As I mentioned a few days ago, the advocates of government-run health care love to quote World Health Organization statistics. They are particularly fond of referencing “World Health Report 2000,” which purports to rank the health care systems of 191 nations.
Glen Whitman of the Cato Institute has written an excellent analysis of the methods used by the WHO to produce that report, and he concludes that it should not be taken seriously as an objective measure of how health care systems perform relative to one another:
The WHO rankings depend crucially on a number of underlying assumptions—-some of them logically incoherent, some characterized by substantial uncertainty, and some rooted in ideological beliefs and values that not everyone shares.
Among the most ideologically-loaded components of the ranking system is that which measures ”financial fairness.” The WHO defines ”fairness” in terms of how much a given government subsidizes health care, which renders single-payer arguments based on these rankings utterly meaningless:
To use the existing WHO ranking to justify more government involvement in health care … is therefore to engage in circular reasoning because the rankings are designed in a manner that favors greater government involvement.
Not that such considerations matter to single-payer advocates. I have pointed out before that these people don’t care about the integrity of their data. Contemporary “progressives” base their views less on facts than on the outward appearance of piety.
Which is why they cling desperately to the faux facts of ”World Health Report 2000.” Its pseudo-statistics provide single-payer advocates with much needed cover, allowing them to pose as thinking people whose opinions are based on actual data.
Single-payer advocates cite recent wait time increases in U.S. emergency rooms as yet another reason to embrace government-run health care. Like most of their arguments, this one ignores some very inconvenient facts. It does not explain, for example, why Britain and Canada have serious wait time issues despite their government-controlled systems.
The reality, of course, is that countries with socialized medicine tend to have far longer ER wait times than we have in the U.S. This reality has been confirmed, once again, by the travails of Norwegian ER patients. As Aftenposten reports, Norway’s state-owned hospitals are unable to provide decent service:
State health officials are sounding the sirens themselves over a state of emergency in Norwegian hospitals’ emergency rooms, where patients face lengthy delays, inexperienced doctors and often chaotic organization.
And, like all government-run health care systems, Norwegian health care produces a bumper crop of horror stories, including the following:
In one case, a patient suspected of suffering a stroke was kept waiting six hours and 10 minutes before being treated. In another case, a patient who drifted in and out of consciousness didn’t get treatment for nearly four hours.
These are government-owned hospitals, mind you. No profit motive eating at the the soul of the system. No evil capitalists syphoning off precious resources to pay for fat Cuban cigars. Just plain, old-fashioned bureaucratic ineptitude and inefficiency.
So, I’ll ask the question again: Why should we in the United States base our health care reform project on a model that consistently produces poor results? Doesn’t it make more sense to try something new, like free-market reform?
Michael Moore’s ridiculous SiCKO was apparently not anti-American enough for the Academy of Motion Picture Arts and Sciences. The political fashion plates at AMPAS let the porcine provocateur languish on the waiting list while awarding the best documentary Oscar to Taxi to the Dark Side:
[Moore’s] health-care study “Sicko” lost the documentary prize to “Taxi to the Dark Side,” a war-on-terror chronicle that centers on an innocent Afghan cab driver killed while in detention.
I haven’t seen—-or even heard of—-this “documentary.” But, considering the Academy’s well-documented taste for BS, I’m willing to bet it’s an exercise in mendacity. One doesn’t have to speculate, however, on the chutzpah of Oscar night producers. Kyle Smith explains:
Given that the most recent statistics show that approximately 97.4 percent of all documentaries present America as a scary place and of those 97.4, most are meant to present the troops in Iraq as overmatched at best and as abusive, sadistic criminals at worst, it’s pretty cheeky of the Oscars to have troops serving overseas present the Oscar for best documentary short subject.
Nonetheless, the defeat of Moore’s schlockumentary offers no small amount of schadenfreude. SiCKO is, like its director, an egregious fraud. It makes claims about Cuba, for example, that have been repeatedly debunked. He makes equally dishonest claims about the socialized systems of Britain and other countries.
So, in the end, SiCKO was just too dishonest and smarmy even for the fantasy mongers of Hollyweird.
