Monday, August 13, 2007

Health Care Debate

Posted by Henry

I recently had an e-mail dialog with a friend of mine who wants nationalized health care. Before this exchange I didn’t know much about it except that the health care industry isn’t really a free market. I learned while responding to my friend’s claims (and his recommendation to see Michael Moore’s mockumentary Sicko) how unfree the market really is. Below are extracts of my e-mails to him.

The problem is that we already have a semi-socialized system of health care. Making it fully socialized will only make it worse. The statistics show that people in countries with national health care have to wait for months or years for procedures or tests that we can have done here tomorrow without waiting. As a result, people die in these counties waiting for life saving procedures. My wife’s brother had stomach surgery in Bermuda which has a system modeled on England. The sutures did not hold, allowing his disgestive waste to leak into his body. He ran a temperature for days while his stomach bloated and the doctors took a “don’t worry, be happy” approach. Fortunately his manager chartered a medivac jet from the U.S. and had my brother-in-law flown to Rhodel Island Hospital. Doctors there said he was within 24 hours of dying had he stayed in Bermuda.

I don't agree that health care is a right for reasons that take too long to spell out in an e-mail. Here it is in a very short nutshell: when you claim a "right" to something you're basically saying you have a right to the time and abilities of other people, which means basically to enslave them. Third, I don't believe Michael Moore. Even people on his side of the political fence have major problems with his way of presenting "facts."

I agree: a caring society SHOULD take care of those who can't take care of themselves ... voluntarily, not by government. It's too easy for all of us to foist the job of taking care of people onto the government (which means onto others via taxation) instead of doing something ourselves.

I also have a couple of practical reasons why I don't want the government to run health care.

  1. The government has created a lot of the problems with its attempt to "fix" things. The solution is not to keep adding more "fixes." (We have nothing like a free market in health care now; it is heavily regulated and getting more so by the day. Medicare causes further problems because the government dictates what it will pay for procedures. Since the government mandated "price" doesn't cover the hospital's cost they just shift these costs to us, thus increasing our health care costs. This is a free market? Plus the government with the blessing of the AMA restricts the number of people who can become doctors which results in higher salaries.)
  2. If you're dissatisfied with something you have the option to switch HMO's or move to something else like Blue Cross. Having the government run health care means it becomes a monolithic, faceless monopoly. If we don't like how it's run where else are we going to go? (In fact, in England and in Canada, people who run into the bureaucratic brick walls of government have resorted to a fledgling and growing alternate market to get what they need, at extra expense.)
  3. The government bureaucrats who run health care would become subject to corruption and influence peddling as companies and the rich use their money to get what they want while we are helpless to do anything about it. I've dealt with the bureaucracy of my HMO and with government bureaucracies. I'll take battling with a private bureaucracy any day because I can always threaten to take my business elsewhere. That kind of threat does not exist with a government bureaucrat. This is the fatal flaw of regulation that is well documented by liberal historian Gabriel Kolko in his book The Triumph of Conservatism (which is not a good thing in Kolko's mind). In his book he shows how businessmen flock to regulators, even campaigning to have their industry regulated (like Melon did with the steel industry), so that they can keep out competition and they can use their money to buy the favor of the regulators and government officials.
  4. The government does such a good job running other things (like building bridges across the Mississippi and the Big Dig in Boston which killed a woman when one of the ceiling panels broke loose due to poor quality epoxy (!?) and crushed her car).

Regarding the alleged “right” to health care and your claim that this is implied in our constitution, it we have the right to life, liberty and the pursuit of happiness. Doesn't say anything about having a right to particular goods or services because we don't have the right to demand that other people to provide them for the reason I stated before. Also doesn't say we have the right to happiness (who is going to provide it?), only the right to pursue happiness. Big difference. The Founding Fathers were brilliant in realizing this critical and often misunderstood distinction. The rights in the constitution apply to the freedom for us to think and act in order to pursue happiness.

As we wind down on our discussion of this issue and at the risk of belaboring this topic, let me finally cover Moore’s claim that we rank 37th. There are major problems with how the World Health Organization (an entity of the U.N.). It is designed so that it automatically relegates the U.S. to a lower ranking because its weighting favors countries with socialized medicine. As a result countries like Columbia, Oman, Morocco, Cyprus, Andorra, Malta, and the United Arab Emirates rank AHEAD of us!

As David Gratzer of the Manhattan Institute says: “But before packing up your daughter for the long plane ride to South America, remember that the WHO criteria are soft - and ideological. Nations are marked down for having private medicine or user fees. Fairness - that is, everyone gets the same treatment regardless of income - is important. Competition, WHO officials believe, is bad since it leads to "fragmentation and duplication in health services." If the criteria aren't skewed enough, the WHO report also considers how well countries perform compared to what experts feel they ought to be doing. It's a bit like giving a gold medal to the eighth fastest runner because he has the shortest legs and tried harder.”

The only way the U.S. could ever rank much higher is to completely socialize health care, a prescription that is worse than the illness.