If you are suffering from abdominal pain due to gallstones, who should decide whether medication or surgery would be more effective for you? The doctor who has felt your abdomen, listened to your heartbeat, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?
Whenever the government controls the medical purse strings, it will inevitably dictate who receives what health care and when. He who pays the piper calls the tune. A Canadian woman who feels a lump in her breast might wait months until the government approves her surgery and chemotherapy. In contrast, an American woman can receive the necessary treatment in days.
The fundamental problem with universal health care is the faulty premise that health care is a right. Health care is a need, not a right. Rights are freedoms of action (such as the right to free speech), not automatic claims on goods or services that must be produced by others.
There is no such thing as a right to a house, or a tonsillectomy. Nor does calling it a right make it so. In socialized medical systems, health care is never truly a right, but just another privilege dispensed at the discretion of bureaucrats.
As much as I’ve railed against the high cost of health insurance, going down the road of socialized medicine is a ludicrous solution. Only by opening up competition and deregulating the insurance industry (and thus creating more incentive for providers) will health care costs come down.
Why is it that it seems like the only people who think socialized health care is a good idea are our leaders? Why haven’t they seen the mess that other countries have made of it? Has their short term thinking overruled their long-term common sense? I guess if they had common sense they wouldn’t be in politics. Humph.
Notice how quickly the word “nationalized” becomes “socialized.” The fact is that government does some things much better than any of the alternatives. (Our socialized highways are a prime example.)
The big problem about the auto industry is not just that our government is now getting into the auto business — as revolting as that is — or just that it’s rewarding people who aren’t getting the business right — as revolting as *that* is. The big(gest) problem is that, as we’ve talked about earlier, the US auto industry is in the healthcare and retirement business, and is in competition with companies that aren’t and don’t have to be because they’re in countries with better systems.
That said, we do have a pretty workable model already in place. Medicare is far from perfect, but — hear this and reflect on your own experiences — it has the highest rate of satisfaction, by several lengths, of any health care plan in America. The government is actually doing something that works pretty well. Like the highway system, there are horrible wastes and inefficiencies, but they’re doing it better than anyone else out there: State Farm, Nationwide, the HMOs, anyone.
The Senate uses a version of it — call it Medicare*. Well, it wouldn’t be socialism, and it wouldn’t make us England or Sweden or Russia, if we were to make something, call it Medicare**, available to anyone who wanted it. Easy. Don’t want it, don’t get it. Want it, get it. Nationalized health care made simple.
You and I are often smug about our work situation, but tons of people have their health care through, thus tied to, their jobs: yeeeesh! That really complicates things when it’s time to move or get fired or switch careers. And as we’ve talked about before, the current system of duct tape and string isn’t going to cut it.
NOW. As for bets about whether such a reasonable and obvious solution will actually get put forth, I think you and I would bet on the same side, and both win.
Comment by barrybrake — March 4, 2009 @ 12:51 pm
“That said, we do have a pretty workable model already in place”
Disagree strongly.
“The Senate uses a version of it — call it Medicare*. Well, it wouldn’t be socialism, and it wouldn’t make us England or Sweden or Russia, if we were to make something, call it Medicare**, available to anyone who wanted it. Easy. Don’t want it, don’t get it. Want it, get it. Nationalized health care made simple.”
Apologies, but this is simplistic thinking. I can’t think of a system that the govt. sets up wherein they take the people’s money, and allow some to opt out if they don’t want the product (at least eventually: all govt. programs grow once initiated). Ancillary thought: Why is the Senate’s version different from the “common people’s”? The only problem with expanding this Medicare** program (well, there are many problems) is that govt. has an abysmal track record of efficiency when it comes to the large-scale spending of citizen’s money. And the program they are proposing, while purporting to offer choice on the face, is actually intended to wean people off of private health care and starve those businesses of revenue, thus accomplishing subtly what they couldn’t do by fiat: the dismantling of the system. Any time private industry competes with government, private industry loses. The government has an inexhaustible supply of revenue (taxes), and the ability to directly hamper its competition (regulations). Partisan politicians have so far not shown much restraint in using either when it increases their power base.
“the current system of duct tape and string isn’t going to cut it.”
Agreed, but the problem is not that we don’t have enough government involvement, but that we have way too much. Studies have shown that if the government were to deregulate the health care business we would see drastic reductions in premiums very quickly. It’s because the government forces its way into private business and mandates regulations that we have such a terrible system right now.