Advocates of government-run health care love to quote studies based on World Health Organization statistics. However, they have been strangely silent on a recent study discussed in this piece by Deroy Murdock:
Low-quality, taxpayer-funded health care killed more than 17,000 Britons in 2004, according to the TaxPayers’ Alliance in London.
And that compares very badly to other European countries whose systems, not coincidentally, are (somewhat) more market-oriented:
The TPA examined the World Health Organization’s data to contrast the NHS with the Dutch, French, German and Spanish health systems, which are less government-dominated.
I have, of course, criticized excessive reliance on WHO statistics. But advocates of government-run health care swear by these data. Thus, the TPA study hangs them by their own petard:
While those four countries averaged a 106.6 amenable mortality rate, Britain was almost 29 percent deadlier, with its rate of 135.3.
Regardless of whether one takes WHO data seriously, it’s pretty clear that Perfidious Albion is (with apologies to Yeats) no country for sick men.
On Friday, I appeared on Canadian national television in a story about the popularity of my video “A Short Course In Brain Surgery” and its contribution to the health care debate. The video (of which there are at least three copies on YouTube) has been viewed over 2 million times. Click the thumbnail to play.
When government-run health care systems encounter difficult problems, the bureaucrats ”solve” them by imposing new regulations and guidelines. Thus, when wait times in British emergency rooms (or A&Es, as they refer to them across the pond) became a national scandal, the government decreed that no one would wait for more than four hours.
Unfortunately for the patients, this command from on high had no effect on the underlying causes of the ever-lengthening wait times. So, the only effect of the four-hour target was the creation of perverse incentives. The NHS trusts knew they couldn’t meet the targets, but they didn’t want to incur the wrath of the Government. The Daily Mail reports the result:
Thousands of people a year are having to wait outside accident and emergency departments because trusts will not let them in until they can treat them within four hours, in line with a Labour pledge.
Figures obtained by the Liberal Democrats show that last year 43,576 patients waited longer than one hour before being let into emergency units.
Why are wait times so egregious? Because, in order to keep physicians from jumping ship over low pay and long hours, the Government gave GPs a little more control over the latter. This created a shortage of after-hours GP care, so patients end up heading to the A&E.
And what do the health care bureaucrats say about all of this? Why, they deny it, of course. They claim that the figures actually mean something else than what they appear to mean. In the end, however, there will probably be a special inquiry and a blue ribbon study.
We in the U.S. are, of course, not without our own ER wait time issues. And, just as they are in the U.K., these problems are caused by government meddling in the health care market. Canada’s ER wait time issue are also traceable to bureaucratic incompetence. Anyone see a pattern here?
I’ve always held that the advocates of government-run health care are motivated primarily by the desire to redistribute wealth and income. This week, a devasting story published in the Canadian newspaper The National Post called Dying to save “The System” describes the Canadian system accurately:
For defenders of Canada’s government-monopoly health care system, there is only one goal that truly matters. And, no, despite their earnest insistences to the contrary, that goal is not the health of patients. It is the preservation of the public monopoly at all costs, even patients’ lives.
Be sure to read the whole story – and then ask yourself what are the true motives of those who say that “health care is a right” and that government should make our medical decisions for us.
Betsy McCaughey suggests some health care questions for tonight’s Presidential debate in Austin. Since Hillary appears to be on the verge of becoming an “also ran,” I’ll focus on three queries relating to Obama’s proposals:
You have said that you will require all parents to have health insurance for their children. What will you do to enforce this law?
This is the question that should be asked about all mandates, including those involving children. Is Obama going to fine parents who don’t comply? Will the Social Service goons descend on them? Obama needs to tell us.
You have pledged to make health insurance “affordable” …. Would you allow Texans (and all of us who live in states with similarly costly insurance requirements) to shop for cheaper insurance outside our own state?
One of the most important contributors to the high cost of health care is the morass of state laws governing the purchase of health insurance and the coverage the plans must provide. Obama’s plan contains no provision for fixing this problem.
Some doctors and hospitals are worried about [your plan] to make electronic record-keeping compulsory. What will be the penalty for a doctor who doesn’t get computerized?
