A canard much beloved of the single-payor crowd holds that the free market doesn’t work for health care. Apparently, Walmart and its customers didn’t get the news. As this NYT article points out, the prescription program introduced last year by that much-maligned retailer has been so successful that it is now being expanded:
Walmart said this morning it was expanding its $4-a-month generic drug program, adding about seven new compounds including generic versions of the widely used heart medication Coreg and the anti-fungal drug Lamisil.
Now, why is Walmart doing that? Altruism? Nope. The company is trying to lure customers away from its competition. And, to prevent that, its competitors have introduced similar programs. Thus, free market competition is benefiting the patient with lower prices and holding down health care inflation:
Government economists recently credited those pricing plans with contributing to a slowdown of inflation in the Consumer Price Index for prescription drugs.
This is what always happens when the free market is allowed operate unimpeded by government apparatchiks and idiotic regulations. The market will likewise solve many of health care’s most intractable problems—if we give it a chance.
The advocates SCHIP expansion have now abandoned all pretense to rationality and settled on a strategy based wholly on moral posturing and prevarication. The essence of this tawdry approach is captured in a national ad being run by the American Cancer Society, approvingly described at GoozNews as follows:
Beneath a picture of a young child and a cigarette, with check boxes next to each, is the headline: “Mr. President, Choose Wisely.
In addition to confirming that the ACS is now just another political front group, this ad is a grotesque mixture of sanctimony and subterfuge. It deliberately perpetuates two falsehoods: that anyone who doesn’t support SCHIP expansion hates children and that it is ethical to pay for the program with a tobacco tax.
As to the children, I have pointed out previously that SCHIP funds have been increasing diverted from the low-income kids for whom they were originally intended to middle class adults who already have insurance. Why? Because adults vote and kids don’t.
And a tobacco tax is particularly underhanded way of forcing low-income people to pay for a program that Congress has redesigned to benefit the middle class. A variety of studies, including this one, have shown that any new tax hike on tobacco products will place an excessive burden on the poor.
The strategy adopted by the advocates SCHIP expansion is utterly contemptible, and the ACS ad is worse. Until it returns to political neutrality, the American Cancer Society will never get another dime from me.
It looks like there’s going to be a good scrap over President Bush’s imminent veto of the SCHIP bill. The NYT, under the tendentious title, “Congress Set for Veto Fight on Child Health Care,” solemnly intones:
President Bush and the Democratic-controlled Congress prepared Monday for a showdown over the future of health insurance for more than 10 million children.
The NYT reporters do their best to depict this as a contest between “a broad bipartisan” coalition that merely wants to provide health coverage for “the kids” and a penny-pinching ideologue:
The president says the measure … costs too much and would be “an incremental step toward the goal of government-run health care for every American.”
They know, of course, that the issue is far more complicated than that. In reality, much of the SCHIP money allocated for the health care of low-income children has been diverted to adults and kids from families with incomes far above the poverty line.
Nonetheless, I imagine most of the establishment media will join the NYT and the Democrats in depicting Bush as a cross between Scrooge and Darth Vader. It will be interesting to see if the public falls for it.
John Fund points out, in the WSJ, that Hillary Clinton’s “new” health care proposal has already been tried in California:
Arnold Schwarzenegger proposed an eerily similar plan using the same rhetoric and even the same slogan adopted by Mrs. Clinton to describe hers: “Shared Responsibility” … That’s no coincidence. Both ArnoldCare and HillaryCare 2.0 are the product of the same advisers.
However, to the chagrin of the single-payer crowd, the plan has been a box office flop:
But despite all of its clever political compromises, ArnoldCare is bogged down in trench warfare in California’s liberal Democratic Legislature. If anything passes, it will likely be only a shell of a bill without any financing component.
In other words, Hillarycare won’t even fly in a state whose legislature is dominated by Democrats. And Her Majesty is clearly frustrated with the pesky exigencies of representative democracy:
”I wish it were possible to just wave a magic wand and say from the White House, ‘Here’s what I want.’ But that’s not the way it works,” she told the Associated Press.
