures that have been instituted. With expensive new technologies and the aging of the population, all the cost-saving schemes they could muster have not slowed healthcare inflation, which approaches 10% per year. Healthcare expenditures in 2004 averaged $6280 per American, and it is much higher than that today. Insurance companies simply can’t increase their premiums fast enough to break even for much longer, let alone make a profit, and they know it.

Rich

I actually wrote a whole book about this, explaining it in detail. But the short answer is: The health insurance system as currently constituted is not anything like a free-market system. It’s the Tooth Fairy model (where doctors and patients decide how much money to spend, and the Tooth Fairy picks up the tab).

If we’re going to pay for all healthcare from a centralized pool of money, then it doesn’t really matter whether that pool of money is controlled by health insurance companies or the government. We’re not going to be able to put enough money in the pool to pay for every bit of healthcare that has some chance of benefiting every person in the land. Our current healthcare reform simply proposes to accelerate the process of transferring control of the money from the companies to the Feds.

Either way, there will be covert rationing. And either way, the rationing will be extraordinarily destructive to doctors, patients and society. Unlike the insurance companies, however, whose only tools of coercion are to withhold healthcare or withhold payment, the Feds can coerce “correct” behaviors by the legal, measured application of violence wherever necessary. So, personally, as nasty as the insurance companies are, I’d rather have covert rationing by them than by the Feds.

But that’s just me. Many Americans have undying trust in the fairness and benignity of a powerful government that has lots of control over our personal lives.

Rich

So what went wrong here? And what are the implications for the free-market reforms that share some of their features with HMOs?