This is another of Obama’s deceptively innocuous proposals. Who could be against modernizing health records? Well, how about the providers who must foot the bill for yet another unfunded mandate? This kind of technology upgrade will be very expensive, particularly if there is some penalty (like medicare payment cuts) for not meeting some arbitrary federal standard.
Questions about the universality of his plan notwithstanding, Obama has been given a mostly free ride from the press and much of the public on his health care proposals. It’s time to start hitting him with the hard questions that any president will have to deal with on this issue.
Single-payer advocates promote the fiction that people who disagree with them are “against reform.” In reality, however, the most ferocious defenders of the status quo are those who favor government-run health care. The Florida Times-Union reports on a typical campaign to undermine market-oriented reform:
Former Florida Gov. Jeb Bush led the most ambitious and significant reform to Medicaid in the country. Since he completed his term one year ago, bureaucracy and special interests are strangling it.
Florida’s old Medicaid system was a disaster for the patients and for the state budget. It was, in other words, a typical government health care program. So, Jeb Bush decided to try a market-based alternative:
Bush’s vision for a new Medicaid would have allowed all people on Medicaid to choose from competing private plans … Today, there are over 200,000 people enrolled in 16 private sector plans in Broward County, seven in Duval, and two each in Clay, Nassau, and Baker counties.
These plans are full of innovative features:
Individuals can earn credits for healthy behaviors, such as getting mammograms, pap smears, colorectal screenings and bringing children in for appropriate screenings.
And the incentives are properly aligned:
These at-risk plans have a strong financial incentive to quickly get each new member in for a thorough checkup because they will be on the hook later for avoidable high-cost encounters.
All of this is what health care reform is supposed to be about. So, naturally, the forces of the status quo are mobilizing. An unholy alliance of bureaucrats and special interests are deploying phony studies in an effort to smother the program:
In one “study” they used opinion data from 186 physicians … to claim that physician participation in the reform counties is declining. But their own footnote admits this was an 8 percent response rate and “the survey findings should not be considered generalizable.”
Not surprisingly, actual county figures refute this “study.” But the apparatchiks are determined to ignore objective data. In fact, they are hurrying to throttle the program before a legitimate study from the University of Florida comes out this Spring:
Officials in Florida’s new administration have announced that they will not be recommending expansion of the pilot and have not indicated any plan to meet the statutory requirement to expand statewide by 2011.
All of which demonstrates that the advocates of government-run health care are not really for “reform” at all. What they really want is more government intrusion into our daily lives. And they will do their best to smother any effort, market-based or otherwise, to reduce the reach of the commissars.
I have written before about ostensibly non-partisan organizations and publications that have been infected by faux-progressive politics. The latest victim of this contagion is the New England journal of Medicine, which provides space for political hack Robert Kuttner to promote discredited Lefty canards such as the following:
The extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization.
We do not, as Kuttner would admit if he were an honest man, have a “commercialized” health care system. It is rather a quasi-market system in which the government meddles at every level. But that doesn’t prevent him from invoking the usual Lefty hobgoblins:
The dominance of for-profit insurance and pharmaceutical companies, a new wave of investor-owned specialty hospitals, and profit-maximizing behavior even by nonprofit players raise costs and distort resource allocation.
He then goes on to describe what the “solution” will look like if he and his fellow travelers have their way:
A comprehensive national system is far better positioned to match resources with needs … A universal system suffers far less of the feast-or-famine misallocation of resources driven by profit maximization.
In other words, what we need is socialized medicine. And, to underscore that point, he praises the worst health care system in Europe as a model of efficiency:
When the British National Health Service faced a shortage of primary care doctors, it adjusted pay schedules and added incentives for high-quality care, and the shortage diminished.
This is manifestly false, as Kuttner well knows. The NHS suffers from a horrendous shortage of PCPs and dentists. And the measures cited by Kuttner have done nothing to alleviate that situation. Thus, the NHS increasingly relies on the importation of foreign-born physicians with these results.
That the NEJM gives space to this dishonest political hack and allows its pages to be sullied by Leftist agitprop is a true disgrace.
Recently, I noted that Barack Obama and John McCain are both right on health insurance mandates. Unfortunately, the same cannot be said about their positions on drug reimportation. Both are for it—which means they are for importing the price controls of Canada and other countries.
