Thursday, April 12, 2007
Universal health care
A few days ago a reader posted a link in response to my post on Universal Healthcare. It was so good I wanted to make it available here to readers who may not read past posts. Hat tip to Softwarenerd.
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4 comments:
So if the government controls universla healthcare, does that mean politicians control what services we recieve. If costs sky-rocket does that mean that we could vote to cut off medical coverage for individuals over the age of 65? Or smokers? Or people who don't take their medicine? Or fat people? Or can we just structure the services that are provided so the typical needs of these people aren't met and they die off and reduce the total cost of healthcare (any maybe that takes care of part of the social security problem too?).
Gruesome and probably a little over the top... but why we want to give the government the freedom to choose what medical services we have access to I do not know. Politicians already have enough power... do we really want to give them power over our health?
Oh and if you're thinking about that one... the answer is NO.
Giving health care to everyone is un-Christian. Jesus didn't heal everyone, only a very select few. Everyone knows the United States has the best health care in the world and the only way way to preserve that is to be as selective as Jesus was about who actually gets it.
Goodness Jon you astound me. Mensa should be calling any day now.
John,
I’m warning you up front this is likely to be a long missive. I wouldn’t blame you if you bailed out now, but I’m going to give you a pretty strong case for why “Universal Healthcare” or “Socialized Medicine” is a foolish, foolish method of trying to help people. If you take anything away from my post, hopefully you’ll get that by making everyone’s healthcare worse, we do not succeed in helping more people or making lives better.
The Current System
We all know the current system has problems. However, we haven’t done a very good job of identifying the real cause of those problems. A large amount of it probably exists because of the odd means of finding and paying doctors. We’ve got an odd situation where the people consuming the services don’t pay the provider directly. A third party manages both the paying and the billing. This hamstrings the free market from operating correctly and creates a layer of complexity that creates an odd shift in market dynamics. Think of it this way:
Consumers really don’t see or care about a bill when they visit a doctor. They only care that they get “good service” or that it’s “convenient” when visiting their physician. Financially, consumers of the services are really only concerned about their co-pay and their monthly cost. Since they feel like they’re paying a lot of money (and they are), they feel as though they’re entitled to go for all sorts of ailments they may not visit a doctor for had they been paying the bills directly. But since the insurance company pays, they go. If this were car insurance, we’d be going in to get slight scratches repainted and expecting a $15 co-pay each time.
The insurance company is there to make money. With consumers visiting doctors more regularly and the costs of care going up, insurance companies only have a few ways to maintain their profit. They can either restrict or limit the amount of services a consumer can get, raise their rates, or make deals with hospitals for lower rates. All of these create ill will and more bureaucracy.
Doctors are dealing with a higher number of patients who visit for non-serious situations. As healthcare costs go up, there are potentially more people who cannot afford medical insurance. However, in the United States it is law that people cannot be denied emergency care for lack of insurance (payment). So, the burden shifts to those who are insured to pay for those who aren’t. Regardless of what politicians are saying, people who need healthcare get it. If you don’t have insurance, you need only call an ambulance (I have a great story on this if you care to hear it). The cost burden just shifts to us. Additionally, the amount of red tape required to get payment has created a gigantic nightmare for doctors to get reimbursed for their services.
Why Universal Healthcare Fails
When we create entitlements like Social Security, we seldom see the problems at the end of the road. Today, we’re looking at a system on the brink of collapse. Those people who are under forty are unlikely to see a dime when they retire. Everyone knows the problem. We use the funds that are collected paycheck to paycheck to pay these “entitlements.”
These are not “401k policies” where retirees are collecting the benefits of a lifetime of interest and savings. Consequently, as the baby boomers start to retire, we need more and more people (or higher taxes) to support their payments. Soon, the amount of taxes collected from the working will be insufficient to support the retired. As it stands, we will never have a chance to save that money (and grow it) because it’s distributed as quickly as it’s collected. This is why everyone under forty more or less realizes that the money taken from their checks as a SS payment is a tax. It isn’t a savings plan and we’re not going to see it again. Unless something is done soon, the system will be unable to meet its obligations.
Let’s talk about healthcare. Again, if we create an entitlement like UHC, we’re going to be paying out immediately. There is not going to be a chance to save money because the baby boomers will consume it as readily as it’s infused into the system. With the rising costs, we’ll need to somehow “manage” the care.
Like the HMOs, the government will have only three real means of controlling its costs. Increasing taxes to pay for services, limiting procedures and accessibility to healthcare, and setting limits doctors can charge are all means currently employed by countries that use UHC.
So, what does that translate into? Well, eventually the quality of care drops because doctors and hospitals have to make their profit somewhere. They drop salaries (getting less of the best and brightest), spend less on innovation (since there is no profit anyway), and reduce the type of care provided.
Care will also have to be “rationed.” Since the type of care and the availability of care is controlled, the wait times to receive procedures will increase and care will be less accessible to people. Additionally, one can almost guarantee that taxes will have to increase year after year to keep up with the increasing numbers of retired and an aging population.
We’re watching this scenario play out in countries all over the world. Some have even gone to euthanasia as “moral” and “acceptable” (all voluntary of course) means of keeping some of those costs down. If it’s too costly to continue cancer treatment (and we’ll lose anyway), why not offer people a “pain free” alternative? Those with disabilities get targeted too.
As the father of a son with Down syndrome, I was told by the Minnesota DS association that certain countries (socialized medicine – yay) recommend termination of pregnancies of mothers that will have children with DS and deny life saving procedures to infants with disabilities. In my case, my son would have died in those instances had he not been born in the United States. However, they rationalize it by saying that paying for a few people to get outrageously priced care takes regular care from the rest of people. Frankly, for me personally, this statement is outrageous and un-American. Doctors’ mantra is to never harm…
Rationed care, does NOT equate to better care.
Some of these countries look artificially good because they refuse to perform procedures on high risk individuals. You can’t “lose” patients when you don’t treat them. If you kill kids with disabilities before birth, your “apparent” mortality rate will be lower. These numbers are easily, easily fudged. The proof is really in the pudding (as they say). Why is there an increasing number of Canadians that come here for procedures? Why do world leaders come to America for risky operations? Why do so many of the breakthroughs in medical science, pharmaceuticals, and innovative procedures happen here? Why do so many of the world’s doctors come here to study (and live)?
It’s because we are the shining light when it comes to medicine. Our system may have problems, it may not always be the best, but it helps the most people, most of the time, with the best average quality. The vast majority of people that want coverage have health coverage. We just need to figure out a way to identify those areas which are causing the most problems and eliminate them. My guess would be that the government red tape would be the first place to start (along with the insane amount of litigation).
UHC is just a means of giving more bureaucrats more control over our lives and our money. Once you start down that road, you open the door to the government controlling more and more of your life. What you eat, what you wear, how you play, and what you think are all acceptable targets for the better good of the community. UHC is one of the building blocks of communism and something that can be later used to strip an individual’s freedom from him. It is not a means to helping those people who are left out of the system today.
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