What if buying coffee was like purchasing health insurance?

Sometimes it is useful to take a step back and look at the bigger picture.

For example, is “health insurance” really health insurance, or has it become a pre-payment plan?  Not everyone with car insurance will get into an accident, but nearly everyone with health insurance gets sick.  We would never expect our car insurance to cover our fuel costs and oil changes, since most of us understand it is only there to cover catastrophic events.  Yet many of us have this kind of expectation every time we see the doctor.

Do patients and doctors spend more or less if someone else is paying the bill?  When we pay cash to see the doctor, or use our health savings account (HSA)  or flexible spending account (FSA), we might choose to manage a mild sinus infection on our own with over the counter remedies.  If we are paying out of pocket when looking for a new doctor, one of the first questions we might ask is how much the office visit will cost us.  We are more likely to request the doctor prescribe a less expensive or generic medication.  We may want a more detailed explanation regarding the medical necessity of labs and procedures, and if we need a CT scan, we will call around to find the least expensive imaging facility.  However, if our cost is the same no matter where we go, we may do what is more convenient and pay less attention to costs.  Patients may even adopt a “buffet mentality and request and receive additional medical services (some of them unnecessary).  Doctors and hospitals also tend to provide more services when patients have “hit their deductible” which of course raises costs.

Is health care a right or a privilege?  If health care is a right, just how much (or how little) health care are we entitled to?  If we abandon a free-market approach in favor of centralized administration, who will make that determination, and who will enforce the provision and payment for said care?  There is a big difference between guaranteeing access to basic emergency medical treatment (i.e. trauma, heart attack, stroke) and mandating coverage for ear infections, minor injuries, chronic medical conditions, and contraception.  Yet we are poised to surrender our health care decision making to the government, along with one of our most personal liberties – the freedom to do what we want with our bodies.  Furthermore, the amount of care we receive will not be guaranteed, but instead will be subject to the whims of unelected bureaucrats, greatly harming the doctor-patient (and consumer-provider) relationship.

We are about to become an expense of the government, and as such they will have an interest in everything we do, from what we eat to the kinds of activities we engage in.

There are other questions we may want to consider as well, such as “is health INSURANCE the same as health CARE,” and “is it charitable when we force other taxpayers to give up more of their money and freedom to benefit our fellow man,” and “what is the downside to creating dependency on the government” (apart from giving up our autonomy and jeopardizing the solvency of the country) – but those are for another post.  For now, we should recognize that there is something fundamentally wrong with our federal government believing it has the authority to compel private individuals to buy goods and services, and to dictate who private businesses engage in commerce with.

One need only look to what is going on in Venezuela right now, where the government is stepping in and forcing retailers to cut prices while arresting others,  to see where we could be headed.


Again, we should be very skeptical of a federal government that believes it can compel you to buy products and services you do not want, so long as they call it a tax.   This runs contrary to the limited form of government our founders envisioned.  They warned us of the ambitions of man, and attempted to constrain these ambitions by establishing a system of checks and balances.  They also made it clear that the powers of the government were to be limited, and that there would be certain “inalienable” rights that the government could not infringe upon.

Yet those presently in government are taking over the private health care system anyway, ostensibly to improve access for those less fortunate (even though we already have Medicare and Medicaid). 

The Individual Mandate hasn’t even gone into effect, and we are already witnessing what is likely just the beginning of a slew of unintended consequences.  Now our politicians are frantically trying to “fix” the problem they created, and are contemplating forcing private companies to sell plans that do not comply with the law.  However insurance companies and state insurance commissioners are warning that if Washington suddenly changes the rules and allows patients to keep the “substandard” plans they liked (which cost less than the required plans), insurance companies will lose some of the revenue they were counting on when they set rates for the exchanges.

Not only that, but if those now running for political cover suspend the Individual Mandate for a year (or until after the 2014 election, as Senator Udall has proposed), and only the sickest individuals sign up for insurance through the exchanges, the private health insurance market could collapse, since young healthy individuals may choose to sit on the sidelines due to the higher plan costs.  Therefore in order to remain viable, the insurance companies will need a “bail-out” from the taxpayer.  

