Apr 18 2009

Touchstone for anti-gun, universal healthcare true believers

Category: guns,healthcareharmonicminer @ 8:27 am

With the recent spate of shootings,  false allegations about how the Mexican drug wars are being fought primarily with guns directly obtained in the USA from gun shops, and the Left’s ambition to institute universal health care of some kind, it seemed good to repost this from last September.

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A lot of folks believe themselves to be very righteous because they care so much about the children (even though they’re pro-choice on abortion). They want you to believe that they care more about human life than you do. So they’re really big on universal health care, and they’re anti-gun. In the first instance, they want you to be forced by government taxation to pay for it. In the second instance, they want to remove your right to self-defense (only meaningful if you have the tools to do so, correct?).

Is it clear yet that they don’t care about you? I hope so. If you don’t grasp that, reread the first paragraph. Their concern is for other folks, not for you. Not even for your children, because, you see, your children are yours, and the universal health care/anti-gun true believers don’t really care about them, just the children of those other people, more or less in the abstract. Otherwise they would not try to take away from you the tools you need to defend them, and the money you need to take care of them.

A few facts to set the table:

1) Auto accidents are the single biggest cause of death in children (and, for that matter, adults up to age 30 or so). At least 40% of those are alcohol related.

2) Since 2004, the next biggest cause of death is poisoning, according to the CDC.

For at least the 40 years prior to 2004, the two leading causes of injury death were MVT deaths and firearms. Beginning in 2004, poisoning deaths outnumbered firearm deaths and have increased at a greater pace than firearm deaths since then. Unintentional drug poisonings are the largest component of poisoning deaths; they are primarily related to drug overdose and their rates of increase have outpaced those of all poisonings. Physicians who prescribe narcotics (e.g., opioids such as methadone or oxycodone) should be aware of the risks associated with the drugs that are contributing to these deaths. Whether the drugs are not prescribed correctly, are not taken according to the physicians directions, or are diverted from a patient to someone else cannot be ascertained, but all possibilities must be considered (3)

3) Of the firearms deaths, despite anti-gun accident-fear propaganda, the biggest causes are suicide and homicide. Of the homicides, most are below age 30 or so. Estimates of the number of gang related murders run from 10-50%, depending on who is asked, and the methodology of classification. There are far fewer firearms “accidents” than the anti-gun industry wants us to believe, and some of those “accidents” may be murders that cannot be proved. (“Yes, officer, I accidentally shot him while cleaning my gun.” Nearly unbelievable to anyone who knows anything about firearms.) Men are more likely to be murdered by strangers, unless it is gang related. Women are somewhat more likely than men to be murdered by someone they know.

What does all of this mean? Among other things: the causes of death up to early middle age are overwhelmingly not precisely “medical” or “health” related, but are related to accidents, poisonings, suicides and murders. If one was deeply concerned about the health status of children and young adults, the single biggest place to start is those causes of death, NOT whether or not they have “health insurance”. And in the case of poisonings with prescribed medications (the second largest cause of death of younger people after auto accidents), it could reasonably be argued that those deceased would have been better off with LESS medical attention….. Note that drug-overdose with illegal drugs seems to be much less a cause of death than overdose with prescribed drugs.

To the biggest cause of death, auto accidents: the leading cause of death of people under age thirty is traumatic brain injury in a vehicle accident. And outside of fatality, the leading cause of disability and enormous medical expense for young people is the same. Who among us does not know, or know of, a young person with such an injury? It is exceedingly common, sadly. Just in my circle of friends and family, I know of perhaps a half dozen such injuries in young people in just the last couple of years. I personally knew of only two people who were murdered in the last 35 years, one who was the child of a friend (murdered by her new husband), and one who was the brother of a former student (murdered by a jealous rival in a love triangle). People who live in gang-ridden neighborhoods will have a different experience, of course. Over those same years, I have known, or known of, more young people than I can remember who have died or been very seriously injured (often permanently) in auto accidents.

Again, a reminder: 40% of those vehicle deaths are alcohol related.

Regarding medical insurance coverage, according to the CDC, in the year 2007:

…the percentage of persons who were uninsured at the time of the interview was highest among those aged 18-24 years (27.5%) and lowest among those under 18 years (8.9%) (Figure 4). Starting at age 18, younger adults were more likely than older adults to lack health insurance coverage. [emphasis mine]

That 27.5% is about TWICE the national average for uninsured status (around 14.5%), which includes all ages, races and sexes. Why is the rate of uninsured status lowest for children under age 18? Simple enough: they tend to be covered on their parent’s insurance until they are 18. The implication of this is straightforward: about 8.9% of adults with children do not have health insurance themselves, and so do not have it for their children.

