Monday, May 21, 2018

Another Tedious Rant for Socialized Medicine

(Thank you to tip from a blog reader!)
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Here we go again. Another conservative socialist rant in favor of a government takeover of health care. 

This time the source is Chase Madar, an attorney who has written about Chelsea Brad Manning. Madar's credentials on health policy are unknown, but that did not stop The American Conservative from giving him ample space to rant. 

And rant he did:
Don’t tell anyone, but American conservatives will soon be embracing single-payer healthcare, or some other form of socialized healthcare. Yes, that’s a bold claim given that a GOP-controlled Congress and President are poised to un-socialize a great deal of healthcare, and may even pull it off. But within five years, plenty of Republicans will be loudly supporting or quietly assenting to universal Medicare. And that’s a good thing, because socializing healthcare is the only demonstrably effective way to control costs and cover everyone. It results in a healthier country and it saves a ton of money.
And then he cranks out every myth ever invented to defend government-run health care. For example, that the lower cost of health care in "every first-world nation that has socialized medicine" is good:
in every first-world nation that has socialized medicine–whether it be  a heavily regulated multi-insurer system like Germany, single-payer like Canada, or a purely socialized system like the United Kingdom–-it costs less.
There is one simple reason why the cost is lower. It is called rationing and, as I explain in my book The Rise of Big Government, is also known as fiscal eugenics. 

To make the case that rationing is somehow good for people, Chase Madar first has to believe that when government gives you the right to something, government also delivers what you claim to have the right, too. 

What planet has he been living on the past 100 years?

For those of us who have actually done some research on health policy, it is apparent that a right to X is not the same as delivery of X. If Madar has a hard time grasping this point, he may want to take a look at how the VA treats our war veterans. 

Next, Madar predictably attempts to explain that we are not healthier than people in other countries:
Nor are healthcare results in America anything to brag about: lower life expectancy, higher infant mortality and poor scores on a wide range of important public health indicators.
The lower life expectancy is irrelevant. First, a very small part of health care is about saving someone's life, urgently or not. It is, in other words, irrelevant to the entirety of health care spending. Secondly, compare life expectancies between countries with socialized medicine, such as North Korea and Japan, or even Sweden and Denmark, and you will find startling variations that have nothing to do with the fact that government pays for health care.

A higher infant mortality is explainable by the fact that we give more babies a chance to live. American mothers are not as easily convinced to abort their babies as they are in countries that practice eugenic abortions. Just to give a couple of examples of how abortions can shift health statistics way beyond the infanticide itself: 
  • Iceland has almost done away with Down's Syndrome by simply not allowing those babies to be born; 
  • In Denmark and Sweden, cleft palate and other conditions, some life-threatening, lead to abortions for the same eugenic reason. 

Statistically speaking, an aborted baby is not born. 

Perhaps Chase Madar would like to join the medical "ethicists" who advocate infanticide as a "solution" for babies being born with difficult medical conditions (again see my chapter on fiscal eugenics in The Rise of Big Government)? No, this question is not at all pointed. In countries with socialized medicine, abortions are being used precisely for eugenic purposes. 

The good Mr. Madar might also want to research differences in the definition of live births. 

On to his next illusion:
Why does socialized healthcare cost less? Getting rid of private insurers, which suck up a lot money without adding any value, would result in a huge savings, as much as 15 percent by one academic estimate published in the American Journal of Public Health. When the government flexing its monopsony muscle as the overwhelmingly largest buyer of medical services, drugs and technology, it would also lower prices-–that’s what happens in nearly every other country.
 
If that were the case, then Sweden would be delivering world-class health care. Yet people with chronic diseases cannot get first-class medicines because the regional health boards that make the kind of decisions Madar mentions, think those medicines are too expensive given the health outcomes they yield. The British National Health Service has a system for euthanasia known as the "Liverpool Care Pathway", into which patients of all ages are sent to die. Sometimes, children are starved to death for a week, sometimes more, once a doctor has decided that it is futile to provide them with health care. (Again, see my book as referenced above.)

As for the fifteen percent savings, the assumption behind it is that nobody has to process health care claims for payments in a socialized-health system. This is a widespread delusion among people who have never bothered to actually research the idea. Or lived in a socialized health care system. I have researched this issue for years (with two books on the issue) and I have lived under two socialized-health systems. 

