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Cutting Costs of Medicare
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One of the best ideas for reducing medical costs was the provision that doctors be paid to counsel patients about end-of-life directives. But it was the *only* idea. All the other proposals to "bend the cost curve" simply bend the compensation curve (arbitrarily paying less for mandated treatments). The biggest "savings" in the current bill is cutting Medicare compensation by *another* 20%, which is something that Congress will *never* allow in any case (eliminating that cut was the "Dr. Fix" that they tried to pull out of the Senate bill, so the $250 billion cost of NOT cutting wouldn't appear in the main "healthcare" bill ... but that failed).
Then, the left-wing media (pejoratively) latched onto Palin's incoherent rant on the topic of “death panels” and pumped it up as The Republican Position. She didn't understand that the Directives (actually authorizing certified advisors, not physicians, to provide the service) had nothing to do with a separate panel that would ration treatments based on an estimate of the "life utility" of patients:
"When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated."
If they wanted to seriously cut *totally useless* government healthcare expenditures, they could do it without passing any legislation. Just prosecute the fraud.
Most libertarians would agree that the premise is fairly simple: in a free [of coercion] market, every individual makes their own decisions about exchanges. Whether or not insurance (or any other service or commodity) is valuable to them depends entirely on their circumstances and the product being offered at a particular price. Assuming an open and honest market, EVERY person who makes a decision makes the best decision for THEM. It may, in fact, be a bad decision - ill-informed or ill-considered - but they assume the consequences of their own choices, good or bad. They are not able to force others (though others may voluntarily assist) to take responsibility for their bad choices.
People make mistakes; good choices for bad reasons; bad choices for good reasons; as well as simple errors. In some cases, government rules or regulations DO benefit everyone, by requiring open competition for consumers and honest representation of the product. But, as soon as they go beyond that, government is inserting the viewpoint of some disinterested third-party into the exchange decision. Almost always, it is a *norm* for the population, not an individual determination. It is therefore *necessarily* uninformed (of the individual's circumstances) and *necessarily* wrong for some large proportion of the population (the average is false for almost 100% of a population).
So, the generic statement is true: government coercion is inherently destructive.