Even before age as a consideration, the CDC had this to say about race/ethnicity:

Based on data from the 2007 NHIS, Hispanic persons were considerably more likely than non-Hispanic white persons, non-Hispanic black persons, and non-Hispanic Asian persons to be uninsured at the time of interview, to have been uninsured for at least part of the past 12 months, and to have been uninsured for more than a year (Table 7). Approximately one-third of Hispanic persons were uninsured at the time of interview [emphasis mine] or had been uninsured for at least part of the past year, and about one-fourth of Hispanic persons had been without health insurance coverage for more than a year.

And now, as promised, I present the touchstone to determine whether a true believer in univeral health care actually “cares about the children”, or is simply pursuing a political agenda for which such poses are convenient.

One touchstone is very simple: more children die of head injuries in auto accidents than any other way, certainly HUGELY more than die for lack of health insurance, or by firearm. If a person is not willing to demand and campaign for a law requiring everyone under the age of, say, 18 to wear a protective helmet when riding in a car (cost, maybe $50 per person), they have no moral standing to demand and campaign for universal health insurance (cost, maybe $3000-4000 per person per year). It is clear that the helmets would save FAR more lives and reduce FAR more suffering than any amount of health insurance.

What is more evidence of your compassion and concern for human beings?

1) your willingness to take a cheap step to reduce the NEED for medical care, and the liklihood of severy injury or death? Or,

2) your willingness to spend a very large amount of money to try to fix problems after they have occurred?

I think the answer is obvious.

Another touchstone: since 40% of fatal auto accidents are alcohol related, we should adopt very radical anti-drunk-driving laws, sufficiently toothy that almost no one will take the risk. Curiously, people who are FOR universal health care (again, requiring tax payer money) are often heard to recommend that we should be more like Europe in our health care policy. I wonder if they would resist our adoption of the drunk driving laws of, say, Germany? Or, we could make it really simple. Drive drunk (defined as a minimum percentage, and/or obvious impairment), and you lose your license for five years. Do it again, and you can never again have a license, and driving without a license in this circumstance is punishable by serious prison time. There would surely be less drunk driving, and MANY lives saved.

Either of these approaches, the helmets, or zero-tolerance drunk driving laws, would save far more lives than covering the uninsured, and also avoid many greivous non-fatal injuries. Together, they would dramatically reduce death and injury in the USA, for HUGELY less money than universal health care.

To be blunt: if you’re for the universal health care, and not for both of these policies, you’re a fraud, pretending you care for people’s health, when what you really care about is some kind of political agenda.

It won’t do to say that society wouldn’t put up with requiring helmets in cars, or with more radical drunk driving statutes. People said that about seat belts, and motorcycle helmets, but the laws exist in most states. And people DO modify their behavior when legal penalties are severe and certain. I don’t remember the last time I saw a cigarette lit in a restaurant in California.

By the way: the same argument applies to being for gun control because you think it will save lives. Either, or both, of these other policies will save MORE lives than removing all guns from society (as if that were possible), and without infringing on the Second Amendment and the basic right of self-defense. Again, you’re a fraud if you’re for gun control, and against helmets in cars and far more stringent drunk driving laws than we have now.

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Dec 18 2008

How much do YOU trust the government to handle life and death decisions for YOU?

Category: government,healthcare,left,militaryharmonicminer @ 10:00 am

Our military wins whenever it isn’t forced to quit by our civilian government. But it isn’t precisely “efficient”, and has the same amount of politics, stupidity, and shortsightedness as the rest of the world. When lives are on the line, that can be deadly.

WASHINGTON, Military leaders knew the dangers posed by roadside bombs before the start of the Iraq war but did little to develop vehicles that were known to better protect forces from what proved to be the conflict’s deadliest weapon, a report by the Pentagon inspector general says.

The Pentagon “was aware of the threat posed by mines and improvised explosive devices (IEDs) … and of the availability of mine resistant vehicles years before insurgent actions began in Iraq in 2003,” says the 72-page report, which was reviewed by USA TODAY.

The report is to be made public today.

Continue reading “How much do YOU trust the government to handle life and death decisions for YOU?”

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Jul 07 2008

The Apostle’s Creed of Universal Health Coverage

Category: healthcare,Uncategorizedharmonicminer @ 4:16 pm

Here it is.
I will, I suppose, be burned at the stake as a heretic for doubting.

