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Middle of the Road in Healthcare Leads to Socialism

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Publié le 26 août 2013
591 mots - Temps de lecture : 1 - 2 minutes
( 12 votes, 4,3/5 ) , 7 commentaires
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Rubrique : Or et Argent

The ever-expanding role of government in healthcare provides an excellent example of Ludwig Von Mises' warning that "The Middle of the Road Leads to Socialism." Beginning in the 1940s, government policies distorted the health care market, causing prices to rise and denying many Americans access to quality care. Congress reacted to the problems caused by their prior interventions with new interventions, such as the HMO Act, ERISA, EMTLA, and various federal entitlement programs. Each new federal intervention not only failed to fix the problems it was supposedly created to solve, it created new problems, leading to calls for even more new federal interventions. This process culminated in 2010, when Congress passed Obamacare.

Contrary to the claims of some of its opponents, Obamacare is not socialized medicine. It is corporatized medicine. After all, the central feature of Obamacare is the mandate that all Americans buy health insurance from private health insurance companies. And, as with previous government interventions in the marketplace, Obamacare is not only failing to correct the problems caused by prior federal laws, it is creating new problems.

Consider the almost weekly stories about how Obamacare is causing health insurance premiums to rise, causing employees to lay off workers or reduce their workers' hours, and causing doctors to leave the profession. Also, consider the problems the administration is already having administering the federal exchanges and other parts of the health care law.

I fully expect the implosion of Obamacare to continue, and the supporters of nationalized health care to use Obamacare's failures to push for a Canadian-style "single payer" health care system. Unfortunately, some Obamacare opponents fail to see that the problem is not just Obamacare, but all government interference with health care. These Obamacare opponents advocate replacing Obamacare with "Obamacare lite." But economic law teaches us that "Obamacare lite" will be no more successful than Obamacare.

In order to win the battle for health freedom, those who oppose nationalized health care must have the courage to advocate for a complete free market in health care. Enhanced individual tax credits and enhanced use of Health Savings Accounts (HSA) are just two polices that could help restore a free-market in health care by putting control over the health care dollar back in the hands of the people. A good place to start would be to repeal Obamacare's restrictions on HSAs.

Long-term group insurance contracts could ensure that those with pre-existing conditions could obtain coverage. Under such a contract, individuals could pool resources to purchase a group policy that would cover any and all problems any member might develop over time. Businesses, churches, community organizations, and even fraternities and sororities could offer these types of contracts.

Negative outcomes insurance, where patients waive the right to sue for medical errors in exchange for guaranteed payouts to those harmed, could reduce the burden of malpractice litigation.

Other free-market health care reforms that could make the health care market more competitive and lower the cost of health care include allowing individuals to purchase insurance from across state lines, removing restrictions on physician-owned hospitals, and reducing the regulatory power of the Food and Drug Administration.

Some will say it is unrealistic to advocate replacing Obamacare with a pure free-market system, but in fact it is unrealistic to expect anything less than a true free-market to provide quality health care for Americans at all income levels. Continuing on the "middle of the road" in health care by mixing free-markets with government spending and regulations will only continue to take us on the road to socialized health care.

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Dr. Paul reveals with this article the perils inherent in being an ideologue. He advocates for health care based on a free market system. He sees the need for health insurance, but does not want the government involved. It is a position totally in keeping with Libertarian philosophy. However, to proclaim it, one must remain ignorant of health care systems in every other western nation (including Japan). If results are to be the criteria by which we judge systems, with a health care system we need to look at both the actual cost of the program as well as medical outcomes. There is no nation in the western world with such high cost per citizen as America. And as best as i can recall, if life expectancy is used as the criteria employed to judge medical outcomes, Americans die at a younger age than do the citizens of the other countries.

Citizens of these nations live longer, pay less for their health care and marvel at the incredible stupidity of Americans on this issue. The free market does not always deliver the best outcome and that applies to more fields than just health care. If you live in a jurisdiction where the public utilities were sold to private enterprise, you are almost certain to be paying more for your water, electricity or what have you than before.