Example:
“State regulations that mandate specific coverage of various treatments such as alcohol and drug abuse treatment, chiropractic treatment, and invitro fertilization, drive up the cost of health insurance. These and many other requirements all drive up the cost of health care by eliminating people’s ability to choose to purchase inexpensive bare bones coverage that would insure only against major accidents and illnesses. In Connecticut, one of the least regulated states, a 35-year-old male can get coverage for as little as $50 a month or $600 per year.” (from http://www.independent.org/newsroom/article.asp?id=1908)
I noticed that you didn’t mention the socialized debacle that is Canada’s healthcare system, where people wait an average of 17 months for treatment (including lifesaving treatments). We are seeking to emulate this very same system on a larger scale than Canada’s, and for some reason, we think we can do it better. I don’t know about you, but if I’m diagnosed with an aggressive cancer I don’t want to have to wait a quarter of a year to see a specialist.
I’m extremely uncomfortable justifying growing government control over such an important aspect of my life when the best argument is the “horrible waste and inefficiencies” of the interstate system.
Comment by jasony — March 4, 2009 @ 1:37 pm
Heh – I guess we’re getting this out of our system before we bore our wives with it….
You write, and correctly so far as it goes, that “govt. has an abysmal track record of efficiency when it comes to the large-scale spending of citizen’s money.”
True, but with some important exceptions: federal money that pays for big projects like dams and water systems and highways — as I mentioned there are inefficiencies there, but you seem to think they outweigh the benefits and outweigh the private-sector versions. But in both cases it just ain’t so: government does some things well, and even if “well” isn’t “great” it’s often better than any other solution: the delivery of mail, for instance; the distribution of traffic lights, for another.
You mention that “the program they are proposing, while purporting to offer choice on the face, is actually intended to wean people off of private health care” — well, I don’t particularly agree with the program they’re currently proposing. But I still fantasize about a version of Medicare, and agree with you that it’s crummy that the Senate gives themselves an advantageous version of health-care that they don’t see fit to give anyone else. Why on earth wouldn’t they?
The result would be superior to the Euro/Canadian system, which is bankrupt both literally and figuratively. I think we can come up with a uniquely American solution, one that deals with Americans’ distaste for the nanny-state policies of other countries, but also gives a fair deal to the millions of Americans who don’t have a fair deal now: whether that means no deal, or whether that means the cripplingly expensive policies so many of us have gotten used to, that nonetheless don’t offer fair coverage.
Your main objection seems to be that you just don’t believe it would happen — that a government program just couldn’t restrain itself and be what it started out as. I tend to agree, but I also think that, if carefully implemented, it could be an incredible improvement on what we’ve got now, which is… what? expensive chaos.
You mention that a national program (which in this political climate would never be mandatory anyway) would have as its result the “dismantling of the system.” Amen, and the sooner the better. Maybe we’ll have a chance to build a better system. We’ll never build a perfect one, but every once in a while America manages to hew to its first principles long enough to come up with something decent. Here at the tail-end of the snail mail era, we can look back and say (Seinfeldian snideness aside), “It worked.”
Comment by barrybrake — March 5, 2009 @ 1:37 pm
Just followed your link and read about Schwarzenegger’s plan…. aaaack!!!! He thinks we need *more* duct tape and string?
Comment by barrybrake — March 5, 2009 @ 1:42 pm
“Just followed your link and read about Schwarzenegger’s plan…. aaaack!!!! He thinks we need *more* duct tape and string?”
As far as I’m concerned, Ahnold isn’t a conservative. He misappropriated the label to garner votes, then governed Cali to become more like the socialist country he came from. California is a good representation of where we’re heading if we don’t start electing representatives that know how to balance the national checkbook.
To your other comment, I have this to say: if nationalizing/socializing health care is such a good idea, then why not do the same thing with car insurance, house insurance, heck, even LIFE insurance for that matter? Seriously, why not? You have to ask why we haven’t done it at some point over the last 200 years? I know you like to argue points because it’s fun (and you know I grow tired of it easily), but surely you must concede that there is SOME aspect of the slippery slope to the idea of government taking over health care, banks, the mortgage industry, the auto industry, etc. If you’re willing to say that socialized medicine is okay, they why -and I’m honestly asking it and not being prickly- not allow fully socialized insurance? Or do you purport that (again, not being nasty) the “Barry level of govt. involvement” is okay, but anything more is obviously too much? I submit that there’s always somebody out there who is comfortable with more handouts, or some sob story or hard luck case, that can serve as the poster child for increased governmental involvement in whatever area you choose.