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Jun 27 2008

Canadian Healthcare: NOT the model for USA

Category: healthcare,socialismharmonicminer @ 3:31 pm

I wrote earlier on the problems of “universal health care”, or pretty much any heavily regulated or government funded health care scheme, which inevitably leads to rationing. That is, while we can find cases in free market systems where people won’t get care, through no fault of their own, we’re foolish to ignore the fact that in government run systems, which will of necessity be rationed, there will also be people who suffer for lack of care.

Writing in Investor’s Business Daily, David Gratzer gives the lowdown on the Canadian experiment with socialized medical care. Claude Castonguay was perhaps the most powerful driving voice behind Canada’s adoption of government run healthcare.

Castonguay’s evolving view of Canadian health care, however, should weigh heavily on how the candidates think about the issue in this country.

Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform …..

The government followed his advice…. until eventually his ideas were implemented from coast to coast.

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

“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

Castonguay advocates contracting out services to the private sector, going so far as suggesting that public hospitals rent space during off-hours to entrepreneurial doctors. He supports co-pays for patients who want to see physicians. Castonguay, the man who championed public health insurance in Canada, now urges for the legalization of private health insurance. [emphasis mine]

In America, these ideas may not sound shocking. But in Canada, where the private sector has been shunned for decades, these are extraordinary views, especially coming from Castonguay. It’s as if John Maynard Keynes, resting on his British death bed in 1946, had declared that his faith in government interventionism was misplaced. [emphasis mine]

What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor. [emphasis mine]

Years ago, Canadians touted their health care system as the best in the world; today, Canadian health care stands in ruinous shape.

Sick with ovarian cancer, Sylvia de Vires, an Ontario woman afflicted with a 13-inch, fluid-filled tumor weighing 40 pounds, was unable to get timely care in Canada. She crossed the American border to Pontiac, Mich., where a surgeon removed the tumor, estimating she could not have lived longer than a few weeks more.

The Canadian government pays for U.S. medical care in some circumstances, but it declined to do so in de Vires’ case for a bureaucratically perfect, but inhumane, reason: She hadn’t properly filled out a form. At death’s door, de Vires should have done her paperwork better.

Read the whole thing.

The facts of economic life are these:

1) When governments engage in any form of price fixing, whether it is intervention in the market by fiat, or wholesale takeover of a sector of the economy, shortages will result. Period. No credible economist denies this. But politicians, or populist/progressive politicians, at any rate, would like to pretend that they can repeal the laws of economics whenever they think they see a good reason (that is, one that will help them get elected or stay in office).

2) No one, absolutely no one, nor any conceivable consortium of geniuses, is able to centrally plan a health care system that is more humane, supplying more health care to more people in a timely way, than the one now in the USA. The very best in the world have tried… and they have failed, pretty much without exception.

3) The US government’s interventions in the health care market, and earlier in wage fixing (in WWII, which led to our entire system of employer provided health insurance, which hid the true costs of health care from the users of it, and, along with Medicare, led directly to our current price spiral), is the single biggest factor in the high health care prices in the USA. But at least we don’t have serious shortages, mostly…. yet.

All of which leads to:

4) The government can only make things worse by further regulation, and most especially by dreaming up more plans that involve taking money from some people in the form of taxes to pay for the health care of others.

As Lazarus Long said (more or less… I didn’t take time to look up the exact quote), “No one ever learns anything from other people’s experience.”

He was wrong, of course, because some people clearly do. But it certainly seems to apply to governments, in spades.

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Jun 03 2008

Healthcare for everyone sounds good, but….

Category: Uncategorizedharmonicminer @ 11:34 pm

A young friend of mine (a graduate student in music) recently sent me an email, detailing his conversation with a friend on the virtues of government (universal) healthcare, and his sense of having inadequate answers to his friend’s points, even though my musician friend is generally conservative in his approach to most things.

Herewith, his questions, and my responses:

1. What would be the ideal solution for the healthcare situation?

This is the wrong question, if you believe that society has to look for a perfect solution in which everyone has all the healthcare they want or need. It is simply unattainable. I didn’t say hard, I didn’t say expensive, I said unattainable. Not a single society has managed it. What in the world makes anyone think we can? In Canada, people often die of cancer waiting for an MRI to diagnose it. Or, if they get the MRI, they die waiting for the surgery. Read here.

Do a Google search for various combinations of the words, “death, Canada, medical, wait, surgery, MRI” and any other words that come to mind. That’s how I found the link above. I didn’t know about it before beginning this post. It took about 25 seconds to find. There are others.