As I discuss here, drug reimportation would stifle innovation while producing insignificant reductions in pharmaceutical spending. So, why has such a bad idea been embraced by the leading Presidential candidates? James Antle explains in the American Spectator:
Unlike raising taxes, railing against drug manufacturers is a win-win proposition at the ballot box. “Big Pharma” isn’t a sympathetic character in political morality tales, where companies like Merck are portrayed as heartless profiteers.
And explanations of the profoundly bad economics of drug reimportation often fall on deaf ears:
Enumerating the downsides of price controls merely makes one look like a defender of a flawed health care system.
Antle nonetheless does his duty, laying out the inevitable effect of such controls:
Bringing each new drug to market costs an average of $800 million and may take between a dozen and fifteen years to complete … Without the prospect of reaping a windfall, companies won’t tie up so much capital in a process where successes are rare.
Unfortunately, the probable nominees of both parties are determined to ignore such realities. So, regardless of who wins in November, it is likely that this flawed policy idea will find its way into law.
“In January, Congress tried and failed for the second time to override President Bush’s veto of a Democratic proposal to expand the State Children’s Health Insurance Program (SCHIP), a 10-year-old initiative that aimed to extend coverage to low-income kids. Congressional leaders promise another attempt in the coming weeks. The rhetoric has been hot: Republicans claim that the Democratic proposal would lead to socialized medicine by creating a middle-class entitlement; Democrats claim that their proposal is vital to poor kids. Unfortunately, this ongoing Washington power struggle will do little to strengthen America’s torn health-care safety net.” Read more from my latest.
Believe it or not, there are people out there who still defend Canadian health care. Among them is Sara Robinson, who last week produced the risible Mythbusting Canadian Health Care. The piece is really just a series of straw men that she makes a great show of knocking down, but it does include the following nod to reality:
You can hear the bitching about it no matter where you live … grousing about health care is still unofficially Canada’s third national sport after curling and hockey.
Unfortunately, that somewhat inconguous note of candor is followed by an utterly preposterous assertion about the depth of Canuck dissatisfaction:
The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits.
The London Free Press, however, reports that the percentage of Canadians who express profound unhappiness with their health care system far exceeds “single digits”:
More than two-thirds of Canadians think the health-care system needs major repairs or a complete overhaul, says a national poll that regularly gauges public attitudes on health.
This sounds a little more serious than the kind of good-natured kvetching implied by the term “national sport.” And it’s not just the patients who are unhappy. Providers of care are deeply dissatisfied:
Sixty-nine per cent of nurses felt the system needed significant change, while 62 per cent of doctors favoured ’some fairly major repairs.’
These kinds of percentages, combined with the increasing number of Canucks who come to the U.S. for medical treatment, suggest that the alleged superiority of Canadian health care is the real myth that needs to be “busted.”
Peter Chowka has written a good piece on the “universal health care” project contemplated by Barack Obama and other Democrats. One of the article’s best passages involves the effect of incessant media crisis-mongering. Discussing a recent public opinion survey, Chowka points out the following:
Vast majorities of those sampled – including 93 per cent of Democrats – say the system requires “fundamental changes” or “needs to be completely rebuilt” … However, in response to a question about “The health care you receive,” 90 percent of Republicans and 74 per cent of Democrats said they are “satisfied.”
Why would people with such positive personal experiences with our medical delivery system tell pollsters that the system needs to be overhauled?
Americans, when answering general questions about the country’s health care, are parroting back negative information that’s been drummed into them for years by the media, politicians, special interest groups, etc., to wit that the American health care system is in crisis and is approaching breakdown.
This crisis-mongering has long been with us. As I noted in this post, journalists and politicians have been forcasting the imminent collapse of American health care for the best part of four decades.
The public should ignore this apocalypticism. It is designed to sell the voters on a set of policies that will do serious damage to a health care system that has its faults but which (the propaganda notwithstanding) is still the best in the world.
The “Potomac primary” has made it more likely than ever that Barack Obama and John McCain will be the nominees of their respective parties in the Fall. That’s good news for those of us who oppose health insurance mandates. It’s not unheard of for politicians to renege on promises, of course, but both have made very strong statements against mandates.