I believe strongly that increasing a proven-wasteful government’s involvement with a socialized heathcare system- a proscription that has many more negative examples in our world than successes- Is folly. We should be limiting government involvement and going with a proven free-market system by DEregulating health care so insurers can offer truly competitive products. The problem with the system now- the reason premiums are so expensive, is that the government is TOO involved. To argue that allowing government to become further entrenched will somehow lower costs for everyone ignores the reasons we got here in the first place.
There is a larger issue here, though, and that’s the decreasing role of the state governments. We must be very, very careful of granting unenumerated powers to the central government. That power, as the founders understood, is too easily granted and too hard rescinded. With regard to short term gains in health care, I think you might be banking on the temporary benefits of having somebody else pay the bills and neglecting the long term downside of a citizenry that is even more thoroughly ruled by a federal government that has shown less and less care for the rights of citizens. Tangential thought: now that Obama has been elected there has been a notable reduction in the complaints about intrusive government involvement in peoples lives, or the fact that none of those terrible rights-robbing laws put on the books by Bush and company have been rescinded. It seems that intrusive government by Republicans = bad while intrusive government by democrats = good. I tend to take the classical “don’t tred on me” viewpoint. There are some places where a strong federal government is necessary, and centralized standards are desirable (your dams, water systems, and highways, for example) but only the most far-left would argue that our central government has too LITTLE power. As I’ve said before, I feel that the pendulum has swung hard and fast toward excessive federal power and away from state power. Up until November 2nd the left was adamant about too much power being in the executive branch. Now it seems that many on that side of the aisle are ready to grant more powers to a charismatic leader than they would ever have considered allowing Bush.
So I guess you could sum up my thoughts thusly: w/r/t the health care crisis we’re out of balance and have too much regulation from a too-strong and too-wasteful federal government. With regard to much else that’s wrong with this country: ditto. Historically, America has shown growth and prosperity when government has gotten out of the way of her markets and citizens.
Comment by jasony — March 5, 2009 @ 3:28 pm
“The big(gest) problem is that, as we’ve talked about earlier, the US auto industry is in the healthcare and retirement business, and is in competition with companies that aren’t and don’t have to be because they’re in countries with better systems.”
Spot on. That was a major failure of the US auto industry and I couldn’t be happier that they’re dying. Let them, and let a thousand more efficient companies bloom from the carcass. Throwing them taxpayer money to keep a broken system afloat for a few more months IS revolting.
“Your main objection seems to be that you just don’t believe it would happen — that a government program just couldn’t restrain itself and be what it started out as. I tend to agree, but I also think that, if carefully implemented, it could be an incredible improvement on what we’ve got now, which is… what? expensive chaos.”
That is, indeed, my main objection. Born of careful observation, I think. Now, if we could enact a “kill switch” that returns things to a certain place if the new system doesn’t work, I would be much more open to the idea of massive social experimentation. But since Washington politicians would sooner give up private jets than enact some sort of common-sense idea like this, I’m loathe to give them carte blanch to go tinkering with something so big and important, broken though it is.
“Medicare is far from perfect, but — hear this and reflect on your own experiences — it has the highest rate of satisfaction, by several lengths, of any health care plan in America.”
That’s because the government is essentially using someone else’s money to bribe people into accepting the system! Of COURSE people are satisfied: they shoulder a much smaller percentage of the bill than they would in a traditional health care setup. The taxpayers (you and me) are subsidizing their care. To Medicare patients, every other option is crazy since their personal costs would increase dramatically. Medicare works as a system until everybody (or at least the majority) are part of it. Then there are more customers and fewer dollars and not only do we get higher costs again (albeit hidden as ever increasing income taxes), but lower quality of service as the patient/doctor ratio goes all to crap (see:Canada). This is the root of my comment regarding socialized medicine strangling private medicine- as soon as we can opt into a cheaper system, most people will follow the money and do so (even if they’re offered choice). Not many will stand on principle and pay the higher premiums in a broken system when everybody else is relenting and accepting a %5, %10, or (by some estimates) %20 deduction from their paychecks. Once enough people go this route, the private insurance industry disappears. THEN we’re in trouble because we will have allowed the free market system of choice to die out and will only have one option: the government teat.
Comment by jasony — March 5, 2009 @ 3:40 pm