So then, while free markets are wonderful things, they are not so in every instance and in the area of health care, the numbers make for an incontrovertible case for socialized medicine. One can only argue otherwise if one is prepared to state that paying more to die sooner is preferable.
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It's really simple to understand the differences between true socialized medicine and US free(?) market medicine.

MRI to check knee in Canada = 12 weeks (give or take a few weeks depending on the province you live in) waiting time
Same MRI in the UK = 7 weeks waiting time
Same MRI in the US = 2 weeks waiting time if you’re buying decent coverage
Same MRI in Mexico = 2 days if you’re paying cash

You figure it out. If health is dependent on the time required for a diagnosis then the US medical system is still looking good.
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If having good pictures taken of one's knee were the only criteria to judge such things by, America would be a shining example for the rest of the world. Sadly, that is not the case. A health care system that sees its citizens living longer implies that critical diagnostic tests are being performed in a timely fashion, otherwise the citizens of nations with socialized medicine would be dropping like flies. But they are living longer than their American counterparts, which does not make the American system seem all that wonderful. And Americans are paying more for the "privilege" of dying younger, which seems like a rather damning indictment of the American for profit system. Moreover, not a single citizen living in a country with socialized health care has ever been forced into personal bankruptcy as a result of medical bills. Correct me if i am wrong, but are not huge medical bills the number one cause of personal bankruptcies in America?

The difference in outcomes is attributable to each having a different focus. Nations with socialized medicine have as their primary concern the health of their citizens. The primary focus in America is the well-being of the insurance providers as detailed in their bottom lines. That is why the first question one is asked when going to the hospital emergency room in each jurisdiction is so very different. In countries with socialized medicine they want to know what is wrong with you. In America they want to know if you can pay for the treatment you require.

So then, aside from the rather meaningless statistic of just how quickly non-critical diagnostic tests are performed for those with decent insurance, the American system comes out on bottom when meaningful comparisons (overall costs and life expectancy) are made to other western nations. Only ideologues and those with shares in the health care insurance companies would (ineffectually) argue otherwise.
Point taken, a better example may have been an MRI of the lower intestine/colon.

As for the shorter life expectancy of Americans, personal observation would put poor eating habits and excess sugar and salt along with various other chemicals that the USDA permits in American food high on the list of items causing Americans to die prematurely. When held up against the same foods distributed in other countries almost universally the goods sold within the US contain higher levels of X (place whatever chemical or substance that is bad for human health here). A good indication that a population isn’t eating properly is that most grocery stores have 10% - 15% of their shelf space devoted to junk food and only a small corner promoting fresh produce. In addition to this, look at the comfortable life style most Americans engage in.

As a non-American, whenever I've traveled into the states a chemical analyses isn't required to tell me that more salt and sugar are included in the recipes used for American consumption. Everything is sticky sweet, it takes me a week to come back down, and loaded with so much salt my blood pressure hit’s uncharted highs. Coupled with a more sedate lifestyle, this is in my opinion a major cause of the medical services being overloaded and shortened lifespans in America.
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While i accept your point about diet and exercise contributing to the comparatively poor life expectancy of Americans when compared to Kiwis, it may not be quite so true if we consider Brits, who never met a vegetable they liked and are not well known for their active life styles. Be that as it may, your line of reasoning says nothing about the significantly higher costs of the American for profit system. So, even if we stipulate that Americans would live as long as their counterparts were it not for their diet and sedentary life styles, we would still be left with the fact that Americans pay about 50% more to do so. And so unless i am missing something, there seems no plausible way to spin this in favour of the American model.
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On the matter of costs in the US vs. other countries. For decades doctors, nurses, lab techs, and almost anyone with training in any medical profession was lured to the US as the compensation was often twice or greater than could be received at home. Take these high costs for staffing and now lets ad on huge costs from liability exposure in the form of law suits and insurance to get an understanding of what helps drive up costs. Law suits against doctors is almost unheard of in many countries with government provided health care and when there is a case wherein the patient wins the awards are minuscule compared to what would be paid out in the US. While not sufficient to break the bank, these two items will have contributed to the huge costs the public has endured. Share holders in the various companies, running multiple hospitals not to mention pharmaceuticals, have made great profits, as they expected when investing in these organizations. This, pharmaceuticals, is another aspect that when compared to other countries can contribute a substantial amount to overall costs. How many billions of dollars are spent on pharmaceuticals in US hospitals every year? Again the pharmaceutical companies know how to charge to compensate for money they will have to pay out to winners of law suits. Years ago I needed a prescription for some antibiotics while traveling in south America. Cost was the equivalent of $12.00 whereas the same medication 3 months later at home was $85.00. To glean a real understanding of where the money goes, a look at the breakdown of all related costs without any details being fudged, or creative embellishment, could be very enlightening. While derived profits are substantial I still suspect that this is small compared to actual costs.

