A friend of mine authored a story for a publication I'm creating- if anyone attended the San Francisco New Media Summit afterparty, I was there passing out business cards. It's called The Legionnaire. They decided to write about healthcare- she's fairly conservative, the kind of person that admires Ron Paul but wouldn't necessarily vote for him.
I read through it and decided to do something unplanned- write a counter-point. This story showcases the sort of free-market bullshit we're going to hear for months on end. The key is to fight back aggressively with strong arguments, good statistics, and aggressive rhetoric.
Below the fold is her story and my counter.
The Socialized Healthcare Pandemic and Why Masks Can’t Protect Us from this Bad Import
Every child will have the right to healthcare. This was the rallying cry behind S-CHIP, a recent bill to subsidize health care for children living below the poverty line. And the very premise seems impossible to oppose—at least from a political perspective. After all, who are we to deny a child the right to a healthy life?
One must question the idea of healthcare as a fundamental right. John Locke once established the rights to life, liberty and property. And these words were again translated into the philosophical basis of the United States by Thomas Jefferson as the rights to life, liberty, and the pursuit of happiness. In the modern incarnation, it has become a promise of equal opportunity.
Let me clear up some of the confusion that seems to be swarming around this issue first. Call it universal, socialized, or single payer healthcare, the object of this game is 100% coverage with equal treatment quality for all. And it’s not happening.
The topic of healthcare is really just a numbers game: one in seven Americans is uninsured, or has inadequate coverage. Healthcare accounts for 14% of the US’s GDP, totaling over 2.2 trillion USD in 2006. Government contributions, on the other hand, have been halved from 36% to 15%. Some of these figures may be familiar, and others, new and shocking, but one thing is certain: these numbers paint a grim picture for our future.
But on the other hand—one in every eight jobs depends on healthcare. Universal healthcare does not mean that everyone gets what they want when they want it. It does not guarantee that the Tiny Tim’s and Grandpa Bill’s will get the same treatment as the Joe Millionaire’s of the world. Let me use the Obama plan as my example.
The premise is to create a "public HMO" to compete with private companies. This is code for socialism—strong words true, but there can be no fair competition when the government is both a competitor and the regulator. It would jeopardize the millions of Americans whose jobs are tied into the healthcare industry and, according to a recent study by the Heritage Foundation, result in the loss of coverage for as many as 120 million Americans currently insured by employers under private plans. After all, if the standards of coverage are already being met by the "public plan", there would be no need for private employer funded insurance. This would leave millions of Americans with an even heavier burden.
In the spirit of Michael Moore’s Sicko, I want to turn our attention to Canada briefly. Health spending accounts for 27 to 45% of provincial budgets. Of these expenses, the federal government provides only 16% of the funds necessary for public healthcare. Compared to the overall block grants which cover 17% of all healthcare expenses in America, there is an enormous burden on the individual provinces.
Currently Canada has approximately 2.1 physicians per 1,000 people, one of the most severe medical shortages of all industrialized nations, which averages 3.2 physicians per 1,000 people. In fact, one in six Canadians doesn’t have a regular doctor. As a result, the a Fraser Institute Study found that, on any given day, there were 800,000 patients waiting for treatment, with an average wait time of 17.7 weeks.
Since hospitals are forced to rely on government funding exclusively, Canadian hospitals have 5 times fewer MRI machines per capita, and only a third as many CAT scanners as the United States. In addition, all expenses are reviewed on a case by case basis, resulting in an enormous bureaucracy centered on the provision of healthcare.
The numbers aren’t much better in other countries. In the UK, the doctor shortage has resulted in a massive lack of accountability: patients are 4 to 7 times more likely to die in surgery. Sweden has twice the infant mortality rate of the United States.
