WE PROTECT YOUR HEALTH

3/19/10

Most of the conversation, or at least most of the political conversation, this weekend centers on health care. As I think about this issue, three points come to mind, which I advance not because I am in favor the current health insurance plan that looks like it is about to become law (I’m not.), but, rather, because I am in favor of rational, rather than knee-jerk, unexamined, argumentation. There are plenty of reasons to oppose the plan without resorting to the following chestnuts that are emanating from those opposed to the plan.

--I addressed this one back in my 8/13/09 post, but it’s worth revising now that such hysteria is being peddled not only by Sarah Palin but by plenty of otherwise thoughtful, intelligent people. We are told that, under the “Obama Plan,” “death panels” will decide who gets “health care” and who doesn’t. We are told that our parents and grandparents will be condemned to death by a pack of faceless, uncaring bureaucrats. But turn off the right ring ranters for a moment and think about this argument for awhile. Just about everyone in this country over the age of 65 gets his or her health insurance, to a greater or lesser (usually greater) extent from Medicare, a government program. If the objective were to kill off the old people in order to save money, the government could do that right now through Medicare. It’s not doing that. Further, “death panels,” if that is what one chooses to call them, already exist, only in private insurance companies rather than the federal government. People die all the time because insurance companies deny them treatment. Perhaps one is willing to argue that large private bureaucracies are more compassionate or more caring than large government bureaucracies. I would argue that’s a close call.

--We are told how awful European and Canadian health systems (or the health systems of any country on earth, other than ours) are awful, terrible, hellish mechanisms which serve only to ration coverage and deny people the “health care” they deserve. We are constantly treated to the horror stories of those who were denied care by the national health systems of our closest international brethren and/or were forced to come to the U.S. for care. We are also told that our health care system is far superior to those in Europe, that no one capable of going anywhere would choose to go to Europe for a procedure rather than to the U.S.

Doubtless there are those who were denied care in Canada, England, or France. Doubtless there are those who have to wait longer than they would in the U.S. for care. And there probably are those who die in other countries who might have been saved here. Leave aside the argument there are plenty of people denied care here, either because they had no insurance or their insurance company denied coverage. Just ask, rather, if these foreign systems are so horrendous, why they are so popular in their home countries. Back in the ‘80s and ‘90s, there was a small but determined movement afoot, mostly from the right and most saliently championed by Pat Buchanan, to have the western provinces of Canada secede and join the United States. It actually made some sense; these resource rich provinces felt they were shortchanged by the older, industrialized, and resource poor, but population rich, east of Canada. America, in the Reagan and immediate post-Reagan years, seemed to be in ascendancy. But the idea never got very far, mostly because people in the western provinces would have no part of any scheme that involved their exchanging the Canadian health system for the U.S. health system. In England, the national health service is, perhaps sadly, as big a part of the fabric of English society and identity as that great nation’s long history as a, and, in some periods, the, global beacon of liberty. If one were to hold a vote in any European country, or in Japan or Canada, in which the citizens were asked to choose either their existing system or the American system, our system would get about as many votes as Harold Stassen did in the ‘50s and ‘60s.

The question one has to ask is if the “European” systems are so awful, why are they so popular?

And one more thing to think about for those who say that our system is so obviously superior to those in Europe: One of the big international stories this week was Egyptian President Hosni Mubarak’s efforts to show his citizenry that he is healthy and in charge after his recent surgery in…Germany. Mubarak could afford to go anywhere, but he chose to go to, and pay for, that hellish, socialist German system for his potentially life threatening surgery. And he’s not the only one. While we get our fair share of Middle Eastern, and other foreign, potentates seeking medical attention, plenty go to France, Germany, or England for even the most elaborate operations and procedures. If those systems, as some would have you believe, stifle innovation by bureaucratic rationing of care and thus are no match for our system, why do people who could go anywhere choose to go there?

--People who, like I, are great believers in the free market say that if the market is given a chance to work in health care, it will work the same magic in health insurance as it does in most other areas of human endeavor. What these people, almost all of whom get their health insurance through work or the government, don’t understand is that there is no free market in health insurance, at least for those who buy their own insurance. Once you have a pre-existing condition (Under the current system, “pre-existing condition” means one has been to a doctor on more than one, or sometimes only one, occasion for a condition, even if that condition is deemed to have been addressed and/or eliminated. If you don’t believe me, try applying for individual insurance and see for yourself.), you no longer can “shop” for health insurance because the only insurer who will cover you is your current insurer, and only because, according to regulation, that insurer has to continue to offer insurance. So once you have visited the doctor for a certain condition, even a seemingly harmless condition, you are trapped in your current insurance company, and your insurance company knows it. Rates skyrocket and there is not a damn thing you can do about it but reduce your coverage to the point at which you are paying still outrageous premia to cover only the most catastrophic of illnesses and to purchase a few “discount coupons” for health expenditures. If I am wrong about this, please show me where I am wrong; it would save me a LOT of money.

Opponents of the Obama proposal say that they recognize the problem of preexisting conditions and that the problem can be addressed by a simple reform. But once you start requiring insurers to cover all comers, you either force them to charge premia that are unaffordable to all but a few or you heavily regulate premia, effectively telling insurance companies that they must charge the very sick non-economic rates. If the former, what would be accomplished? If the latter, the process would be effectively socialized anyway.

Again, these are not arguments in favor of ObamaCare but, rather, arguments in favor of reasoned discussion rather than mindless repeating of spoon fed, and consumed, drivel that withers upon the most cursory of examination.