Additionally, timely access to technology such as CT Scans, MRI, and even lab results loads the system with higher costs but you get what you pay for. A real world example of this is the number of people from countries with socialized medicine willing to pay the travel costs as well as cash for treatments and diagnosis in countries like Mexico or Guatemala. Personal opinion will of course vary on the quality of service people will receive in these countries and there are many horror stories but there are as many stories of needless suffering caused by horrendous wait times in countries like the UK and Canada.

Your point that the American systems are for profit, so are those in countries with socialized medicine schemes. As proof that socialized health care provides profits, an easily observable example for anyone would be the accoutrements and palatial landscaped gardens found in and around hospitals in these countries. If there were no profit monies would not be spent on glorifying these institutions. There is so much more, it would come down to analyzing at a micro level to see what the money is thrown at so keeping this discussion at a 10000 foot level and looking at the bigger slices of pie is adequate.

Interestingly, some Canadian provinces are looking at offering a mix of private and government health care. If implemented, in a few years time there should be enough data to ascertain which provided the best care vs. cost.
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I think the piece you may be missing, is that Dr. Paul is saying a free-market health care system would work better. He is not saying that the present or recent (pre-Obamacare) system is better. You are acting like the US market was a free market, when according to Dr. Paul, it was not. Although you did not have a Canadian type system,your government still had "government policies and entitlement programs starting in the 1940's", as Dr. Paul states in his opening paragraph. So to base your argument around pretending the US had free market healthcare, is misleading. Also, I would like to point out that although we can walk into a Dr. Office here in Canada, and not apear to pay a cent, we are really paying a lot. Like "more than we can afford". let me explain. First, our tax rates are higher than the US. Second, our government is in a lot of debt. The USA spends money it does not have, on wars it should not start. In Canada, our government spends money we do not have, to provide "free healthcare", to old smokers or drinkers with lung or liver cancer. For Free! And guess who will pay for it? The children and grandchildren and great-grandchildren. I have a problem with paying the medical bills of those who do not exercise, are to lazy to read about nutrition or even use common sense, and who smoke, drink excessively, etc. I would rather spend my hard earned dollars buying myself farm fresh organic food, and also on things like yoga, gym membership, race entry fees, etc. That way, I will keep myself healthier, and no-one else will have to pay for my huge healthcare bill. If young people saw their grandpa or parent have to sell the house and car, to pay for the cancer treatment from an unhealthy lifestyle, they would think twice about lifestyle choices. I know that there are many health issues that come up that are unavoidable, but pretending that we can pay for it all, with a government run bourocracy forced upon all, is not the correct solution. This will become evident in the near future when the baby-boom (me first) generation starts overwhelming the system with it's demands in retirement, and there is no way to pay for it anymore.
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I think the piece you may be missing, is that Dr. Paul is saying a free-market health care system would work better. He is not saying that the present or recent (pre-Obamacare) system is better. You are acting like the US market was a free market, when  Lire la suite
scepticofall - 27/08/2013 à 07:04 GMT
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