The choice is simply NOT between what we have now and perfection, because perfection (if defined in terms of the result that “everyone has all the healthcare they want or need at a price they don’t really notice”) is simply not available.

Let me put it another way: expensive cars tend to be safer. Many people died last year because they drove a cheap car. Some died because they rode a bike (couldn’t afford a car trip) and got hit BY a car, cheap or otherwise. What would happen if we decided, as a society, that everyone should have the same level of car safety, no matter what decisions they make personally about what they’re willing to buy?

You know, and so do I.

Right now, it is in line with the conservative principles of “Free Market” but it’s going terrible thus making this Universal Healthcare disaster look all the more appealing! Are things the way they should be?

No, things are not as they should be. The government has affected the way healthcare is distributed in the USA in several ways, some good, some bad, some indifferent. I’ll focus here on the bad, since we’re wondering how things “should” be.

First principles: when more of something desired is available at no apparent cost increase to the consumer, more of it will be used. When something desired costs the consumer in proportion to its use, less of it will be used than if the consumer pays no cost difference.

The first major way the federal government screwed up healthcare coverage was during World War II, as an unintended consequence of wage fixing in a limited labor market. Employers had to compete to find workers, because so many were off fighting the war, yet the government forbade them to raise wages, so they introduced the notion of “fringe benefits”, including health coverage. Since this coverage was pooled among all an employer’s workers, the net result for any given employee was a disconnect between how much health care they consumed and how much they paid for out of pocket. Providers of health care discovered they could charge a bit more without losing customers, because the cost was “spread around”, and wasn’t felt much by any given individual. That was the beginning of our current problem with prices.

When social security was created, there was no official “retirement” age. The age of 65 was chosen to begin benefits, because very few lived that long. It wasn’t going to cost much to fund, and everyone felt good about knowing someone’s grandma was getting money from the government (read, all of us). The result is that by the 1950s age 65 or so had become the EXPECTED retirement age. Yet, people were living longer and longer, and consuming more and more healthcare, during the period of time AFTER retirement when they no longer had “employer funded” healthcare. In any earlier time, more people would have worked longer, keeping their medical coverage if it was “employer funded”.

So, the combination of wage fixing/labor shortage leading to “employer funded” healthcare, and the effect of Social Security on retirement expectations combined with longer life spans, was that “more old people couldn’t afford healthcare”, whose prices had been steadily rising precisely because costs were hidden from the people actually consuming the healthcare, allowing providers to jack up prices a little at a time.

This led Congress to react by creating Medicare for the elderly (read, age 65, after employer health coverage stopped), which FURTHER insulated people from the effect of providers charging more. A hospital could get away with billing unnecessary charges, because no individual cared that much about controlling it. So could doctors. In fact, they could get away with setting fixed prices (HIGH ones) for particular procedures/tests, whether or not there was any direct relation between the expense of the test and the expertise and time it took to do. Have you seen those fixed prices in your automotive repair garage, “Brake jobs: $119 front disc”? Did you ever see a sign like that at the doctor’s office, or in the hospital? People USED to ask what something would cost, and providers USED to bargain with patients. These days, that happens precious little. Medicare really boosted the ability of providers to disconnect their pricing from consumer awareness and reaction, a guaranteed way to increase usage (demand), and therefore encourage prices to go even higher.

And when the standard Medicare price for, say, an xray became a certain amount, that amount became the FLOOR for pricing the same test for other patients who weren’t on Medicare. And so it went.

Now people live longer and longer, and retire sooner and sooner, and spend more and more time on government funded healthcare, and the predictable result is that ALL of our prices go up. We’ve increased demand, but not supply. It’s really pretty simple.

In addition, by regulating (FDA) the release of new medications so severely (and expensively), making it easy for patients to sue providers for outrageously out-of-proportion awards, and generally discouraging people from acting like actual consumers with choices based on price and need, we’ve seen a great deal of damage from government involvement in healthcare.

If not, what is the conservative solution to the absurd prices and difficulty in obtaining coverage for many?

Different consumers make different judgments about how much and what kind of healthcare they want to pay for. The common statistics about how many people are “uninsured” do not account for all the young, healthy adults with jobs sufficient to buy health coverage, but simply choose not to, in order to have a more luxurious lifestyle. It’s always a gamble, of course, but if a person is in their 20s and healthy, they may elect to buy a fancier car instead of health insurance they don’t expect to use much. Also, there will be young people in good health, just starting out, whose first job or two won’t offer health insurance as a benefit, but who will move up to a job that does.

