[June 30, 2008 @ 10:34 pm] David Catron

A variety of Democrats and advocacy groups have been telling us for years that “Medicare-for-All” is the cure for what ails U.S. health care. Well, Congress has just demonstrated why that’s such a dumb idea. Donald Johnson over at The Health Care Blog spells it out:

Under a “universal health insurance system,” which is advocated by the Democrats, political fights like this would happen every year. Doctors and insurers, if they were still in business, would face payment cuts. Patients would face uncertainty about who their doctors and insurers would be. And relationships between doctors, insurers and patients would become more strained than some of them already are.

The kind of political skullduggery that I describe here will be much MUCH worse if the whole health care system is turned over the the federal government. Government-run health care is politicized health care.

[June 29, 2008 @ 9:34 am] David Catron

Claude Castonguay is known as “the father of Quebec Medicare.” However, as David Gratzer points out in IBD, Castonguay can be more accurately described as the “father” of the Canadian single-payer system:

Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec adopt government-administered health care … Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.

Now, however, Dad is not happy with the way his child turned out:

Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”

And how does Castonguay propose to get Canadian health care back on track?

We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.

That’s right. While our leading politicians advocate turning more and more of U.S. health care over to the government, the father of Canadian health care is advocating less government involvement. Which prompts Gratzer to ask:

If Claude Castonguay is abandoning ship, why should Americans bother climbing on board?

Why indeed.

[June 25, 2008 @ 10:15 pm] David Catron

Barack Obama often says, ”the reason people don’t have health insurance isn’t because they don’t want it, it’s because they can’t afford it.” He is right in this. Unfortunately, like the rest of his Democrat brethren, he has offered no plausible plan for reducing health insurance premiums.

One of the most significant contributors to the high cost of health insurance, and thus the uninsured problem, is the increasing trend toward state-mandated benefits. Many states dictate the services that must be covered by insurance policies, often requiring coverage for all manner of odd items such as chiropratic care and accupuncture.

Studies commisioned by AHIP and CAHI suggest that at least 20% of uninsured Americans lack coverage because of state-mandated benefits, and that such mandates add as much as 50% to the cost of individual insurance plans. Yet politicians of both major parties routinely advocate even more mandates.

There are, however, a few politicians who understand how much damage is done by mandated benefits.  Among them is GOP Governor Charlie Crist of Florida, who has pushed through legislation that will allow mandate-free policies to be sold in his state:

Insurance companies will be permitted to sell stripped-down, no-frills policies exempted from the more than 50 mandates that Florida otherwise imposes … The new plans will be designed to cost as little as $150 a month, or less.

This kind of state legislation won’t completely solve the uninsured problem, but it will put a serious dent in it. Unfortunately, only about a third of the states allow their citizens to buy mandate-free individual policies. More state governors should follow Charlie Crist’s lead.

[June 19, 2008 @ 2:42 pm] David Catron

Robert Goldberg has a mordant op-ed in the Washington Times about Barack Obama’s plan to “reform” U.S. health care. Here is his succinct description of Obamacare:

Mr. Obama plans to make Medicaid and State Children’s Health Insurance Program (SCHIP) expansion the foundation of his proposal to expand coverage. He would make private health insurance affordable by having the government force doctors to accept below-cost rates for their services and impose a 4 percent tax on physician earnings. Then he would have a national health board determine which drugs and procedures the government would pay for under his new plan.

If it’s not obvious that this is bad news, consider what has happened in states where such policies have already been tried:

Many states have used the same approaches to cover the uninsured and to make existing premiums less expensive. Instead of doing so, such proposals have driven many doctors out of government-run programs and have rationed access to new medicines. Private insurers are leaving markets. And patients who are forced to wait months for needed care often wind up not getting the medicines they need.

This last issue relating to the denial of proper medications will certainly become a serious and widespread problem if Obama’s wrong-headed policies are enacted:

Mr. Obama would also create a new health board to create lists of “cost effective” new drugs and medical devices, and set prices for their payment. Similar review boards in Canada and Europe delay access to new medicines by months or years and are biased by cost-containment considerations.

This “health board” would emulate Great Britain’s ironically named NICE, whose many outrageous policies include the refusal to provide up-to-date cancer drugs to desperately ill patients.

This is the kind of “change” we’re going to get if the voters are foolish enough to put Barack Obama in the White House.

[June 17, 2008 @ 6:22 am] David Catron

In response to this post, commenter Groetzinger asks the following question: “If you believe [the health care problem] is fixable what is the fix?” 

