14 Jun 2009

Home Truths on Socialised Health Care

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Mark Steyn notes that the claim that government can deliver a scarce item cheaper to more people resembles promises to sell you a certain well-known bridge.

When President Barack Obama tells you he’s “reforming” health care to “control costs,” the point to remember is that the only way to “control costs” in health care is to have less of it. In a government system, the doctor, the nurse, the janitor and the Assistant Deputy Associate Director of Cost-Control System Management all have to be paid every Friday, so the sole means of “controlling costs” is to restrict the patient’s access to treatment. In the Province of Quebec, patients with severe incontinence – i.e., they’re in the bathroom 12 times a night – wait three years for a simple 30-minute procedure. True, Quebeckers have a year or two on Americans in the life expectancy hit parade, but, if you’re making 12 trips a night to the john 365 times a year for three years, in terms of life-spent-outside-the-bathroom expectancy, an uninsured Vermonter may actually come out ahead.

As Louis XV is said to have predicted, “Après moi, le deluge” – which seems as incisive an observation as any on a world in which freeborn citizens of the wealthiest societies in human history are content to rise from their beds every half-hour every night and traipse to the toilet for yet another flush simply because a government bureaucracy orders them to do so. “Health” is potentially a big-ticket item, but so’s a house and a car, and most folks manage to handle those without a Government Accommodation Plan or a Government Motor Vehicles System – or, at any rate, they did in pre-bailout America. …

[B]y historical standards, we’re loaded: We have TVs and iPods and machines to wash our clothes and our dishes. We’re the first society in which a symptom of poverty is obesity: Every man his own William Howard Taft. Of course we’re “vulnerable”: By definition, we always are. But to demand a government organized on the principle of preemptively “taking care” of potential “vulnerabilities” is to make all of us, in the long run, far more vulnerable. A society of children cannot survive, no matter how all-embracing the government nanny.

When I was young, eons ago, when dinosaurs still walked the earth, doctors didn’t turn people away because they didn’t have health insurance. When Doctor Jones ran into an indigent patient, he simply shrugged, took care of the patent, and figured that it was his turn to do something charitable.

What has changed isn’t human nature, but the intensity of our regulatory environment and our politics. Government tax policy gradually created a health care corporate regime in which people employed by big companies used to get any amount of health services for absolutely nothing.

When you don’t pay for things, you have no incentive to economize, so demand rose and health care costs dramatically escalated. Meanwhile, government went along giving away more and more free health care to the elderly. So a while back, it became a joint interest of government and insurance companies to do something to control costs.

They made a deal. Government would set fixed prices for procedures and services delivered via medicare, and insurance companies would only pay at those same (lesser) medicare rates. Hard cheese for doctors, of course, but hey! cost cutting is important.

We have since experienced a bizarre regime of increasingly reduced health insurance benefits, managed by occult fine print to bamboozle beneficiaries into thinking they have coverage until doctors and hospitals subsequently surprise them by balance billing. The balance is the difference between what insurance companies are willing to pay and what health care providers want to charge.

The current situation featuring constant covert fighting over dollars makes charity its victim, too. If a hospital or physician treats that derelict indigent for free, ahem! the eyeshade-wearing bean-counter in Mega Insurance’s head office contends that was only possible by adding extra unjustified costs to the services Mega is paying for, and Mega wants a refund. That refund, you see, is supposed to come from your uncle and mine in Washington.

Thus, Capitalism is busily greasing the skids as we slide into Socialism.

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