These statistics also don’t account for other people who simply choose to take the gamble, preferring to buy lifestyle instead of insurance. The stats don’t account for people who are simply between jobs, with healthcare in each, but are currently uninsured, perhaps for a few weeks or months (and by the way, even though people often decide not to pay for it, coverage is available for such people, by federal law).

There are also people (including children in poor families) who cannot buy health insurance privately, but are currently covered under a federal or state program anyway. They are counted as “uninsured”, though the reality is different.

The BIG LIE is simple: it is that those millions who are currently uninsured are ALL people who can’t afford it now, and won’t be able to afford it next year. This is simply NOT the case. There is a group of “hardcore” uninsured adults who cannot afford to buy any level of health coverage, but it is far smaller than most people think.

I invite you to try to find true numbers that account for all these factors. It will be harder than you think, because the advocacy organizations who bandy about the stats don’t really want you to know. For example, they will say that some number, say, 45 million, were uninsured “sometime in 2005”. They don’t separate out the various groups I mentioned above, because it would RADICALLY change the numbers, and since it doesn’t help their case, they just don’t mention it. If you subtract illegal immigrants, young people who don’t need it or choose not to buy for reasons of their own, people who are between jobs at the point of measurement, etc., the number is around half of what they report. And a very large proportion of them are children who are covered by various existing government programs, but are still listed as “uninsured”.

So, does that mean ALL those people were without coverage ALL YEAR, and did not make economic decisions on their own, valuing other things over health insurance?

Of course, it does not.

2. In a debate on the universal healthcare issue with a staunch liberal, I was stumped when he cited the success of governmental control over such intities as Gas, Water, Electricity and the successful regulation of these utilities. He explained that we are all safe because the government sets standards concerning what can be in the water and how much of it etc. Is it good that the gov. is involved in these things?

Your friend is misinformed, or is distorting the situation, I’m not sure which, since I didn’t hear exactly what was said. I certainly agree that we need some reasonable set of standards for what constitutes safe drinking water. However, is there any reason to believe that private companies, suitably licensed, couldn’t do it as well? One of the characteristics of privately owned enterprises is competition, which includes a constantly improving product quality. Our water, however, is worse than it used to be in some ways, is it not? Regulation (and the stagnation it encourages [pun intended]) often means setting a lowest common denominator above which no improvement is likely.

What would happen if private water companies had to bid, maybe every 3-5 years, for the contract to put water into the public system? What if the criteria involved some combination of quality improvement and minimum price? And what motivation does ANYONE now working for or managing a public utility, with a guaranteed market and no competition, have to even adhere to current standards, let alone aspire to higher ones? Of course, they don’t do it REALLY badly, or they’d lose the gig… But they can be minimally sloppy about it all with no real consequence.

There is an extensive literature on privatization of public utilities, some pro, some con. Just type “public utility privatization” into Google. I think the pro position is winning on points. Britain (land of socialized medicine!) privatized many utilities under Margaret Thatcher in the 1980s. They actually improved on the US situation, with less regulation, and as a result there is actually some price competition and incentive to be more efficient.

3. Electricity was regulated in California until Enron people lobbied to degregulate and allow the free market to handle it. Then the Enron scandal was born and we are still paying the inflated Electricity prices today. What can we as Free Market advocates say about this? Or about the deregulation of the airline industry that is reported to be unsuccessful my some. Or the horrible gas prices of today?

It is a mistake to confuse simultaneity with cause and effect. It is a mistake to evaluate a reasonable policy by the results achieved when corrupt people implement it.

California was DUE an electricity crisis, with or without regulation, because it wasn’t building generation stations, but was increasing demand. The deregulation initiative was partly to try to allow the market some flexibility to deal with the fact the California simply wasn’t making enough electricity, and needed to get it from other states (trust me, I live here, and California wasn’t suddenly overcome at the state level with conservative economic sentiment… they were grasping at straws). But this is like using a generally good health strategy, such as eating right and getting exercise, to treat a serious disease that arose from previous BAD health habits. You will still be sick, and may get sicker, but if you blame your new health regimen for the disease, you’ll be seriously confused about cause and effect.

The reason California wasn’t building new generation stations was REGULATION, on many levels. It takes time for the market to undo the damage done by years of regulation. De-regulation is not a “quick fix”, it’s an overall good strategy for developing sufficient capacity and getting it where it needs to go.