If there is such an inherently unpleasant aftertaste to "American Exceptionalism", then how can we assume that American will be able to pull off what none of her OECD compatriots have been able to? How can we lean such a massive burden on our overtaxed state budgets? Within my home state of Washington, our public schools are so starved of cash that in Seattle alone, there have been almost 200 teachers cut from the district payroll, and four special needs elementary schools have been closed. One of our most important highways, the Alaskan Way Viaduct, is slated to collapse at the next earthquake above a magnitude of 4.3—and we can’t afford to fix it.
Obama claims his plan will provide the same healthcare for all Americans. Here’s my question for Obama: if this public plan is so great, why is the Federal Employees Health Benefits Program so different? We should look to this as the standard for healthcare—in the absence of packaged coverage, our statesmen are free to choose the features right for them, and thus, dramatically lower their costs. To compare the public plan to the FEHBP is comparable to a "bait-and-switch"—a felony crime.
The solution to our problems can only be found in competition and choice. Japan, Germany, France, have all faced far fewer problems with their socialized healthcare systems, simply because they have allowed private competition to offer new options. However, in the United States, we are unwilling to risk the two-tiered system, one where wealth will determine the quality of care. But when 85% of employers offer only one healthcare plan, it is clear that the axe is hovering over the free market.
Even if we ignore the huge logistical leaps, there still remains a question regarding the quality of care. Creation of a public competitor would only serve to increase the wealth gap. No longer would death come for rich and poor equally—instead, only those that can afford the increased taxes, in addition to a private package, will receive that highest standard of care. In addition, those residing in poor states, such as Arkansas, will be ineligible for the same standard of care as those in a state with more available funds, such as Virginia.
How about defensive medicine? When all expenses must be justified and reported to the government for approval, we will find ourselves in a world where the mammogram for the woman without risk factors, or the preventative HPV vaccine becomes a distant memory. It means that more people will be left behind—after all, under a public plan, with limited resources, the treatment of a 70 year old kidney patient seems much less likely than the twenty year old with a broken leg. Are we willing to become the kind of society that evaluates worth based on fitness?
We may be able to provide 100% under universal healthcare, but it sure as hell won’t be equal.
Faux Capitalism- The Snake Oil of Free Market Healthcare
There seems to be a strawman in this conservative critique of socialized medicine- it seems to defend a greatly broken system while misconstruing the goals of universal coverage. Ultimately, there needs to be a great clarification- Obama's health plan is market-friendly, and it never will attempt to make sure everyone has equal quality heath coverage- just that everyone in the nation has some.
First of all, a new study must be brought up that validates the public plan. Healthcare is increasingly becoming consolidated- many markets now have a private monopoly. The largest insurer's median share grew to 47 percent in 2008, up 15 percent from six years ago. A public plan would simply make sure that everywhere in the United States, there is an actual market for healthcare- so private insurance can not get away with gouging simply because they have the only facilities citizens can access. In any other business, if there are antitrust considerations, companies are divided and made to compete- the public plan does this while also insuring that everyone gets coverage, increasing both efficiency and equity.
High costs are rampant in the United States because there is not strong preventative care, and insurance companies have greatly raised premiums. Sloppy legislation like Medicare Plan D has made existing public programs greatly expensive (the cost of medication is increasing four times faster than inflation, that the government cannot negotiate with drug companies over prices). The United States has a massive per-capita GDP but cannot even approach other countries in life expectancy or coverage. The idea that we need to raise taxes or spend more (thus taking away from other considerations) is a red herring- the United States spends more than twice what France and the United Kingdom do on healthcare.
This discussion of equality seems odd- the rich can get an unlimited amount of healthcare, while the poor get none. If the poor can get basic healthcare, the rich cannot suddenly get some kind of new, platinum edition of health coverage- any universal system will close the wealth gap and help restore equal opportunity. The number one cause of bankruptcy in the middle class is health expenses- a lack of universal coverage is enhancing disparity. A public plan creates healthy markets and citizens, and is within our reach with structural reforms.
I'll add some updates soon, perhaps.
