Dr. Rand Paul Addresses American Academy of Ophthalmology Conference
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Dr.
The transcript of his remarks as prepared for delivery can be found below.
TRANSCRIPT:
Good morning. It really is a pleasure to be here with you all today. It's great to be with normal people for a change. I work in a city where logic is the exception and dysfunction the norm. DC is so dysfunctional we can't even pass things we agree on. I have a bill that I co-sponsor with
When I think of how screwed up DC is, I think of what Groucho Marx said about politics: "The art of politics is looking for problems everywhere, finding them, misdiagnosing them, and applying the wrong remedies."
Being here in
I would like to thank the
People often ask if being a physician affects my view of our nation's problems. Absolutely. I think physicians tend to be problem solvers. Physicians typically analyze a problem and apply the remedy based on the facts, not preconceptions.
Today I want to examine our healthcare system and look at ideas for making healthcare less expensive and more accessible.
Many years ago when my father first entered politics, he wrote an essay on Kwashiorkor. As you may remember Kwashiorkor is a stage in chronic starvation when protein deficiency becomes so severe that there is not enough intravascular colloid to maintain osmotic balance and fluid leaks into the abdomen creating ascites, the swollen bellies of starvation.
As a medical student, my father dreamed of a cure for Kwashiorkor, but the more he read, the more he discovered that the answer was economic, not medical.
I traveled to
The team was lead by
I read with fascination of the exploits of two great surgeons, Sanduk Ruit and
I was fascinated to read of
Ruit had discovered how to perform cataract surgery as quickly as we do in America, but at one-tenth of the cost. His surgery gave just as good a result but didn't require phacoemulsification.
The medical advance of bringing sight to tens of thousands of the blind people in the developing world was as much an economic miracle as it was a medical breakthrough.
In our country we have had a debate over what system best delivers the highest quality of healthcare to the most amount of people, at the least cost, and the least time spent waiting for it.
Though the debate over Obamacare may appear, at times, to be a debate over healthcare, it is really a debate over what type of economic system distributes goods the most efficiently.
Which really, when you think about it, is extraordinary that the debate is necessary at all. Since the collapse of the
What does that mean?
It means that the
The
If they set the prices too high, the bread would rot on the shelves and bread would again be in shortage.
Only democratic capitalism, where millions of consumers vote daily, can determine the price of any good. The correct price of good is the price at which the most stuff is distributed to the most people.
There is no moral price. There is no correct price that any one individual can discover.
The Nobel Prize winning economist,
Every time a
You might respond that food or healthcare is too precious to let consumers decide its price.
If you believe that, realize you cannot escape economic truths. If you insist that healthcare is somehow different from all other goods and services, you will still suffer the consequences of economic fallacy.
If you set the price of cataract surgery too low, let's say free, the demand will be infinite and there will be shortages of cataract surgeries and cataract surgeons....and the only way to sort this out is by having the patients wait in line until supply can catch up with demand.
Adjusting supply to meet demand is not just a theoretical concept. It is the new normal in societies that reduce the apparent price of medical services to zero. In
When LASIK first arrived on the scene, I remember hearing of a prominent Canadian eye surgeon who would run through his government allotted number of surgeries by September and then come to the U.S. for the rest of the year and perform refractive surgeries.
But proponents of government intervention will argue, "Vision is too important a goal to be treated as a mere commodity. We could never leave something so precious as vision up to the vagaries of the cold, immutable marketplace."
Yet, look at what happens in the LASIK marketplace and the contact lens marketplace. Prices fall and both LASIK surgery and contact lens are available in abundance.
But emotions run high when we talk of healthcare or basic needs such as food. Some argue that healthcare and food and water are too vital to be left up to capitalism. Only the government can distribute them fairly.
If you believe that, realize that the laws of economics, like the laws of thermodynamics, are inescapable... there will be consequences.
Rationing, either by mandate or by waiting in line, is an inevitable side effect of government distribution of goods.
