Medicrats: Medical Bureaucrats That Rule Your Health Care.
Article Type: Book review
Subject: Books (Book reviews)
Author: Snavely, Adrienne
Pub Date: 03/22/2012
Publication: Name: Journal of American Physicians and Surgeons Publisher: Association of American Physicians and Surgeons, Inc. Audience: Academic Format: Magazine/Journal Subject: Health care industry Copyright: COPYRIGHT 2012 Association of American Physicians and Surgeons, Inc. ISSN: 1543-4826
Issue: Date: Spring, 2012 Source Volume: 17 Source Issue: 1
Topic: NamedWork: Medicrats: Medical Bureaucrats That Rule Your Health Care (Nonfiction work)
Persons: Reviewee: Weber, Ralph; Racer, Dave
Accession Number: 293813003
Full Text: Medicrats: Medical Bureaucrats That Rule Your Health Care, by Ralph Weber and Dave Racer, softcover, 149 pp, ISBN: 978-09777534-9-9, $14.95, St. Paul, Minn., AlethosPress, 2011.

Ralph Weber and Dave Racer have offered a concise summary of the benefits of a free market in medicine, and the harm done when the free market is distorted by government regulation and price controls.

"Medicrat" is a term the authors use to describe entrenched government and insurance bureaucrats who rule over our medical care. These unseen and often inaccessible bureaucrats make coverage decisions, set prices, and regulate nearly every aspect of modern medical practice.

The public seldom recognizes how much damage medicrats do. The authors point out that price controls have led to cost-shifting, whereby the uninsured, self-insured, and those who have high-deductible health plans often get charged some multiple of fees paid by those under Medicare or who have HMO coverage. Noting that coverage is not the same as access to care, the authors point out that price controls have often led to rationing of care by limiting access to it.

The authors also point out the inflationary effect government mandates have on insurance premiums. Although the public was assured that health insurance premiums would decrease under "ObamaCare," the Patient Protection and Affordable Care Act has had the opposite effect. The authors explain how the fixed medical loss ratio (that percentage of the premium that actually goes to pay for medical care, as opposed to administrative and marketing expense) dictated by "ObamaCare" will predictably increase medical premiums:

The authors also provide a brief historical perspective of the third-party payment system of pre-paid medical care that we have today. In a section titled "Birth of the Blues," the authors review how Blue Cross and Blue Shield were formed to ensure that hospitals and physicians would receive payment for services. With the lure of guaranteed money, however, comes loss of control by patients and their physicians over care they are eligible to receive.

The authors advocate a return to true insurance, as opposed to the pre-paid type of medical care most have today. True insurance was never meant to cover the small expenses of routine office visits. Unlike catastrophic medical insurance or life insurance, with pre-paid care, people have an expectation of using their insurance coverage, and of getting their money's worth. Thus, pre-paid healthcare has been a major factor in dramatically increasing medical premiums.

Like other free-market supporters, the authors believe that competition, even across state lines, is key to patients receiving better value at lower prices. Prices need to be transparent, predictable, and negotiable for patients.

Although the information presented in this small paperback may not be new for readers of this journal, it does offer a basic primer on the benefits of free-market medicine that many previously have not thought about at all.

Adrienne Snavely

Tucson, Ariz.
If the average health plan
   premium is $500 per month, then
   the MLR [medical loss ratio] allows
   20 percent ($100) for overhead. If an
   insurance company takes steps to
   reduce [the] premium by increasing
   co-pays and deductibles, by cutting
   mandates, and by reducing
   reimbursement rates, and the
   premium fell to $250, it would only
   leave them with $50 for overhead.
   This, of course, makes no sense. The
   overhead costs do not go down;
   they either remain constant or
   increase. Actually, the MLR provides
   an incentive for insurance companies
   to increase premiums, thereby
   also increasing their 20 percent
   overhead share.
Gale Copyright: Copyright 2012 Gale, Cengage Learning. All rights reserved.