10.16.09
Lies They Told Me About Healthcare
Okay, just needed to get this off my chest. I can’t stand the idiocy on all sides of the healthcare debate. Here are a small portion of the lies I have recently read about healthcare, with my refutations. I don’t link all the facts I’ve seen to refute these lies; look them up yourself.
1. The current bill will be revenue neutral. No it won’t. The assumptions in the bill are absurd. It will increase the deficit significantly.
2. Government death panels will ration care under proposed health bills. Under the bills most likely to pass, this is not the case. The death panels will be outsourced to the private insurers, who already have death panels. Sorry, but resources are not infinite. People will always die under every health system because their treatment is not cost effective. Someone will always make that decision.
3. Preventative care saves money. No, it usually doesn’t. Consider high blood pressure. Giving blood pressure medications to everyone who has high blood pressure reduces the number of heart attacks, but because the medications are given to many people who would never have had a heart attack, money is not saved. Preventative care is still usually cost effective, though, and that is what matters, saving life-years at as small a cost as possible.
4. We need single-payer healthcare (ie, government-funded care like Canada has). No we don’t. There are many different systems used in OECD countries, and plans (such as that of Switzerland) that do not have single-payer at all but require private health insurance have similar costs and outcomes to single-payer plans. Furthermore, there are many different hybrid systems, such as in France.
5. Surveys show people in America/England/Canada like their healthcare. This is irrelevant. 90% of people are fairly healthy; for them they will likely be satisfied anywhere. I for one have had the opportunity to see radiologists in both France and the United States. In both cases the diagnosis was quick and cheap. I paid maybe $300 out of pocket for multiple wrist x-rays and a consultation with a hand surgeon in the USA (and this is with a high-deductible health plan), and I was seen three days after calling for an appointment. In France I was seen in about the same time and paid maybe 40 Euros out of pocket for a consultation with a radiologist and a back x-ray.
6. A single-payer system will keep costs down. No, not really. Single payer or hybrid systems in England and France are having cost troubles just like here. The cost problems in the American system will not be cured by single-payer. See this great article in the New Yorker.
7. It is only because of greedy profiteering companies that our healthcare costs are so high. Actually, there are a decent number of health insurance companies and hospitals that are non-profits. Look at car insurance for a comparison: a non-profit mutual insurance company like Amica competes well with for-profit companies like Geico and Allstate, but the for-profit companies are on par in cost and service with the non-profits. With hospitals, for-profit hospitals often provide more charity care than non-profit hospitals.
8. The problems with our system can be fixed by reducing government interference and regulation. I am as much of a free-market ideologue as anyone (in fact, I consider myself to be an anarcho-capitalist rather than a libertarian, and I am definitely not a conservative), but there are problems with health insurance that are structural. The main problem is that many diseases are chronic, but health insurance is renewed annually. This is the pre-existing condition problem. One legitimate way around this problem is to force everyone to hold insurance. A free-market way around this problem would be for insurance companies to offer pre-existing condition insurance, separate from health insurance, such that if a person acquired a chronic disease during a 30-year term the insurance would pay for all future costs of the disease. This is a very risky kind of insurance to offer, though, and is unlikely to come into existence on its own. What is certain is that the present system of forcing insurance companies to cover pre-existing conditions, but only under certain conditions, is quite flawed.
9. Low American life expectancy (relative to other OECD countries) is proof that our health care system is flawed. I have blogged about this before. Life expectancy is driven by all sorts of things, and the US has higher violent death rates and accidental death rates than other countries. Furthermore, the quickest way to reduce life expectancy at birth is to have plenty of babies die. The US has more pre-term babies and babies to teen mothers than other OECD countries. Despite heroic neonatal ICU expenditures, many of those babies die. Rather than look at life expectancy, it makes more sense to compare disease rates and cure rates of diseases.
10. We should keep our current system of employer-provided health insurance. Even Obama tells people that the health care bills won’t take away their insurance. No matter what system you believe in, it makes no sense to tie health insurance to employment. This makes the labor force less mobile and reduces entrepreneurship.
11. Everybody has a right to good healthcare. Nobody should die because they can’t afford healthcare. These statements sound noble but when you apply them to other situations you will realize that they are absurd outside of a socialist utopia. People die every day in Detroit and Gary and Cleveland because they cannot afford to live in the suburbs and thus avoid crime. Tens of thousands of poor people die every year because they acquire disease from a poor diet or lead poisoning from living in a poorly kept-up building. Or they die of heat stroke because they cannot afford air conditioning or they die of diabetes or a heart attack because they do not have time to exercise due to working multiple jobs. The one thing that people consider most important is their health. As long as we are not living in a socialist utopia the rich will live longer and healthier lives because they can spend money on healthcare, personal care, safety, and quality food.
12. Single-payer healthcare will at least ensure access to decent basic care for the poor. Here in Michigan we have single-payer education: almost every school district receives the same amount of money from the state per capita. The poor students still get far worse education than the rich students, and for many school districts the education is truly horrendous.
13. Obamacare will be socialized medicine. Yes, it will be slightly more socialized than our current system, but Medicare, Medicaid, SCHIP, and the VA already spend a large chunk of our health dollars. In other words, our health are system is already quite socialized.