Mimsy Were the Borogoves


Strangling the iPhone of health care

Jerry Stratton, May 29, 2015

Osborne Model 1

Can you imagine being afraid to give this up as your daily computer because you have never seen an iPad or iMac, and believe that a laptop weighing less than three pounds is not only impossible but dangerous to even imagine? That’s where we are with health care today. Except that instead of being stuck with a computer of the eighties, we’re stuck with health plans of the forties. (Image courtesy Johann H. Addicks, CC-BY-NC-ND 3.0)

In the latest Commentary, a Dale Edmondson writes in that its all well and good to say that employee wages would increase if employers didn’t pay for their health insurance, but wouldn’t this just mean that the employee would have to spend the same money to get the same care?

The author of the original piece, Benjamin Domenech, writes that there would be significant savings because

By funneling benefits through employers, you increase transaction costs, subsidize demand, and insulate consumers from price signals. We see this particularly in the health-care arena, where the subsidization of employer-sponsored health insurance and the problems of third-party payer form a particularly dangerous combination.

There is no question that reducing the number of middlemen from three, four, or even five1 down to one would vastly improve our health care market, reducing prices and increasing quality.

But there is a bigger issue involved that almost always accompanies government mandates of a particular form of something. We do not know how many better forms exist.

The assumption is that an individual market would replace, on an individual level, the very strange system of health “insurance” that has arisen around government mandates, subsidies, and tax incentives. But there is no reason to assume that this is true, and in fact a direct connection between people and their health needs would almost certainly bring about not just a better version of what we have now, but entirely new means of meeting health care needs customized to each individual.

Just as with the archaic computer I postulated in Walking into quicksand, our current health insurance system is designed around what we thought would be a good idea in response to government polices in the forties. We locked our current form of employer health plans into place over seventy years ago. Our health care system today looks a lot like that old back-breaking luggable I wrote about. We just don’t recognize it because we don’t have anything newer to compare it with. It’s the only form we’ve ever seen, and we’re afraid to lose it because we don’t know what else is out there.

We have no idea what the tablets and laptops and 27-inch screens of health care are, nor how much better life will be when we get government out of the way and let them exist.


  1. The employer, government, and the insurer, at least. Potentially also the insurance packager and the health care packager.

  1. <- Insurance canceled
  2. Public Citizen single-payer ->