That Hillarycare continues to turn everyone off suggests to most reasonable people that it is simply a bad idea. For Hillary, however, its ongoing troubles mean that the democratic process has become an irritating nuisance.
Think about it.
As I pointed out here, there is much less than meets the eye in the recent Census Bureau report concerning the uninsured. That did not, of course, prevent single-payer advocates from advertising it as proof that the “crisis” of the uninsured had reached critical mass.
Fortunately, some analysts have actually examined the data. Jeff Goldsmith, at the Health Affairs blog, shows that the “plight of the uninsured” is nowhere near as dire as the advocates of government-run health care would have us believe. Regarding the reported increase, he reveals the following:
Almost the entire increase in people without health insurance from 2005 to 2006 took place in families with incomes above $50,000.
And most of these families are way over that modest benchmark:
Two-thirds of the 2005-2006 increase was actually in families with incomes above $75,000!
Well, you ask, what about the working poor?
The number of uninsured people in families whose incomes were below $25,000 actually declined by about 4%.
So, what we have here is a “crisis” of choice. Most of the fabled uninsured fall into two categories: people who can afford coverage but choose not to buy it and people who are eligible for government aid but choose not to apply for it.
This is not a problem that warrants a government takeover of health care.
Yet another Canadian politician has chosen the much-maligned U.S. health care system over that of her own country. CTV reports the following:
Liberal MP Belinda Stronach, who is battling breast cancer, traveled to California last June for an operation that was recommended as part of her treatment.
Stronach is merely the latest of Canada’s worthies to reject the health care system she foists upon her constituents. As I have pointed out here, Paul Martin, Jean Chretien and Joe Clark also share Stronach’s aversion to Canada’s vaunted single-payer system.
Not all of these people have come to the U.S. for care. Some have merely chosen private care over the public version they ostensibly support. One can hardly blame them, of course. Only American “progressives” are dumb enough to think government-run systems actually provide acceptable medical treatment.
Stronach’s choice once again begs this question: If Canada has such a wonderful single-payer system, why do its political leaders avoid it like the plague?
Yesterday, I alluded to the weird Orwellian tones of Hillary’s press releases for Hillarycare 2.0. Well, it gets scarier. In an interview with AP, she provided a glimpse of her authoritarian vision:
She said she could envision a day when “you have to show proof to your employer that you’re insured as a part of the job interview — like when your kid goes to school and has to show proof of vaccination,” but said such details would be worked out through negotiations with Congress.
I shudder to think of the “details” that Czarina Hillary would “work out” with a Democrat-controlled congress. I hope the voters aren’t crazy enough to put this person in the White House.
It appears that the Senator from New York will take a few minutes off from her normal routine of collecting illegal campaign contributions to grace us with another chapter in the ongoing saga of Hillarycare. Here’s how one of her minions described it to the AP:
“It puts the consumer in the driver’s seat by offering more choices and lowering costs,” Neera Tanden, Clinton’s top policy adviser, told The Associated Press.
And how does Her Majesty plan to “put the consumer in driver’s seat”? She will issue a royal decree mandating that all her subjects buy coverage:
The centerpiece of Clinton’s plan is the so-called “individual mandate,” requiring everyone to have health insurance.
That’s right. In the Orwellian world if Hillarycare, “more choices” means a law requiring you to buy insurance, whether you want it or not. And it’s not just individuals who will be subjected Hillary’s version of “choice”:
Businesses … would be required to offer insurance to employees, or contribute to a government-run pool that would help pay for those not covered.
I can’t decide which is creepier: the overweening statism of Hillary’s vision or the doublespeak she and her lackeys use to describe it. If these people don’t give you the willies (sorry about that), you’re not paying attention.
