A nation of averages

In "Government-Run Health Care vs. the Hippocratic Oath," Paul Hsieh argues that government control of care subverts your doctor's judgment -- and undermines your ability to trust your doctor. One of the ways in which this happens is that bureaucrats inherently make rules based on averages. Instead of deciding how much and what kind of care a patient needs based on that patient's individual symptoms, overall health status, and general situation, as a doctor who has direct contact with a patient can do, bureaucrats look at the average level of care required by a patient with a particular condition, based on data from a large group of such patients. Then they condemn a doctor giving more care than the average as an "outlier" who is using "unnecessary resources," even if the patient's health situation makes that care all too necessary. An average, after all, is a calculation that includes both patients who need less care and patients who need more. In a free market, patients who need more than the average amount of care can seek it, and pay for it. In a government-controlled market, such patients are deemed "outliers," and to put it bluntly, they're screwed.

But payments to doctors aren't the only way in which government-run health care imposes an average to the detriment of anyone who happens to be "above average" in their need for care. The New York Times reports that the health care "reform" bill is capping the annual limit of money that can be put into a tax-free health-care flexible spending account at $2,500, starting in 2013. Proponents of the limit argue that the average amount put into such accounts is much less than that -- only $1,400 (of course, I'm sure people would put more money in if it could be rolled over from year to year and thus used to insure against serious, unforeseen events). So who are we really hurting by imposing it?

Those with chronic conditions, that's who. The article cites a Florida couple who spend $350 per month just on their co-pays for prescription drugs for heart disease, diabetes, and Crohn's disease -- let alone any money they spend on over-the-counter meds, which won't be allowed reimbursement from an HSA starting next year. They are hardly the only Americans who take multiple medications, or who have children who need orthodontic work, or who would simply prefer paying for their health care out of pocket rather than buying an expensive comprehensive insurance plan that doesn't deliver the value paid for. Such people will now have to pay for those expenses with post-tax, not pre-tax, dollars.

Just another way in which letting the government take over health care will screw you if you're "above average" in any way...