McCain has said that mandating health insurance makes no more sense than requiring everyone to buy a house. And Obama has, of course, infuriated a variety of left-leaning pundits and policy wonks by insisting that “the reason people don’t have health insurance isn’t because they don’t want it, it’s because they can’t afford it.”
Thus, if these two guys are the nominees, it isn’t very likely that the next President will propose a health care reform package that includes an insurance mandate. That doesn’t mean that Congress won’t try to add one to whatever reform proposal ends up in its hands. But it does at least mean that a mandate won’t be inevitable.
“In Boston, people can walk into a store and buy tobacco and alcohol. They can also purchase sugary soft drinks, high-fat foods and herbal medicines of dubious clinical use. If Mayor Thomas Menino gets his way, however, they will be unable to see a licensed health professional for a flu shot because it ‘jeopardizes patient safety.’Vice, junk food and snake oils are OK, but the mayor has started a campaign to ban retailer-based walk-in clinics, reasoning that ‘allowing retailers to make money off of sick people is wrong.’ The problem for American health care is that while Mr. Menino’s position is exceptional — he is as yet the only mayor to oppose these clinics — his sentiment has influenced health care laws and regulations for decades, leaving us with fewer options and higher costs.” So opens my latest, published in the Baltimore Examiner.
Respected health care analyst Jeff Goldsmith has a great post over at The Health Care Blog, in which he makes the following point about mandated universal coverage:
To simply assume that extending coverage to the 47 million uninsured somehow assures access and, therefore, better health, requires multiple leaps of faith. There are many physical, cultural and economic barriers separating “coverage” from “access”.
Mandates don’t have magical powers. Seems reasonable. So, what does he suggest?
Rather than focusing on unaffordable mandates and massive tax-based subsidies, extending coverage should focus on affordability (vitally important for the more than ten million younger uninsured) and ease of access to multiple insurance options …
In other words, treat the disease rather than the symptom. Why is it that so many “progressive” analysts have such difficulty absorbing something so obvious?
Had any commentator predicted in 1994 that the health care industry would one day be an important financial contributor to Hillary Clinton’s presidential campaign, that person would have been laughed out of the commentariat.
After the fall of Hillarycare, everyone assumed that Mrs. Clinton and “the health care industrial complex” would be sworn enemies until one or the other prevailed in the final battle between good and evil. Well, the times they are achanging.
This chart comes from The Center for Responsive Politics, which shows Hillary on the receiving end of more money from the health care industry than any other Presidential candidate. Here’s a more detailed breakdown of where her $3.6 million came from:
Health Professionals: $2,331,527
Hospitals/Nursing Homes: $520,631
Pharmaceutical/Health Products: $349,270
Health Services/HMO: $326,456
Misc Health: $142,743
So, what’s behind this phenomenon? Is it a case of Stockholm Syndrome? Or is the health care industry betting that Hillary is really the candidate of the status quo?
Watching Barack Obama bedevil Hillary is a real pleasure. It would not do, however, to become too drunk on schadenfruede. Like Hillary, Obama is a nanny state liberal whose proposed policies would do real damage to the U.S. health care system.
In fact, Obama is in some ways even more dangerous than Hillary. If he emerges as the Democratic nominee for President, he will be harder to beat in the general election. I flesh out this argument in the American Spectator.
Here’s my latest, published in Investor’s Business Daily, just before the State of the Union address.
Adele Roberson –
Regarding the comment (reprinted at the bottom of this entry) that you left on the Free Market Cure website: Please make sure that it is not you doing the “bamboozling”.
The story is true. The cost of the surgery was indeed $28,000. It was arranged (as the video “A Short Course in Brain Surgery” explains) by Canadian medical broker Rick Baker of Timely Medical Alternatives – a company that specializes in negotiating low rates on surgical procedures in the United States for Canadians on long waiting lists.
Perhaps, if you had watched the video and had been curious enough to look up Timely Medical Alternatives on the internet, you might have figured this out.
By the way – we’ve never received a check from the AMA or any other organization with a financial interest in this debate. If you had read the disclaimer to that effect here on freemarketcure.com, you might have figured that out also.
