In the Mommy-state world few things are as delicious as pointing out the negative effects of corporations, businessmen, consumer products, and private market transactions of all varieties. Shrill big government interventionists like Ralph Nader, or rich Liberals, or ‘the uber wealthy chicks against fur, profit, and war’, shill their anti-capitalist nonsense to applause and acclaim. If they want a real gig to do some social good they should forget about the seal hunt and get busy with Health Care reform. How about these so-called activists spending some time screaming against the literal dead-hand of big government mommy-state health care? Not only are costs out of control in mommy-state health care consuming 40 % of budgets in most jurisdictions, the system literally kills thousands of people each year – somewhere around 5.000-20.000 in Canada and a cool 20.000-80.000 in the USA. Try killing people with private consumer products and get away with it. Yet the big teeth, coiffed hair crowd raise barely an eyebrow over the financial and moral bankruptcy of mommy-state health care – too busy getting their care in a private clinic one imagines.

In the big mommy-state government can not only financially bankrupt a system but they can also kill people and cover the atrocity with ‘values’ statements and air-head rhetoric about equal access and affordability. Try that in explaining for instance war casualties. We could write off the 2000 US dead in Iraq as ‘national values’ – keeping in mind of course that more US soldiers die every 2 years from accidents than have died in Iraq. Maybe shedding some light on the sewer system that passes for modern health care would force some reforms. Two simple ideas would start the revolution; send a health care statement each quarter to the good citizens of the mommy-state and publish the lists each week of those who die in hospitals from diseases contracted while in the hospital or due to malpractice.

Let’s imagine you are Joe Average citizen of the modern mommy-state. You are 55 years old with a wife that gets ever wider as more junk is shoveled down her throat, you have 2 kids that are according to statistics overweight and addicted to twinkies, and you yourself have a 38 inch waist trending rapidly to 44. A good day of exercise for the average Joe is sprinting betwixt couch and fridge for that third calorie loaded beer. His wife gets her workout from nervously lighting with shaking hands 5 cigarettes each day. Joe and his expanding wife are not too concerned with health since both believe that the mommy-state will take care of them if the impossible should happen and their internals stop working. They rationalize it as their ‘right’ and entitlement and point out quite huffily that their largeness just seems to naturally blend into the general mommy-state population where all is relative and big is beautiful.

So let’s analyze Joe’s claim on his human right health care entitlement. If Joe started work at say age 25 his average salary would be about $30.000 per year trending up to the current average level of $55.000 by age 55. So let’s say that on average our average Joe has paid about $18.000 per year in taxes to the mommy state for 30 years. Joe has paid about $540.000 in taxes during his working life to date. Using some basic tax calculators you will find out that in the average modern state 1/3 of this is towards the mommy-state health system. So average Joe has paid over 30 years a cool $180.000 towards the health system or about $6.000 per year as his health insurance premium. Quite a lot of cash for an average Joe.

What happens over time as Joe goes from his beer swilling 20s into his light beer swilling 50s? During the first 15 or so years of work the average Joe will seldom use the Health system. Statistically 75 % of all health expenses are for the over 55 grey haired crowd. So let’s assume that for the first 30 years the average Joe is moderate in Health care usage. He goes once a year for a checkup and once in a while for something a little more severe – a small operation; a bruised knee; a dislocated limb or a sprain. The system costs for moderate usage are according to statistics about $200 per visit; and $1500 per small operation or non life threatening treatment. Let’s assume that average Joe visits 2 times per year and has one minor adjustment per annum from age 25 to 55. His total 30 year cost is $1900 x 30 or about $60.000. But good old Joe has paid $180.00.

Let’s assume that average Joe has an average family. Total family health care consumption would be about $3.500 for the expanding wife and bawling kids. Over 30 years this would cost about $100.000. The system still nets from Joe about $20.000 net after paying all his health care costs. Society wins in the example of the average Joe family making a 10 % profit on Joe’s health contributions. This is an obvious problem if you are the average Joe with an average salary – but what happens if your family needs more care?

