With the Affordable Care Act (ACA) dominating the 2012 presidential campaign, those who are justifiably worried about the future of health care in America may appear to have little recourse when the bill is completely implemented in 2014.
Thankfully, however, freedom and the market always find ways to address demand and the desires of individuals. Consumer-driven health care plans (CDHPs) have increased by 18% in the past year and offer a viable alternative to corporatized medicine and increasing government control over health care.
Libertarians like myself are often accused of dabbling too much in theory and not enough in the practicality and implementation of our principles. And while I believe philosophy and ethics are absolutely vital — after all, all political ideologies rest on some set of axioms and principles — people desire answers. There are so many reasons to oppose the ACA, and government medicine in general, but short of a completely free market in health care, the growth of CDHPs offers a look at what short-term alternatives there are.
CDHPs are health insurance policies that unlike most health care plans, have high deductibles and lower co-pays from insurance companies. This not only incentivizes individuals to be more careful consumers, but brings the health care market closer to, well, an actual market.
When one goes to a doctor or hospital, the most obvious thing that is missing are prices. After all, why should there be any? With third-parties covering the vast majority of the cost, whether it be insurance companies, HMOs, or Medicare transfer payments, there is little to no discrimination or calculation based on the actual cost and an incentive to charge the maximum amount, the opposite of how markets function.
CDHPs are a great way to avoid this problem, allowing health care decisions to be made closer to the individual where they belong as well as having the effect of lowering costs. Prices are market signals that allow society to cooperate, exchange, and coordinate, something the health care industry (and industries that government intervenes in the most, like education and security protection) desperately needs.
A great example of this is Dr. G. Keith Smith's Surgery Center of Oklahoma. With or without insurance, for over a decade Smith's hospital offers fantastic care with transparent, direct, and package pricing, allowing consumers to know what they are receving as well as keeping costs and overhead low (see Smith's interview with Lew Rockwell). People from across the country, as well as Canada and Europe, travel to the Center for the type of medical care that resembles a grocery store or Best Buy rather than a DMV or TSA-filled airport.
Health Savings Accounts (HSA) are also a great way to take control of your own health care. Although currently limited, millions of Americans use them, and with the proper reform would allow individuals to bypass government control and insurance companies. And I'm not talking about the forced HSAs that President George W. Bush advocated, which simply funnelled tax money into politically favored corporations and investment firms on Wall Street. I mean something like what Congressman Ron Paul (R-Texas) has advocated for years, HSAs that get the government out of the way with 100% tax-credits, no restrictions based on what type of insurance you have, using HSAs to pay for premiums on high-deductible plans, on abolishing controls on how people use their HSAs.
Plus, as a libertarian and an opponent of artificial credit and debt, incentivizing individuals to save money for any reason is always a good thing, especially in this current economy where slow economic growth and the declining value of the dollar leave many people trapped.
Although it is virtually unlikely that a President Romney, would actually repeal the ACA (even if the GOP had the votes in Congress) or do anything other than go in a corporatist direction, the power of the market is finding ways, against heavy odds, to provide alternatives. Avoiding the mess that government intervention has done, and will continue to do, to the deliverance of health care will hopefully become easier as more and more people "opt-out" by circumventing their way around it.
I have a heavy distate for electoral politics and little faith in legislation, which is why withdrawing from it as much as possible remains and will continue to be the best way to create change and practical libertarian alternatives. The market is truly the most humane, peaceful, and efficient system in the world, and even under immense tax and regulatory burden, CDHPs, HSAs, and Dr. Smith's Surgery Center of Oklahoma are great examples of what the future of medicine will look like.