Free Market Cure
Your Comment at FreeMarketCure.com:
There is an E-Mail currently being sent all over the country that tells us that some Canadian came across the border to the US to get brain surgery because he was diagnosed with cancer and could not get the attention in his country for four months.This E-Mail tells us that this man was treated in the US and the total cost for this brain surgery was $28,000.00Where the hell can you get brain surgery for $28,000 in the US?This whole story sounds fishy to me. An operation such as this is estimated to cost $150,000.00 to $200,000.00. Recent news on the front page of the Wall Street Journal.I spent $38,000.00 a year ago at St. Luke’s Hospital in Houston, Texas. Four days of tests…. that were “inconclusive”. I am still unable to digest my food properly.A BOOB JOB, IN THE US COSTS $5,000.00.My young neighbor just paid $9,500.00 for a normal delivery of her child.Anyone reading stupid stuff like this needs to think about what is being said and why.I suspect this is just moreAmerican Medical Association propaganda.The AMA is responsible for stuff like this.A bout a year ago there was news coming out about some man from Canada that came to Arizona for medical treatment. Later it was found that the whole thing was bogus. Be alert.Don’t let yourself be bamboozled.
The title of Hillary Clinton’s health care plan is “American Health Choices,” but how much flexibility would she really permit? Well, to paraphrase her husband, that depends on what the meaning of “choice” is. On Sunday morning, Hillary gave us a glimpse of how she defines the word:
Democrat Hillary Rodham Clinton said Sunday she might be willing to garnish the wages of workers who refuse to buy health insurance to achieve coverage for all Americans.
Here’s how she fleshed that out when pressed on the point:
‘I think there are a number of mechanisms” that are possible, including ‘going after people’s wages, automatic enrollment.’
This is perfectly consistent with the Orwellian character of Hillary’s plan. For her, “putting the consumer in the driver’s seat” means a federal statute requiring him to buy insurance. Thus, it should be no surprise that “choice” means ”give us your money or we’ll take it out of your paycheck.”
Some commentators believe this will do Hillary considerable damage in the upcoming primaries, but I doubt it. Most of the people voting in the Democrat primaries are perfectly OK with Hillary as Big Sister. They actually like socialism.
The general election will be a different matter, however. If the Republicans have any sense, admittedly a very big if, they’ll produce lots of ads that show Hillary talking about “going after people’s wages.” If the voters still want her after that, they deserve her.
A variety of “progressive” health care analysts are still deluding themselves about the future of “universal” health care. Ezra Klein, as I wrote last week, is as clueless as ever on this point, and he is by no means alone.
Like all cases of self-delusion, those of Klein and his fellow “progressives” require that they ignore mountains of contrary evidence. They have refused, for example, to absorb the obvious lessons of the SCHIP debate and the demise of Oregon’s ”Healthy Kids” initiative.
They will no doubt continue this pattern of denial and ignore the death of Arnoldcare. As reported in the WSJ, California’s Democrat-controlled legislature finally did the humane thing for this writhing, moribund beast:
Arnold Schwarzenegger’s “universal” health-care plan died in the California legislature on Monday, in what can only be called a mercy killing.
Anyone not impervious to objective data will notice that the death of Arnoldcare, “Healthy Kids,” and SCHIP have one item in common. They occurred in legislative environments controlled by DEMOCRATS:
The California legislature is probably the most liberal this side of Vermont, and even Democrats refused to become shock troops for this latest liberal experiment.
Why? Because they can’t pay for it.
Like collapses in Illinois, Wisconsin and Pennsylvania, this one crumpled because of the costs, which are always much higher than anticipated.
No matter how much BS is piled up by the advocates of universal health care, the goals of unlimited access and low cost are mutually exclusive. You can have one or the other, but you can’t have both:
You can’t make coverage “universal” while at the same time keeping costs in check — at least without prohibitive tax increases.
This is the rock on which Oregon’s plan wrecked, and why Nancy Pelosi and her accomplices had to promote a tobacco tax scheme that would have created the need for new smokers.
So, what does this mean for the fantasies of Klein and others of his persuasion? It means that, even if the voters are foolish enough to put Hillary in the White House this November, no radical overhaul of U.S. health care will ensue.
+ May 2009
+ May 2008
+ May 2007