Anyone with a clue how Medicare works will be amused by Ezra Klein’s recent post on the subject. Desperate to add something pithy to a Jonathan Cohn observation concerning that program’s huge cost, he delivers himself of the following howler:
And let me go a step further and mention the huge cost private insurance imposes on Medicare. Medicare is a Very Expensive Program for the same reasons that American health care is Very Expensive. So long as it operates within a fragmented, patchwork system that largely exists to amp up insurance industry profits, Medicare will largely act as a private insurers [sic] whose costs are borne by taxpayers. It will suffer from most all the inefficiencies endemic to the system, save the few where Medicare can act in a self-contained manner (i.e, administrative costs, where they pay 3% compared to the 14% of your average private insurer).
What the hell is the boy talking about?! Private insurance doesn’t impose costs on Medicare. In fact, precisely the reverse is true. If one believes, as Klein apparently does, that the phenomenon of “cost shifting” is a reality, it is perfectly obvious that Medicare’s Byzantine price control strategy places a considerable burden on private insurance. In other words, providers offset Medicare-imposed losses by overcharging insurance companies.
And Klein’s tired talking point about administrative costs has been repeatedly debunked. For example, this study shows that Medicare’s administrative costs come to a minimum of 5.2%. Moreover, when the administrative costs associated with its numerous fiscal intermediaries are factored in, the percentage is probably twice that. Meanwhile, the actual administrative costs for private insurance are about 8.9%.
Finally, the “fragmented, patchwork system” that is American health care has not resulted from a conspiracy to “amp up insurance industry profits.” It is rather the result of a regulatory morass created by the federal government and exacerbated by an additional layer of red tape imposed by the various state governments. The notion that “Medicare for All” will be less expensive and more efficient than our current (admittedly dysfunctional) system is laughable.
Klein’s contribution to the debate over health care reform would be easier to take seriously if he would take the time to do his homework.
In his final column for the American Spectator, David Hogberg discusses what he calls “Balanced Budget Conservatism,” the first tenet of which he describes as follows:
Balanced Budget Conservatism starts with the premise that any surplus should first be used to create personal savings that will be used to stave off the coming entitlement crisis.
What surplus? Well, according to the CBO, it’s looking more and more likely that the fabled budget surplus may once again emerge from the mists of legend. But entitlements like Medicare may, like so many ravenous dragons, swallow them up.
For more, David’s article can be found here.
FOR IMMEDIATE RELEASE
Tuesday, September 11, 2007
Jon Caldara, president, 303-279-6536 or [email protected]
Amy Oliver, operations director, 970-371-3413 or [email protected]
Think tank hosts independent film maker and free market health care advocate Stuart Browning for the Colorado premiere of Free Market Cure
GOLDEN, Colo – The Independence Institute is proud to announce that it will be hosting the Colorado premiere of Free Market Cure, a series of short films that honestly depicts the dangers of socialized medicine. Independent film maker and producer of Free Market Cure Stuart Browning will be our guest of honor.
According to Browning, those on the left including Hollywood and many politicians “are gearing up to bring socialized medicine to the U.S. under the guise of ‘universal healthcare.’ Americans should be aware, however, that government-run health care means high taxes, medical rationing – and waiting lists to see specialists, get diagnostic tests and to receive surgery.”
Free Market Cure is designed to counter Michael Moore’s Sicko, which Browning called “a large dose of misinformation and propaganda.”
The premiere will be on Wednesday, September 19, at the Shwayder in the Mizel Center for Culture and Arts at 350 S. Dahlia Street in Denver. The movies and Browning’s commentary will begin at 7 p.m. and will be followed by coffee and dessert. The event is free and open to the public but seating is limited so reservations are requested. Please contact Kay at 303-279-6536 or [email protected]
“Anyone who is even remotely concerned about the direction in which medical care in Colorado is headed must see Free Market Cure,” said President Jon Caldara.
Caldara issued a personal invitation to all of Colorado’s 208 commission members. “I understand that members were invited to hear Donna Smith who was featured in Sicko. I invite all of them to hear another perspective.” he added.
Visit the Independence Institute Web site for more information.
The Independence Institute is a non-partisan, non-profit public policy research organization based in Golden, Colo.
