Wednesday, July 23, 2008

Democrats Will Destroy Health Care

Some people are mystified by John McCain's health care proposals. Basically, they're simple. He wants to bring the private enterprise system into play. He wants people to be able to choose their own insurers and level of coverage. He also wants them to be able to choose the quality of services and the price of the services they purchase.

It's a very good idea. It won't work out perfectly, but it will begin the process of driving health costs down, increasing choice, and -- ultimately -- improving care. The Democrats' proposals? They'll have the opposite effect, leading to all the bad results found in universal health care programs in Canada, Britain, and similar countries.

Right now, if you have insurance (or lots of money) the U.S. provides health care second to none. The Democrats, under Obama and his willing stooges in Congress, are poised to destroy American health care. John McCain is proposing changes that would bring our health care into the free enterprise economy -- and make a basically good system better and more cost-effective. Scroll down to read Part 1 of this three-part series.

Previously, I referred you to Dr. David Gratzer's superb book The Cure: How Capitalism Can Save American Health Care. He described how the much-praised (over-praised) Canadian system leads to endless waits, needless deaths, and a poor quality of care. The "good news" is that it pretends to be free. The "bad news" is that it should be.

What we don't want is a Canadian-style system. That's the one Gratzer describes as having elderly patients waiting for days on stretchers in emergency room corridors. They're lying there drenched in their own sweat and urine.

Gratzer notes that the downside of American health care is that the cost has spiralled. He points to the example of Vice-President Cheney's pacemaker, which "costs more than fifty times the average annual health-care expenditure of an American in 1950." Thus, care is in the U.S. is superb, but a lot of people can't afford it. Eventually, the government may not be able to afford it either.

Two factors have led to the challenges America faces in health care. One if the fact that, in 1943, the government announced that "employer-sponsored health insurance would not be taxed." Thus, for tax reasons and as a recruitment-retention tool, most employers began offering health insurance to employees. The burden of providing health care -- unlike every other burden (housing costs, food, etc.) -- fell to employers. Later, part of the burden would be assumed by government.

A second factor affecting the health system is the advance of medical technology. A generation ago, Dick Cheney would not have had a pacemaker, because it hadn't been invested. A generation ago, someone like Dick Cheney would have been dead. Technology that preserves life is wonderful, but it comes at an extremely high cost.

In Gratzer's words, here's what happens: "These two forces, the insurance model and technological advances, are mutually reinforcing: because insured patients don't pay directly for their own state-of-the-art care, they can't make the consumer choices that would curb the cost of this high-end treatment. As costs have increased to the point of crisis, reformers have sought to reduce them."

Gratzer thinks the reforms favored by Democrats (basically, Medicare and Medicaid) have been a disaster, sharply raising costs without really improving the overall quality of care. But Dems can relax, because Gratzer believes the reform favored by Republicans -- basically, the HMO model -- also has been a catastrophe. It brought a large, expensive -- and often ham-handed -- bureaucracy into the system.

Overall, a major problem with health care -- in our country and others -- is the illusion that it's free. In life, every good and service comes at a cost. In health care, however, the cost is hidden -- or, more accurately, paid by someone other than the user (patient).

When things appear to be free, people tend to overuse them. If tomorrow, the service station near you were to start offering a tank of gasoline for free, the line of "customers" would stretch for miles. If steak and lobster were free, I would have had them for all three meals.

Do people overuse medical services that don't directly cost them money. Yes. In fact, I do it (to a small extent) myself. There are stories of elderly people in Florida and elsewhere who look at visits to the doctor as social occasions. Some of them would go every day if the doctor would allow it -- and perhaps some doctors do.

A heart bypass operation in the U.S. costs about $35,000 to $40,000. In this country there are more heart bypass surgeries than in the rest of the world combined. What's that all about?!

The same with expensive MRI procedures. Do some doctors and hospitals encourage overuse? In my experience, the answer is yes. Why? Because the more patients, the more money the physicians make.

The problem with Obama plan or the Hillary Clinton plan or the congressional Democrats plan is that they will encourage more demand for services. Also, they will continue the illusion that health care is free. John McCain's plan would remove the illusion. It would turn relatively clueless health care consumers into savvy health care shoppers.

(More tomorrow)

No comments: