Authored by Connor O’Keeffe via The Mises Institute,
Last week, UnitedHealthcare CEO Brian Thompson was shot to death on a New York City sidewalk in what was clearly a thoroughly planned-out attack. Over the next few days, as authorities hunted for the killer, online progressives did not try hard to hide their delight that a millionaire health insurance executive like Thompson was killed.
Social media was flooded with posts and videos—with different ranges of subtlety—suggesting that Thompson, at the very least, did not deserve to be mourned because of all the health care his company has denied to poor and working people. Progressives framed the shooting as an act of self-defense on behalf of the working class. Before the alleged killer was caught Monday, they promised not to snitch if they saw the shooter themselves and fantasized about a working-class jury nullifying all charges, leading to other CEOs getting gunned down with impunity if they oversaw price increases.
The narrative that these online progressives clearly subscribe to and perpetuate is one where, in the United States, healthcare is a totally unfettered, unregulated industry; where – because of a total lack of government involvement – wealthy CEOs charge whatever prices they want and then refuse to provide customers what they already paid for without facing any bad consequences.
The characterization of healthcare and health insurance companies charging absurdly high prices while treating their customers terribly without the risk of losing them is spot on.
But the idea that what caused this was a lack of government involvement in the healthcare system is completely delusional.
And this delusion conveniently removes all the responsibility progressives bear for the nightmare that is the US healthcare system.
Today, healthcare is one of the most heavily government-regulated industries in the economy – right up there with the finance and energy sectors. Government agencies are involved in all parts of the process, from the research and production of drugs, the training and licensing of medical professionals, and the building of hospitals to the availability of health insurance, the makeup of insurance plans, and the complicated payment processes.
And that is nothing new. The US government has been intervening heavily in the healthcare industry for over a century. And no group has done more to bring this about than the progressives.
It really began, after all, during the Progressive Era, when the American Medical Association maneuvered its way into setting the official accreditation standards for the nation’s “unregulated” medical schools. The AMA wrote standards that excluded the medical approaches of their competitors, which forced half of the nation’s medical schools to close. The new shortage of trained doctors drove up the price of medical services—to the delight of the AMA and other government-recognized doctor’s groups—setting the familiar healthcare affordability crisis in motion.
Around the same time, progressives successfully pushed for strict restrictions on the production of drugs and, shortly afterward, to grant drug producers monopoly privileges.
After WWII, as healthcare grew more expensive, the government used the tax code to warp how Americans paid for healthcare. Under President Truman, the IRS made employer-provided health insurance tax deductible while continuing to tax other means of payment. It didn’t take long for employer plans to become the dominant arrangement and for health insurance to morph away from actual insurance into a general third-party payment system.
These government interventions restricting the supply of medical care and privileging insurance over other payment methods created a real affordability problem for many Americans. But the crisis didn’t really start until the 1960s when Congress passed two of the progressive’s favorite government programs—Medicare and Medicaid.
Initially, industry groups like the AMA opposed Medicare and Medicaid because they believed the government subsidies would deteriorate the quality of care. They were right about that, but what they clearly didn’t anticipate was how rich the programs would make them.
Anyone who’s taken even a single introductory economics class could tell you that prices will rise if supply decreases or demand increases. The government was already keeping the supply of medical services artificially low—leading to artificially high prices. Medicare and Medicaid left those shortages in place and poured a ton of tax dollars into the healthcare sector—significantly increasing demand. The result was an easily predictable explosion in the cost of healthcare.
Fewer and fewer people could afford healthcare at these rising prices, meaning more people required government assistance, which meant more demand, causing prices to grow faster and faster.
Meanwhile, private health “insurance” providers were also benefiting from the mounting crisis. In a free market, insurance serves as a means to trade risk. Insurance works well for accidents and calamities that are hard to predict individually but relatively easy to predict in bulk, like car accidents, house fires, and unexpected family deaths.
Health insurance providers were already being subsidized by all the taxes on competing means of payment, which allowed their plans to grow beyond the typical bounds of insurance and begin to cover easily-predictable occurrences like annual physicals. And, as the price of all of these services continued to shoot up, the costs of these routine procedures were becoming high enough to resemble the costs of emergencies—making consumers even more reliant on insurance.
With progressives cheering on, the political class used government intervention to create a healthcare system that behaves as if its sole purpose is to move as much money as possible into the pockets of healthcare providers, drug companies, hospitals, health-related federal agencies, and insurance providers.
But the party could not last forever. As the price of healthcare rose, the price of health insurance rose, too. Eventually, when insurance premiums grew too high, fewer employers or individual buyers were willing to buy insurance, and the flow of money into the healthcare system started to falter.
The data suggests that that tipping point was reached in the early 2000s. For the first time since the cycle began back in the 1960s, the number of people with health insurance began to fall each year.
Healthcare providers—who had seemingly assumed that the flow of money would never stop increasing—began to panic.
Then came Barack Obama.
Obama’s seminal legislative accomplishment—the Affordable Care Act, or Obamacare—can best be understood as a ploy by healthcare providers and the government to keep the party going.
Obamacare required all fifty million uninsured Americans to obtain insurance, and it greatly expanded what these “insurance” companies covered. Demand for healthcare shot back up, and the vicious cycle started back up again—which is why the bill enjoyed so much support from big corporations all across the healthcare industry.
Before it was passed, economists were practically screaming that the Affordable Care Act would make care less affordable by raising premiums and healthcare prices while making shortages worse. Progressives dismissed such concerns as Reagan-era “free market fundamentalist” propaganda. But that is exactly what happened.
Now, the affordability crisis is worse than ever as prices reach historic levels. And, because Obamacare brought American healthcare much closer to a single-payer system, the demand for healthcare far exceeds the supply of healthcare – leading to deadly shortages.
There are literally not enough resources or available medical professionals to treat everyone who can pay for care. Also, the tax code and warped “insurance” market protect these providers from competition—making it almost impossible for people to switch to a different provider after their claims are unfairly denied. If it were simply greed, denying customers who already paid would be a feature in all industries. But it’s not. It requires the kind of policy protections progressives helped implement.
And on top of all that, despite paying all this money, Americans are quickly becoming one of the sickest populations on Earth.
This is one of the most pressing problems facing the country.
A problem that requires immediate, radical change to solve. But it also requires an accurate and precise diagnosis—something that, this week, progressives demonstrated they are incapable of making.
The American progressive movement is responsible for providing the political class the intellectual cover they needed to break the healthcare market and transform the entire system into a means to transfer wealth to people like Brian Thompson.
Now, they want to sit back, pretend like they’ve never gotten their way, that the government has never done anything with the healthcare market, and that these healthcare executives just popped up and started doing this all on their own—all so they can celebrate him being gunned down in the street. It’s disgusting.
Brian Thompson acted exactly like every economically literate person over the last fifty years has said health insurance CEOs would act if progressives got their way. If we’re ever going to see the end of this century-long nightmare, we need to start listening to the people who have gotten it right, not those who pretend they are blameless as they fantasize online about others starting a violent revolution.
