That's why the US Air Force, NASA, and the CDC should be eliminated.
You might get the USAF through either on "provide for the common defense" as a part of raising arsenals. You are right - the CDC, Social Security and Medicare are not constitutional.
The only legitimate approach for these changing needs is to amend the constitution, and this is exactly why the detailed amendment mechanism was designed.. Simply violating the constitution with the argument of "urgent need" has lead to the current set of scoundrels who claim that your personal liberties must be forsaken due to the new permanent state of terrorist threat. What baloney ! What bull... ! 1984 came late. Or the "urgent urgent healthcare crisis" - baloney^3.
Our current system is terrible. The complete disconnect between the people who buy healthcare services, the people who sell healthcare services, and the people who pay for healthcare services is totally unworkable. In certain respects a free market may function better than our current system (although we would be telling a lot of poor sick people to die).
I agree that it is terrible and a free market system WOULD clearly function better,
but you are confused several issues. Insurance is ONLY about risk amortization. Your complaint that a free-market insurance would not cover the poor is like complaining that sweeping your carpets doesn't remove the weeds in your lawn. FM is about creating competition among both buyers and sellers of goods and services. The competition can often bring the price very close to cost, but no lower.
This is NOT telling a lot of poor ppl to die - (such a phony-baloney rhetoric). Hospitals cover many cases without remuneration, and also medicare which provides insufficient remuneration. Charities and free clinics provide free services. I would agree that this together is not sufficient and not a good system, but giving more than one receives in a transaction is not a problem the free market can ever address. IF we (as the government) would agree to pay for competitive service providers then free markets could respond. Perhaps you didn't get the memo - but no one thinks the free market alone addresses all human needs. Why have or care for children for example ? Why give to charity ?
*Insurance* is only about risk. If you have a pre-existing condition then obviously the risk is 100%, and it's unfair to call this "insurance". Just as you can't buy insurance for your auto after the crash. That is NOT insurance by any rational definition.
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But it is absurd to say that government cannot offer healthcare more efficiently than the private sector. Pretty much every industrialized nation in the world does exactly that. They cover their entire population, have outcomes just as good as the US, and pay far, far less than we do. That is a fact.
You make a point, but not a very good one; there is a world of difference between "cannot" and "will not".
First you must understand that some of the recent "facts" on the subject have been highly spun/skewed for political ends. Most of the measures use things like infant mortality or average lifespan to compare and this is not a good measure. The US does rank worse in these measurement but there are some very clear reasons if you are willing to examine issue in detail. The US has more auto related deaths than Europe and correspondingly higher numbers of miles driven per capita. The US has more deaths by violence - enough to notably impact the average lifespan figures. The infant death rates are higher, but primarily among the very young and those not covered by insurance. In some of the healthcare areas which involve active testing and intervention (breast cancer, colon cancer) and advanced treatment methods (pancreatic cancer) the US ranks first, despite the fact that ~15% of the population isn't covered. I think if you looked at the outcomes of the middle 50% of the income demographic the US would fare very well. The US has a wider range of income distribution than most advanced countries (GINI index for example) - more wealthy and more poor, and so the average can be very far from the median. The opportunity to succeed is closely related to the opportunity to fail.
Then your claim that these systems are so efficient is nonsense. The German system is nearly bankrupt, the UK system has a safety-valve in that many ppl (most ppl with any means) use private docs when the bureaucracy log-jams. The Canadian system seems better than most IMO, but the Canuks have figured out how run a gov program within budget - but and that is politically impossible in the US IMO. It's hard to say how waiting 8 months for a joint replacement surgery impacts "efficiency" but I don't consider this a good feature of their system. Then you must address this inefficiency too ...
http://en.wikipedia.org/wiki/Chaoulli_v._Quebec
A haven't seen figures on others, but the German system covers only 92% of the population, which is only slightly better that US insurance systems if we ignore illegal immigrants ! (89-90%). German average hospital stays are considerably longer than in the US (which speaks to it's inefficiency).
The HongKong system is probably among the best, but ther are cultural reasons than cannot be reproduced by edict.
So
IF we got rid of your employer in the HC system, and
IF we had readily accessible insurance risk pools, and
IF we had actual advertised prices for services from physicians, and insurance, and
IF we had tort reform so that every pediatrician and neurosurgeon wasn't paying $80-120k per year in liability insurance and the excessive tests weren't needed.,
IF we had an electronic record system that insured privacy and access when needed,
the world would look very different, but we still need to address what happens to the treatment of the indigent and also for those who failed to buy insurance and now need treatment. These topics should be the basis for reform of the HC system, but instead the current program seems hell-bent on destroying the small bits of free-market that still exists.
-S