Well, the first thing we need to know is this - prior to World War Two less than 10% of Americans (probably between 7-8%) had health insurance. Presumably Rand Paul is aware of this. At that time Doctors often used a sliding fee system ("discriminatory pricing") to account for their patients' ability to pay. But for injuries and illnesses that required hospital treatment, people were often out of luck. Presumably, Rand Paul knows that too.

What might Rand Paul's health care vision mean, specifically ? His January 29, 1999 appearance on Kentucky Tonight provided some possible answers. As Paul told Kentucky Tonight viewers on January 1999,

"If you go to the doctor, you don't pay directly for your doctor's services, your insurance company pays for it. ... So the price goes up indiscriminately because nobody is there to barter down the price. What we need is higher-deductible plans, people paying more cash as they go into the doctor, and then what we'll have is the prices will level off."

Rand Paul, who has been accused of hypocrisy because his ophthalmology practice accepts Medicare and Medicaid payments, seems strangely unaware that insurance companies already bargain down doctor's fees.

And, what are patients supposed to do when they don't have "more cash" ? Rand Paul's and Sue Lowden's approach conjures up an America in which people who don't have ready cash would, in desperation, try to barter, for health care.

Unlike Sue Lowden, Rand Paul hasn't specifically proposed that sick and injured patients should arrive at their doctor's waiting rooms with chickens or farm animals as barter for treatment. But Paul's statement that patients should "interact with their doctor the way they did basically before World War II" (when most people didn't have heath insurance) leads to the same place - to Sue Lowden's chicken-based barter-for-health care approach, with people in doctor's offices or hospital emergency rooms clutching scarce cash, jewelry, car and house deeds, and whatever easily portable fungible goods could be grabbed in a hurry en route to offices or hospitals, pleading and haggling with doctors, EMT's, and hospital accountants... while their loved ones suffered and bled.

Of course, the overwhelming majority of Americans who work in the health care profession would find such a system morally abhorrent to the extreme. Yet Rand Paul seems to find it eminently reasonable and sensible. Why ?

One possible explanation is Rand Paul's association with the overtly theocratic, Christian nationalist Constitution Party that espouses positions on health care suspiciously similar to Rand Paul's. Alternet's Adele Stan has raised the issue and, as I have reported, in 2009 Rand Paul gave a keynote address a convention the Minnesota Constitution Party. The Constitution Party is closely associated with Christian Reconstructionism, which holds that no one has any "right" to heath care at all.

[other Rand Paul news - Rand Paul Agrees That He's a "Torpedo" In "The Revolution"]