But how would we take care of the poor? Isn't the civilized way to have government be in charge of healthcare and foodcare and the necessities of life?
I think there is another option: free up prices. Allow a marketplace of freely fluctuating prices for everyone. The consequences would startle you. The beauty of capitalism is that it distributes the greatest amount of goods at the cheapest price.
The economist, Joseph Schumpeter, once remarked, "The capitalist achievement does not typically consist in providing more silk stockings for queens, but in bringing them within the reach of factory girls in return for steadily decreasing amounts of effort..."
The wonder of Capitalism is not in producing a silk stocking that the Queen can purchase, but in producing silk stockings that even a shop girl can buy.
But wouldn't capitalism leave some people behind? Wouldn't some people be left without healthcare? Yes, but instead of destroying a system that works efficiently for the vast majority, why not address the needs of those left behind?
Instead of taking capitalism and pricing out of healthcare, why not let capitalism distribute most of healthcare and then devise ways of taking care of the indigent.
When poverty is the exception not the rule, the government and charities could get involved to fix the exception, but not screw up the system for the vast majority. Competition, when allowed to thrive, drives prices down.
How would we do this practically? Get government out of the business of setting prices. End the SGR, the government system that sets fees. It was wrongheaded policy from the beginning. It's been temporarily suspended over dozen times. Let's not temporarily fix SGR, let's abolish it once and for all!
Once prices are free to be set by millions of consumers, bidding instantaneously, will we free up choice.
For
If you did that, there would be no need for government to fix either physician fees or patient prices.
Let consumers decide what kind of insurance they want and where they want to purchase it. It is a crime against nature to give unmarried young adults, insurance that covers pregnancy for the wife they don't have, in vitro fertilization for the kids they are not ready for, and pediatric dental coverage for the kids they don't have.
True freedom of choice would let patients buy any type of insurance they want, including inexpensive insurance. Shouldn't every American get to decide whether they'd rather buy expensive insurance or save that money for something they prefer?
To allow the marketplace to work in healthcare, we should allow the purchase of insurance with lifelong tax-free savings accounts. Health Savings Accounts started at birth would accumulate such remarkable amounts that health insurance costs would plummet to approach the costs that we associate with term life insurance.
For the exceptions to the rule, for those who live in poverty or are afflicted with expensive chronic medical conditions, government and charity can find a cure.
As physicians, we think of healthcare as medical problem. Only when we begin to understand that the most vexing medical problems are really economic problems will we be closer to a cure.
I think it would be an improvement if politicians acted more like doctors----
and if doctors became more involved in politics. We've been put through the meat grinder in the last few years, and no one in government seems to ask physicians how to improve healthcare.
America leads the world in so many medical innovations. I hope we don't lose that edge I hope the medical devices tax doesn't drive American medical companies overseas.
Our system wasn't perfect before Obamacare but I fear it's much worse now. There was nothing inherently wrong with medicine in our country.
The old system before Obamacare was not perfect, but I fear the new system with more government intervention will be worse. We are already reading of newly empowered patients who have subsidized health insurance and a
We are in for a rude awakening when we discover that free or subsidized health insurance provides an incentive to seek care but with a
As we discover the number of non-payers, we will also discover that premiums must rise to cover that cost. Unfortunately, the premiums will be paid by fewer and fewer non-subsidized purchasers of insurance.
We can search around for blame, and there is plenty. But the fact is, everyone in this room can help.
The voices in this room belong to experts in ophthalmology and leaders in communities across
Don't let the powers that be ruin medicine. Become part of the solution. Help fix the process. Support candidates who understand the problem and offer proper solutions.
Support policies that enable doctors and treat patients like consumers, while minimizing government.
If you don't like what you see, be part of the next round of diagnosis and treatment.
I plan to be, and I would love to see you all with me. Maybe it's time for a doctor to fix the problem.
I hope you'll join me and be part of the solution.
Read this original document at: http://www.paul.senate.gov/?p=press_release&id=1229
Copyright: | (c) 2010 Federal Information & News Dispatch, Inc. |
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