The idea that there is no need for payment claims administration under a single-payer model is about as connected to reality as a three-legged unicorn. It should not be that hard for single-payer activists to realize this - after all, they constantly tell us that their government takeover will deliver megalithic cost savings. 

How do they think those cost savings are accomplished?

No, wait, don't ask them. Let me fill in the blank: cost savings materialize because bureaucrats work over time calculating the Quality Adjusted Life Years for treatment, then force doctors to abide by their calculations in deciding what patients to treat and what patients to abandon. But those bureaucrats are for some reason not counted as a cost to the health care system, simply because they are not employed by a hospital or an insurance agency. They are employed outside of the health care system itself.

Another reason why cost savings materialize in single-payer systems is that health care professionals take over administrator jobs. See, an administrator at a hospital looks like a net cost to the system because he is not delivering health care. A medical professional, on the other hand, looks like a 100 percent gain in terms of providing health care. After all, he is a doctor, right? Or a nurse. 

If a health care professional spends 50, 70 or 100 percent of his time doing administrative work (such as processing health care cost claims) it does not show up in the statistics over health care costs. The fact that he is away from patients does not matter, statistically. It matters to the patient, but that is of no consequence to the socialized-medicine bullhorns. 

As for the monopsony nonsense: half of the world's medical research is done here in the United States. If government decided to use its monopsony power to purchase only specific pharmaceutical and med-tech products, a good part of that industry would die out. Or does Chase Madar really believe that a cost-conscious government pharmaceutical agency would buy brand new medicines instead of wait for the generics to show up? Of course it would wait for the generics. Now: what does Madar think will happen to the original product that the generics are derived from? Who is going to invest in the research needed to invent that new product, when the normal period from idea to final product is anywhere between seven and eleven years? 

The conventional-wisdom answer from socialized-health pundits is that government will then take over the research and development part, as well. In other words, if government socialized car production and car sales, and allotted cars to people instead of letting the free market do so, and if government then took over research and development of cars - we would suddenly have better, cheaper cars, right?

Can you say Trabant?

But Madar is not done yet. His argument for Trabant health care for all continues:
Why does the Netherlands have less teen pregnancy and less HIV?
They abort their babies and they are generous with handing out pills to teenage girls. Neither has anything to do with socialized medicine. Besides, the Netherlands has abandoned the strict single-payer model that Madar so stalwartly advocates, so his question is irrelevant anyway.
people need take an honest look at the various health crises in the United States compared to other OECD (Organisation for Economic Cooperation and Development) countries. 
Is it a crisis in Sweden when cancer patients die in droves because they are denied care? Is it a crisis in Denmark when they have to send patients to non-single payer Germany because their own single payer system can't guarantee them treatment in time? Is it a crisis in Canada when waiting times for health care have doubled in fourteen years?
Among first-world countries, the U.S. is a public health disaster zone.
Sure. Two members of my family needed knee replacement surgery the same year. One lived in Sweden, one in the United States. The U.S. patient could have had surgery a week after being determined to need it, but chose to wait four weeks in order to get in with a top-rated surgeon in a nearby town. The patient in Sweden had to wait for a year and could not choose what surgeon she wanted to have. 

When Madar insults America's health care professionals with the term "public health disaster zone", he proves that he has no clue what is going on in other countries. All he can muster is the spreading of standard socialist mythology.

Madar then declares that
virtually no one looks at our expensive American mess as a model
Each year 300,000 international patients flock to the United States for health care. Why don't they go to Canada, if their system is so much better? It can't be because they have to wait four weeks just to get a CT scan, or ten weeks for an MRI, can it?

I have nothing against discussing single-payer health care with advocates who actually do some research before they rant. But when people take to the keyboard just because they had an epiphany, they get boring and tedious after a while. 

The epiphany in Madar's case was apparently a conversation with a German "policy intellectual" whose only argument in favor of single-payer (which, strictly speaking, they don't have in Germany) was that equal health care rationing for all is better than no rationing at all. If Chase Madar thinks that makes for a great selling point for having government take over health care, then perhaps he should try it on food, clothes, housing and other basic necessities in life. 

Or just move to Cuba and get the whole package in one big, happy experience.

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