Left-leaning policy wonks, Democrat politicians, and the establishment media have tried to create the impression that only government intervention can resolve the “crisis” of American health care. However, as David Hogberg points out, they have ignored some interesting and significant free market innovations:
As of late, there are some very hopeful developments, ones that move our health care system away from one that is mismanaged by the government and toward one that is more market driven.
Among the most interesting of these developments is the reform legislation enacted by the state of Missouri:
Missouri has passed reform that expands free markets by changing the tax treatment of health insurance for those who purchase an individual policy. Called the “Missouri Health Insurance Portability and Accountability Act,” it moves the insurance system in Missouri from one that is employer-based to one based more on the individual.
Hogberg’s article discusses a variety of other hopeful free market reforms as well. The full text can be read at the American Spectator.
Well, that last post was as good as any to end my blogging at Free Market Cure. I will miss it a great deal. Getting a chance to write alongside Stuart Browning, David Catron and David Gratzer is both a privilege and pleasure.
I am going to work on Capitol Hill where I will be working on policy, including health care. With health care likely to be a major issue for the foreseeable future, I cannot pass up an opportunity to work on the inside of the policy process. However, that means no outside work, including blogging.
I have written two last articles for the American Spectator, which David Catron has been nice enough to agree to post links to here for me when they appear.
Other than that, just let me thank all of the readers who have come to Free Market Cure. You make it all worth it.
Reading over this post by David Catron, I was reminded of a recent article in Health Affairs debunking the notion that many Canadians were coming south of the border to seek health care. Titled, “Phantoms In The Snow: Canadians’ Use Of Health Care Services In The United States,” the political left in this country went ga ga over it.
I finally got a chance to read it carefully, and what is remarkable is how limited the data is, and how broad the claims that the authors make given the limits of the data.
Here are the limitations:
1. The data does not go beyond 1998. This seems like a pretty serious limitation, since things may very well have worsened in the nine years since. Of course, the deterioration of Canada’s system might not have been so bad as to precipitate a huge jump in those going south of the border. Nevertheless, any serious increase in the number going south in recent years would be missed since the data ends at 1998.
2. The study limited its data collection to the three most populous provinces in Canada. By my count, that means that nine provinces were excluded.
3. The phone survey the researchers conducted on the U.S. side of the border only surveyed Buffalo, Detroit, and Seattle. Similarly, the researchers also looked at inpatient care for statewide hospitals in the U.S., but limited themselves to data from Michigan, Washington, and New York State. That means they excluded data from the border states of Idaho, Minnesota, North Dakota, Montana, New Hampshire, Vermont, and Maine, not to mention the two states, Ohio and Pennsylvania, that are just a trip across one of the Great Lakes for Canadians.
4. Near the end of the article, there is this rather eye-opening passage:
Periodic formal contracts between provincial payers and U.S. providers have a long history, but a few such contracts have received considerable attention on both sides of the border. Most notable have been contracts for the provision of radiation therapy for cancer patients, in response to backlogs created by shortages of radiation technicians. For example, Quebec contracted with three radiation centers in Vermont and Maine in October 1999 for treatment of patients with breast and prostate cancer; 1,030 patients were treated during the subsequent year. Ontario contracted with three health care organizations in Michigan, New York, and Ohio in March 1999 to provide treatment for patients with breast and prostate cancer, and 1,416 patients had been referred as of 31 October 2000. This is equivalent to approximately 8.5 percent of all prostate and breast cancer patients treated with radiation therapy in Ontario during the same time frame.
8.5%?! That would mean that about 1 in 12 prostate and breast cancer patients from Ontario treated with radiation therapy went south to the U.S. for that treatment!
How can 1 in 12 be described as “Phantoms”?
So not only does the data in this article have some severe limitations, the authors include data that undermines their case.
Perhaps the article should have been titled, “Phantoms In The Snow: Are Their Researchers That Don’t Let Their Biases Color Their Research?”
One last thing that I’d sure like to hear the political left explain to me: For all of those people who argue that SCHIP is vital, how did our society ever survive prior to 1997, when SCHIP was created?
