Ryan asks...

in a text that he sent me last night:

"Do you agree that for the state to compell me to purchase or otherwise carry health insurance is unconstitutional?"

The short answer is YES, I do feel that compulsory involvement in such a national plan is unconstitutional. What is really wrong with any kind of compulsory health coverage is that it is completely unnecessary...

Most of us live in States where we are required to show proof that we carry adequate automobile insurance to cover a minimum amount of general liability, or the cost of replacing a car that isn't owned out-right. All of us have lived in (or still live in) homes where we are required to carry enough insurance to replace the structure of the house in the event of a disastrous loss of that house (some of that coverage is, in fact, government coverage, since this country has a national flood insurance program). If we are good drivers and careful home owners, neither of these requirements are unduly burdensome, and actually benefit the holder of the policy and the economy at large.

What staggers the imagination is that people have become so institutionalized concerning health insurance coverage that they accept as FACT that one cannot go to the doctor without a card promising coverage of the bill, either in whole or in part.

You cannot turn on the television without being inundated with commercials promising lower and lower monthly premiums from competing auto, life and home owners insurance providers. These companies offer discounts upon discounts if only you have multiple policies written under the same company (for example: two cars, a home and some supplemental life all with one provider).

This is NEVER the case with health insurance, though... and no one ever seems to ask WHY NOT?

Open your local phone book and look under "Doctors"... if you live in a big city or a small town, one of the biggest sections of that book will be "doctors". Now go through and see how many are "general" or "family" practitioners. Less than 10% of all doctors nationally are licensed general practitioners. The remaining 90%+ are specialists... meaning that they specialize in a particular brand or category of medicine and pay a LOWER PREMIUM in medical malpractice insurance. With the average cost of malpractice premiums nation-wide riding at $50k per year (with the high-end of average being $64k annually, right here in my state of PA), who can blame the doctors for charging $150 just for walking into the examination room?

In my "ideal" world, we should be able to open that phone book, look under "Doctors" and start calling around looking for the best (but not necessarily the lowest) price doctor we can find, and making the appointments accordingly. If we find someone we trust, who is fast, friendly and efficient with out visits, then we give them our business... paying for each visit as it is given. If we find that we need to see why Junior's throat is sore... we know we are going to pay $40 for the examination, and another outlay for the prescription (if required).

I do not file an insurance claim each time I change the oil or rotate the tires or check my brake pads on my vehicles, do I? I carry the insurance in case there is something really BIG that I simply cannot afford to pay out-of-pocket. If my 7-year-old puts a Wii-mote through the living room window, I don't call my home owner's insurance adjuster... I call a window repair company. Why is health care any different? Why are we "forced" to see doctors according to who will take our insurance plan, as opposed to who will give the best service for the dollar?

This isn't simply an intellectual exercise, either... it is pure fact. From November, '05 to June of '07 I was without health insurance, and I lost my insurance again in Nov of '09. During those months, I simply called doctors and explained that I needed to be seen, but had no insurance, and found the ones that provided the services I needed at a price I could afford. Shockingly enough, this was remarkably EASY to do, and most offices gladly made the arrangements, knowing they were going to get a cool $100 in cash (for example) rather than wait 6 months for an insurance company to pay them their share of $400 for the same visit. Add to this the simple fact that once I was covered again, I kept going to those doctors because they provided a good service... and it was easier to keep seeing them at $40 per visit than it was to find a new doctor who took my insurance plan.

Using this method of health care, I had a broken crown replaced by a top-notch dentist for $248, and I defy anyone to show me that the same procedure wouldn't have cost $1500 to an insurance company. I had a nasty case of "pink eye" cleared up for the price of a $40 visit and a handful of free antibiotic samples... all without ever having to get a referral to a specialist or calling to find who was on my company's plan.

Those politicians are arguing that "Big Insurance" is at fault, and that a government plan is the answer... but I am telling you that they are pandering to the malpractice lawyers and allowing a failed system to perpetuate itself through a compulsory government plan that will only spread the burden to everyone, rather than keep the market competitive and open to anyone that might wish to practice it.

What really needs to happen to fix American health care is tort reform, malpractice award caps, and a method of showing the CONSUMER that they have a choice, which will ensure a competitive marketplace and a wide selection of providers for people to choose from. Then, a newly established doctor in an small town or a big city can look to earn an honest income $100k annually WITHOUT having to also earn an additional $100k to cover his insurance premiums.

End of rant.