Well, if I were appointed Grand Imperial Poobah for Health Care and Bottle Washing, here’s what I would do:

Decouple employment from health care by eliminating the tax advantage that exists for employer-provided health insurance.

Create a national health insurance market by knocking down the state-imposed barriers that prevent people from buying insurance across state lines.

Encourage the spread of HSAs that incentivize consumers to economize on unnecessary medical expenditures.

Reform Medicare/Medicaid/SCHIP by moving the whole system to a market-based model similar to the Medicare Advantage program.

Pass nationwide tort reform to reduce the huge number of unnecessary tests and procedures that now result from defensive medicine.

Remove the stealth price controls (e.g. MS-DRG, APC, RBRVS) that have gradually been imposed on the system by the federal government.

Repeal EMTALA, HIPAA, and all other federal statutes that add huge costs but no real value to the health care system.

Eliminate all state and federal barriers (e.g. certificate of need statutes) to provider entry into the market.

Eliminate all state and federal barriers (e.g. the Stark law) to provider combination and competition.

Allow all hospitals, doctors, and other health care providers to charge what the market will bear.

Having thus cured the health care crisis, I would move on to world hunger and world peace. Then I’d go to lunch.

[June 10, 2008 @ 4:27 pm] David Catron

Anyone doubting that contemporary Progressivism is intellectually moribund should consider the credulous reaction of the Left to Barack Obama’s recent victory speech. Does one not have to be totally brain dead to take the following seriously?

I am absolutely certain that generations from now, we will be able to look back and tell our children that this was the moment when we began to provide care for the sick and good jobs to the jobless; this was the moment when the rise of the oceans began to slow and our planet began to heal …

How could ”progressives” fail to ”laugh until their ribs squeaked,” as George Will phrases it,  when Obama threw in the bit about the oceans? There is only one plausible explanation—-they no longer possess the capacity for critical thinking. 

This goes a long way toward explaining why these people favor so many bad ideas relating to health care reform and strongly suggests that it would be a monumental blunder to trust them (or their candidate) with any important matter of domestic or foreign policy.

So, we should definitely not allow “progressives” to meddle with health care.  Come to think of it, it might be a good idea to keep them away from sharp implements as well.

[June 6, 2008 @ 9:06 pm] David Catron

Pete Stark apparently resides in an alternate reality. There is no other explanation, beyond sheer mendacity, for the op-ed he recently wrote for The Hill. The piece contains so many erroneous assertions that no single blog post can address them all, so I’ll focus on the following representative passage:

Shifting more cost and responsibility to the consumer as a strategy for reform or cost-containment is useless. 

This is, of course, an allusion to consumer-driven health care. Stark’s assertion is refuted by every serious study of patient behavior in cost sharing situations, including this one which showed that high deductible plans reduce expensive ER utilization for minor complaints:

Traditional health plan members who switched to high-deductible coverage visited the emergency department less frequently than controls, with reductions occurring primarily in repeat visits for conditions that were not classified as high severity …

Visits to the ER for minor illnesses constitute a significant driver of health care inflation. So, anything that reduces such visits will be far from “useless” as a cost-containment measure. And, contrary to claims made by enemies of the free market, high deductible plans have no effect on ER utilization for real emergencies: 

HDHPs may be associated with reduced overall emergency department utilization without significantly affecting the highest-severity visits.

So, Stark either lives in a fantasy world or he’s a profoundly dishonest man. Either way, as the chairman of the Health Subcommittee on the Ways and Means Committee (in the House of Representatives), he exerts a very unhealthy influence on national health care policy.

[June 3, 2008 @ 7:33 am] David Catron

I have written before about how Great Britain’s National Health Service compounds its disgraceful refusal to provide up-to-date cancer drugs by punishing patients who are willing to pay for these medications out of their own pockets.

That’s right. If a patient buys a drug like cetuximab or Avastin with her own money, she is no longer entitled to free care via the NHS. The Telegraph reports on a case that illustrates how this sadistic policy affects real people:

A woman who was refused free NHS cancer treatment after she paid for extra drugs has died, reigniting the debate over whether patients should be allowed to “top up” their care.

The government bureaucrats who run Britain’s dilapidated system of socialized medicine would rather let a patient die than allow her to break the rules. And what is the overarching principle at work here?

Alan Johnson, the Health Secretary, claims that co-payment will create a two-tier NHS, with preferential treatment for patients who can afford the extra drugs. 

Cancer patients are, in other words, being sacrificed on the altar of “equality.” Mr. Johnson and his fellow bureaucrats are determined that British patients will all be “equal,” even if it kills them.

This is government-run health care, folks.