Enron was a special case of corporate skullduggery combined with influence peddling and willful conspiracy on the part of certain government actors. Others have written about this in some detail, and I defer to them. There is a case to be made that Enron was unmasked in spite of regulation and government influence peddling, not because of it, and that de-regulation had nothing much to do with the timing of the debacle.

But, just to test the idea: if a large pharmaceutical company was found to be doing something illegal like deliberately cheapening its medications in a way that made them ineffective, and selling them as the original item, and cooking its books and lying about its financial status, and perjuring itself about its business practices, and lying about the scientific tests demonstrating the efficacy of its medications, would that be grounds for nationalizing all the OTHER pharmaceutical companies? That is essentially the argument being made by someone who says that the ENRON debacle proves we need to regulate the utilities and keep them in public hands.

We are still paying high electricity prices for several reasons: we haven’t built and gotten online enough plants in CA to keep up with demand, the price of oil to generate electricity continues to climb (along with everything else affected by the price of oil… Meaning almost everything, period.), and so on. But: as a percentage of my income, I pay less for electricity now than I did at the age of 25, per kilowatt hour (though I use more hours… And that’s part of my point; when demand goes up, supply has to go up, or prices will.). And we STILL do not have adequate competition in the generation/distribution business.

Similarly, we have high gas prices for very simple reasons: we have more people wanting oil (around the world and in the USA), but haven’t increased the supply, either of crude or refining capacity. We haven’t increased the supply of oil because Congress won’t let us drill on the north slope of Alaska (affecting about 1% of the “pristine tundra”), or off the coast of California, Oregon and Washington, or in the Gulf of Mexico, or for shale in the West, or develop coal to liquid technologies, or about twenty other things. And they’ve made sure that we have to burn oil to create electricity by making it essentially impossible to build a nuclear power plant.

Ask all the MILLIONS of people who have been able to fly (not just at lower prices, but fly, period) since airline deregulation, if they think the prices should have been kept artificially high, with no competition between the airlines.

Other factors

Without question, one contributor to costs in healthcare is the proliferation of new and expensive tests and procedures, many of which, though wonderful, are simply far beyond the scope of what medicine could do in some earlier era when medical care cost less. For these tests and procedures, it is even more critical that consumers know what they cost, and pay more to get them. But the current system tries to provide 21st century top flight care to everyone when most people still want to pay 1950s prices. One reason many procedures cost more than they used to is because the excess charge is used to fund the losses incurred by newer procedures whose cost cannot be fully passed on to the consumer and insurer. It’s hard to quantify how much this effect is, but it’s there, and won’t be solved by any amount of government intervention or regulation.

Medical science is going to advance. It is not beyond possibility that methods for extending life to a couple of centuries will be available in a few decades (I think I’m being conservative, actually). If those methods are very expensive, will the government decide that everyone must have them, regardless of cost? This is just not realistic. The economics of medical care can’t be ignored anymore than the economics of automobiles. We can’t all drive the safest car, and we can’t all get the best medical care, and that will be true essentially forever, or until such incredible advances in efficiency exist that medical care is a negligible part of the budget for almost anyone. After all, we CAN all drink the best cola beverage.

Conclusions

The bottom line for all of this: it’s very difficult to put the genie back in the bottle. The people have been misled about what it is reasonable to expect. They have been duped about the real cost of things. They are told the government is helping them, when nearly the exact opposite is the case, in terms of long term effect on the experiences of most people.

In very many ways, the government and regulation IS the problem in health care delivery. It is beyond me to explain why anyone would consider MORE of the same to be the solution, when it has created many of the problems in the first place.

We are going to have people who don’t get as much care as they need, or want. Period. The only question is whether they are “the uninsured” in our current system, or are on a waiting list in a nationalized system. But there will be people who don’t get the care they need when they need it, and people who get much more than they need, regardless of what system we adopt. The “uninsured”, in our system, at least have a chance of changing some of the aspects of their lives that have resulted in them being uninsured. People on a waiting list in a nationalized system have no options at all… except, perhaps, to come to the USA and buy the care they need.

In the meantime, there is simply no question that the USA is the world leader in healthcare innovation, and the reason is because the government isn’t in charge of all the research, and companies who DO the research stand to make some money from it.

Unfortunately, there will always be imperfect results in the world. And if we act prudently, and try to move the USA healthcare system away from the regulatory precipice, there will be people who individually experience negative effects from the change. Nevertheless, it is the right thing to do, for all those people who will positively benefit from making our system more efficient, not less, and more competitive, not less.

We can, however, create a great deal of suffering by trying to repeal the laws of economics.

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