Assume that the expanding wife does not work and the expanding kids won’t pay taxes for 25 years. Let’s assume that the expanding wife has a congenital disorder that requires regular treatment, drugs, and home care. Such expenses on average would cost the health system about $2.500 per serious treatment, $2.000 per annum in drug costs and about $2.000 per annum in home care and other costs. Say the wife consumes about $6.500 per year in health costs. Let’s add in the kids with above average ailments and aches and pains necessitating quarterly visits and some small operations each year. This would cost the system, for 2 such cases, about $5.500 per annum.

Over time then average Joe’s wife and kids will consume in 30 years about $360.000 in total costs. Added to Joe’s $60.000 that comes out to approximately $420.000. Joe has paid in tax only $180.000 so his net benefit is $240.000. So what are Joe’s political preferences if average Joe has a family that is above average in sickness? Joe is obviously all for the welfare mommy-state. Society at large has covered average Joe’s family for a quarter of million before the age of 55. This says nothing of the costs going forward when Joe retires and really starts to consume the ‘free’ health care resources. By the time average Joe with the above average ill family dies and melts into the earth society will pay $500.000 for his health care.

Is this fair? For the average Joe society rakes in a tidy profit – 10 % over the first 30 years. Going forward after 30 years that profit can be applied against the future increase in health costs as average Joe and expanding wife consume ever more resources. Probably it nets out to zero all things considered. But in the second example society takes a massive loss on Joe. Is this fair? Most would say yes if the illnesses contracted are natural or unforeseen. No point in bankrupting someone if they get sick. Fair enough. But is this a rational way to organize any insurance scheme? The answer is of course no. No one would organize a system of care premised on universal payments and non-transparency or an understanding of costs and benefits. If health care is a system of insurance – and it is – it should be treated as such.

Full disclosures and quarterly statements should be issued as well as lists of good and bad hospitals; good and bad doctors; good and bad technologies and the number of dead that pile up in various care facilities due to socialist medicine’s incompetence, inattention or unsanitary practices. For the average Joe who is out of shape, eats and smokes too much and generally consumes more than he puts in he might get some existential joy at making ‘the rich pay’ for his entitlement. For the other average Joe who is fit, sleeps well, eats right, does not smoke or drink and chews his vitamins each day thoughtfully, he is liable to plump for a revolution to burn down various government buildings when he receives his quarterly statement and realizes that he is paying about $6.000 per year in taxes to fund mommy-state health care and consumes nothing. Sure past age 65 he will eat into this insurance payment but no one can morally or financially justify stealing from the average healthy worker $6.000 per annum to fund and buy the votes of those who are ill, old or unwilling to take care of themselves.

As with any market system transparency, price points and consumer choice are necessary. There is no rational reason why government needs to impose itself and run Health systems. Even in the US the government is now the biggest payor of health claims and controls over 8 % of GDP in health care spending – more than in socialist ninny Canada. To say that the US system is free market based is incredible nonsense. Government in the US is the problem in health care and has seriously limited choice and transparency.

Insurance markets can only work if there is transparent pricing. This is not to say that those who are poor or unable to pay should be left to die in the cold. This is another socialist nonsense and lie. Apparently only big government and heavy socialists care for the poor. Tell that to the rich conservatives and capitalists that are financing through charity and gifts every health and poor program imaginable. Producing wealth and aiding those in need with charity is far more noble than pretending to care while you amass power through stifling regulation that actually hurts those you are supposed to help. Governments do have a role to play in health but the role must be defined, open and held up to scrutiny. Governments can supplement the poor or people afflicated by disaster with various public insurance premium programs, credits, guarantees and well defined payments based on need and limited by proper resource usage. But to hide the entire system behind a single payor tax and never reveal how money is spent, on who and why, and worse to disavow the deaths and casualties from poor quality is a moral and financial crime.

There are many ways to organize an insurance market and the big mommy-state model is the worst alternative imaginable. It is time for some intelligent debate and reform for the mommy-state health system – before it bankrupts mommy.