"And speaking of poor treatment, those who favor national healthcare..."

"And speaking of poor treatment, those who favor national healthcare schemes should take a good, hard look at out veterans' hospitals.  There is your national health care.  These institutions are a national disgrace.  If this is the care the government dispenses to those it honors as its most heroic and admirable citizens, why should anyone else expect to be treated any better?" -Pages 90 & 91 of The Revolution, A Manifesto

"The story behind the creation of the HMOs is a classic..."

"The story behind the creation of the HMOs is a classic illustration of what economist Ludwig von Mises once said: government interventions create unintended consequences that lead to calls for further investigation, and so on into a destructive spiral of more and more government control. During the early 1970s, Congress embraced HMOs in order to address concerns about rising health care costs. But it was Congress itself that had caused health care costs to spiral by removing control over the health care dollar from so many consumers in the 1960s, and thus eliminating any incentive to pay attention to costs when selecting health care. Now, Congress wants to intervene yet again to address problems caused by HMOs, the product of still earlier interventions.

Now the HMO's are all but universally unpopular, the very politicians who brought them to us are joining the bandwagon to denounce them, hoping the American people will forget, or never be told, that the federal government itself virtually mandated HMOs in the first place.

Consumer complaints about insurers and HMOs compel politicians to draft new laws and more regulations to curry voter favor. More regulations breed more costs, limiting more choices, causing more anguish- and the cycle continues.

The most obvious way to break this cycle is to get the government out of the business of meddling in health care, which was far more affordable and accessible before government got involved. Short of that, and more politically feasible in the immediate run, is to allow consumers and their doctors to pull themselves out of the system through medical savings accounts. Under this system, consumers could save pretax dollars in special accounts. Those dollars would be used to pay for health care expenses, with patients negotiating directly with the physicians of t heir choice for the care they choose, without regard for HMO rules or a bureaucrat's decision. The incentive for the physician is that he gets paid as the service is rendered, rather than having to wait months for an HMO or insurance provider's billing cycle.

With the cash for the MSAs coming from pretax dollars, most Americans could afford deposits that would cover routine expenses that families experience in a year. Insurance would tend to return to its normal function of providing for large-scale, unanticipated occurrences, and would become far more affordable." - Pages 85-89 of The Revolution, A Manifesto

"HMOs have become corporate, bureaucratic middlemen..."

"HMOs have become corporate, bureaucratic middlemen in our health care system, driving up costs while degrading the quality of medical care. In all other industries, technology has nearly always led to lower prices- except in health care, thanks to the managed-care system that has been forced upon us." -Page 87 of The Revolution, A Manifesto

"Just about everyone is unhappy with the health care system..."

"Just about everyone is unhappy with the health care system we now have, a system some people wrongly blame on the free market. To the contrary, our system is shot through with government intervention, regulation, mandates, and other distortions that have put us in this unenviable situation.

It is easy to forget that for decades the United States had a health care system that was the envy of the world. We had the finest doctors and hospitals, patients received high-quality, affordable medical care, and thousands of privately funded charities provided health services for the poor. I worked in an emergency room where nobody was turned away for lack of funds. People had insurance policies for serious health problems but paid cash for routine doctor visits. That makes sense: insurance is intended to protect against unforeseen and catastrophic events like fire, floods or grave illness. Insurance, in short, is suppose to measure risk. It has nothing to do with that now. Something has obviously gone wrong with the system when we need insurance for routine visits and checkups, which are entirely predictable parts of our lives. " -Page 86 of The Revolution, A Manifesto

"In the days before Medicare and Medicaid...."

"In the days before Medicare and Medicaid, for instance, the poor and elderly were admitted to hospitals at about the same rate they are now, and receive good care. As a physician I never accepted Medicare and Medicaid money from the government, and instead offered cut-rate or free services to those who could not afford care. Before those programs came into existence, every physician understood that he or she had a responsibility toward the less fortunate, and free medical care for the poor was the norm. Hardly anyone is aware of this today, since it doesn't fit into the typical, by-the-script story of government rescuing us from a predatory private sector. Laws and regulations that inflated cost of medical services and imposed unreasonable liability standards on medical professionals even when they were acting in a volunteer capacity later made offering free care cost prohibitive, but free care for the poor was common at a time when America wasn't so "governmentish" (to borrow a word from William Penn). We have lost our belief that freedom works, because we no longer have the imagination to conceive of how a free people might solve its problems without introducing threats of violence- which is what government solutions ultimately amount to."  -Page 85 of The Revolution, A Manifesto

"Our out-of-control welfare state also helps account for..."

"Our out-of-control welfare state also helps account for the scope of our illegal immigration problem.  When you subsidize something, you get more of it, and by offering free medical care and other services, as well as the prospect of amnesty, we get more illegal immigration.  Meanwhile, hospitals have begun closing as our states and localities struggle to pay the bills.
...
When, thanks to government policy, the economy is shaky, as it is now with the housing bubble bursting and inflation on the rise, it is all the easier to hold up immigrants as the scapegoats for the people's economic woes, thereby letting the incompetents and shysters who make our economic policy off the hook." -Pages 83 & 84 of The Revolution, A Manifesto

"The kind of spending cuts we obviously need..."

"The kind of spending cuts we obviously need will not be easy, since our government has encouraged so many Americans to become dependent on federal programs.  These programs cannot survive much longer without a financial collapse.  Our national debt, now nine trillion dollars, does not include the unfunded liabilities to programs like Social Security and Medicare that will come due in the coming decades to the tune of another $50 trillion.  It is simply impossible to fulfill those promises.  The level of taxation necessary to fund a figure like that would destroy the American economy and dramatically shrink the productive base from which those funds could be drawn."  -Page 82 of The Revolution, A Manifesto