What is the likelihood that wait times here in the U.S. are any where near as bad as in other nations? Thoughts over at Health Hog.
Having already exposed as inaccurate many of the claims being made for French health care, I was not surprised by this piece about a French researcher who offers a dire prognosis for the vaunted Gallic system.
It’s true we really have good access, but what if the system is not sustainable anymore? … It’s going to break. It’s going to blow.
Alice Teil, representing “one of France’s leading independent health research centers,” says the problem is cost:
Tiel says the cost of France’s socialized health care is growing faster than its economy.
And how much does it cost?
Workers pay about fifty percent of their paycheck each month into healthcare, retirement and unemployment.
Mon Dieu! That’s a hefty bite.
Hey …. Wait a minute! I thought cost was not an issue for government-run health care. That’s what the socialized medicine crowd keeps telling us, right?
I guess government-run health care doesn’t have magical powers in France any more than it does in Canada or Great Britain.
The Toronto Star reports that two patients have had enough of the vaunted Canadian health care system:
Two Ontario patients who had brain tumours removed in the United States because they say they couldn’t get quick treatment here are suing the provincial government over what they claim are unjustly long wait times for medical care.
And, contrary to the claims of the single-payer crowd, such wait times have real costs-beyond the obvious pain and suffering of the patients:
[One plaintiff] paid $27,650 for his consultation, biopsy and surgery in Buffalo and OHIP has refused to reimburse him because he failed to seek pre-approval for the expense, the claim notes.
Moreover, these folks aren’t rich. They have made considerable sacrifices to get access to care. Here’s how the second plaintiff puts it:
We’ve re-mortgaged our home. It has to be known. People can’t go through this … I was very fortunate to save my eyesight but the cost and the battle has been devastating.
So … tell me again: Why the hell would we want to emulate a system that produces such results every day of the week?
Why we should not model our health care system on the Veterans Health Administration.
While wait times for a mole examination are indicative of the problems we have with the health care system in the U.S., better to deal with that than what they deal with in Canada:
A shortage of urologists has become so pronounced that patients’ lives are at risk, managers of a St. John’s-based health authority have been warned.
In a powerfully worded letter to the Eastern Health regional authority, urologist Dr. Douglas Drover said an “excessive volume of work” in the specialty has meant waiting times of almost a year for patients seeking treatment.
Not exactly one of those problems that you can take two aspirin and call me in morning:
Andy Grant, a member of a prostate cancer support group in St. John’s, said he is afraid that people will die — or already have — while waiting for surgery.
“First of all, [patients deal with] the shock you might have prostate cancer, then the shock of being confirmed with prostate cancer,” he said. “Now you have the shock of saying, ‘I have to wait until next year?’ “
And what is the government’s response? What it always is, trot out a “new” government strategy to solve the problem:
Health Minister Ross Wiseman said the government is working on a solution to staffing shortages in urology and other areas.
“We’re in the process now of developing a physician human resource plan, and we hope to be able to, either in the early fall or late winter, roll out that strategy,” Wiseman said.
The more I read about the Canadian health care system, the more I think it should have the moniker “Operation Wheelspin.”
Canada, we are constantly being told by single-payer advocates, is a model social democracy with a medical delivery system that we should envy. Oddly, the people who make such claims never want to answer a question that Bill Steigerwald reiterates in a recent column:
If Canada’s national health care system is so dang wonderful, why are so many Canadians coming to America to pay for their own medical care?
And it’s not only pregnant women, like the one who recently had to drive to Montana to have her baby, who cross into the U.S. on a daily basis seeking health care. Thus, Steigerwald inquires further:
Why is the hip replacement center of Canada in Ohio-at the Cleveland Clinic, where 10% of its international patients are Canadians … Why is Brain and Spine Center in Buffalo serving about 10 border-crossing Canadians a week?
By way of answering his own questions, Steigerwald provides the following datum:
Number of Canadians on waiting lists for referrals to specialists or for medical services-875,000.
It would appear that Canadians with sufficient financial means are seeking medical treatment in a country where such waiting lists exist only the the fond dreams of single-payer advocates.