It is now painfully clear that this mess cannot be fixed, and needs to be repealed or defunded before it destroys our health care and our economy.

Watch this hilarious but illustrative video about what buying coffee in America would be like if we had Coffeecare (video)


The point is this:  while it is absolutely necessary that we continue to work to elect liberty-minded and principled small government people to represent us, D.C. has amassed so much power that this strategy alone will not be enough to rein in the federal government.  There are simply too many “fingers in the pie” now with all of the interests that have come to rely on a bureaucracy that regulates so much of our economy and controls the redistribution of our tax dollars.

We ultimately must find a way to re-establish the principle of co-equal branches of government, each with limited and defined powers as enumerated in the Constitution.  Just as important, we must restore the relationship between the federal government and the states, such that government becomes more accountable to the people.

To do this, I have heard some suggest a strategy of winning a couple of election cycles back-to-back, while having politicians sign “pledges” that they will term limit themselves (the thought being, if you have private citizens instead of career politicians rotating through office, they will be less corruptible).  While this may look good on paper, it could take a very long time to accomplish and assumes that freedom-loving people can still be elected.  We also then would have to rely on politicians to actually follow through on their promises.


“In the compound republic of America, the power surrendered by the people is first divided between two distinct governments, and then the portion allotted to each subdivided among distinct and separate departments.”  Federalist 51

A multi-pronged approach would be sensible.  In order to hedge our bets, in addition to running candidates on a platform of liberty, personal choice, and limited government, we need to simultaneously pursue the process for state governments to rein in the federal government, as outlined in the U.S. Constitution.  Legal expert and constitutional scholar Rob Natelson  proposes using the amendment powers enumerated in Article V to directly amend and restore the Constitution.  Instead of years of waiting and hoping, we could literally have term limits become law, as part of a larger constitutional amendment reducing the size of the federal government, in a couple of years.  While national politicians will drag their feet on this, state legislatures could pick delegates to meet with delegates from other states to agree on the wording of amendments.  These would then be sent back to the states for ratification, and if three quarters of them agree, the Constitution would immediately be amended.

This same process could then be used to cap spending as a percent of GDP.  We could also insist that politicians be subject to the same laws they pass for the rest of us.  There could be a requirement that bills costing more than a certain percent of revenues be posted in their final amended form for thirty days before voting on final passage (no more “we have to pass the bill so that you can find out what is in it”).  The Constitution could be amended to simplify the tax code, instituting a flat tax.  Non-essential government programs could be set to expire after three years unless voted to be continued by Congress.  (These and other amendments to restore the Constitution can be found in Mark Levin’s book, The Liberty Amendments.)


We already have a runaway federal government, so some argue that this may be moot – but would using Article V risk a runaway convention?  The short answer is no.  State legislators control the delegates.  If delegates start to “wander off topic,” the states can pull those delegates.  Also, any amendment that the convention agrees on, the legislatures of three-quarters of the states would have to ratify it before it would amend the U.S. Constitution.  Additionally, EACH STATE ONLY HAS ONE VOTE.  So if California tries to propose something irresponsible, and is even able to convince the delegates from a couple of blue states to go along, the rest of the blue states and the moderate and red states outnumber them.


Some will run for office.  Others will help with vetting candidates and supporting them.  There are people out there today canvassing neighborhoods fighting for what we believe.  A number of us build email lists and network with like-minded folks so that we can keep people informed.

Get to know a legislator.  Become an expert on a topic you are interested in.  Don’t hunker down – remain engaged.  And remember:

“Freedom is never more than one generation away from extinction. We didn’t pass it to our children in the bloodstream.   It must be fought for, protected, and handed on for them to do the same, or one day we will spend our sunset years telling our children and our children’s children what it was once like in the United States where men were free.”  Ronald Reagan

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