And what about the Canadians who don’t have the money to come here for care? I guess they just pray that their illnesses don’t kill them before the vaunted Canadian system can fit them in.
Looking over this blog post at Health Affairs, I noticed quite a few curious comments about SCHIP and uninsured children. First, from Bob Greenstein at the Center for Budget and Policy Priorities:
“[S]ince 2004, as funding for SCHIP has grown scarcer among states and a restrictive Medicaid policy enacted in early 2006 took effect, the number of uninsured children under 18 has climbed — from 7.7 million in 2004 to 8.7 million in 2006.”
“The number of uninsured children fell when the federal government and states worked together to increase coverage for children under SCHIP and Medicaid,” noted Robert Greenstein, executive director of the Center on Budget and Policy Priorities. “Now, progress has stalled and begun to reverse. Moreover, the Administration has announced a new policy that further weakens children’s coverage under SCHIP by placing coverage of as many as several hundred thousand children at risk.”
How exactly did progress “stall” and begin to “reverse”? Have states been cutting back their SCHIP benefits? Not to my knowledge. If anything, a few states have made them even more generous. Thus, Greenstein’s remark seems little more than an attempt to hoodwink the public into believing the increase in uninsured children is somehow linked to declining SCHIP benefits.
But that’s not the only bit of deceit in his comment. Note how he chooses 2004 and 2006 as his data points. But SCHIP has been around since 1998, so picking 1999 from the Census numbers (sorry, 1998 isn’t available in that data set), would be more accurate. In 1999 the number of uninsured children was about 9 million. Although the numbers of uninsured children has bounced around a lot and in some years showing vast improvement, we now seem to be almost right back where we started.
Related to that is this comment from Families USA:
Today census numbers only confirm what state officials and health care advocates have seen first-hand — SCHIP resources must be increased to meet the health care needs of the increasing number of uninsured children. Congress is currently working to reauthorize the SCHIP program with enough funding to ensure that as many as 5 million uninsured kids in this country get the coverage they so desperately need.
Before we take as given that the proposed SCHIP expansion would cover another 5 million uninsured children, shouldn’t we first ask why the introduction of SCHIP has, at best, only made a small dent? And, why, despite the introduction of SCHIP, the overall number seems to be on the rise?
Here’s my answer: Many of the children in SCHIP were not previously uninsured. Rather, their parents had private coverage for them, coverage which they then dropped to put their kids on the government dole, a phenomenon known as “crowd out.” Now, children tend to be healthier than the population as a whole (and, of course, younger). So, when they leave private insurance, those remaining in private insurance tend to be older and sicker. That, naturally, drives the price of private insurance higher, which will make it less affordable. More people will then opt to go the uninsured route.
Now, before anyone suggests that I am arguing that the introduction of SCHIP has caused our present woes, let me clarify: I’m sure SCHIP is not the biggest cause of the rise in the uninsured, and I doubt it is even a major factor. But I suspect that it has had, on balance, a negative effect.
What good, then, will come from expanding it?
Mine and Paul Gessing’s take on Bill Richardson’s health care plan.
In a column characterized by a fierce competition between sanctimony and sophistry, Bob Herbert inadvertently gives his readers a glimpse of the truth about SCHIP. He solemnly advises that President Bush’s opposition to that program’s expansion is driven by a “cruel” ideology …
… that views CHIP, correctly, as yet another important step on the road to universal health care.
Herbert must have misplaced his talking points. The party line, typified by Paul Krugman’s recent brayings, is that people who claim SCHIP is about the gradual imposition of ”universal health care” are paranoid wingnuts.
Apparently unable to comprehend the implications of this passage, the denizens of the wackosphere have blithely reproduced Herbert’s piece as if it supports their claim that SCHIP is about “the children.”
Meanwhile, the usual suspects are using the latest Census Bureau report on the uninsured as further justification to expand SCHIP. I guess it’s just too much work for any of these people to look at the actual facts about SCHIP and the uninsured.
+ May 2009
+ May 2008
+ May 2007