Tuesday, June 16, 2009

ObamaMed: Social Justice or History Unlearned?

Universal healthcare is one of President Obama’s latest, and arguably greatest, ambitions. The sales pitch is nothing new: 46 Million Americans without access to healthcare. Children are unable to get medical treatment. All such claims are without merit. While there may be 46 million Americans without insurance, they can certainly receive medical treatment at the many publicly supplemented hospitals around the country. Even (or especially) our illegal alien population takes advantage of this funding and utilizes our hospitals for medical care, and their numbers are included in the claim of 46 Million uninsured. Furthermore, there are numerous federal, state, and local insurance programs for “underprivileged” children to receive medical coverage – not to mention the many privately funded charities providing care. Finally, a full 20% of the reported 46 million uninsured are considered capable of paying for medical insurance, but choose not to.

Canadian healthcare is often upheld as the example of a working socialized healthcare system, but why then do so many Canadians come to the United States for elective surgery and pay out of their own pockets to do so? Even Canadian politicians, purported supporters of their single-payer system, are known to have elective surgery and ambulatory care in the U.S. Why have Canadian citizens with life-threatening conditions been redirected to U.S. hospitals for emergency care when Canadian hospitals have lacked the capacity to attend to them? The answer is that the public health system in Canada has capped physician incomes via arbitrarily limited per visit fees. There is a fundamental shortage of physicians and nurses resulting in rationing and government edicted prioritization. Many Canadians pay their taxes to fund their healthcare system, but pay out-of-pocket in America for surgery because they don’t want to wait 18 months for a hip replacement. There are extremely long waits for specialist and surgical treatment in Canada because of their rationing and government control. Our friend’s grandfather was suffering from intensive GI pain, but had to wait 6 months for simple diagnostics (colonoscopy) that would be performed the same week in the U.S. No wonder those who can afford to do so head for the U.S.

Although Canadian prescription drugs are often cheaper, prompting many Americans to cross the border for their purchase, the reality is that government caps on prices in Canada only mean the U.S. consumers are subsidizing Canadian drugs through higher prices in our country. In addition, many new drugs are not available in Canada because they are not authorized by the Canadian government owing to their high cost. Untold by the liberal media are the countless numbers of Canadians coming to America to buy drugs they cannot get in Canada.

Originally, Canadian public healthcare started out as an alternative to the private plans. However, Canada banned private alternatives. Why? Were they scamming consumers? No, liberal politicians cited the private plans as unfair because only wealthier Canadians could afford the plans which provided a greater level of medical care. This is termed a “two-tier” system. More recently, many Canadians have been purchasing (often through their employers) supplemental insurance to help cover the costs not paid by the government. Recent Supreme Court decisions in Canada have also indicated possible renewed support for private insurance citing the Canadian Bill of Rights, although the decision was put on hold at the request of the government. Yet many of the same politicians opposing private insurance as a “two-tier” approach to healthcare (public-bad, private-better) are also the same people paying for care in the United States – a rather blatant admonition that the public system in Canada is inferior to a private system. This reversing trend to greater privatization is also being seen in many European countries as government healthcare plans have failed to deliver on promises and preclude their citizens from seeking proper medical treatment.

While healthcare costs in the U.S. are indeed high, by what standard is a socialized system an improvement to what we have? Are we citizens so impressed with how our government has run the VA or Medicare and Medicaid that we want everyone to be subjected to the same low standard? My grandparents, after decades of responsibly paying their FICA, have to pay for supplemental insurance despite being required to receive “benefits” from our “free” Medicare system. Is this not still a two-tier system whereupon those who can afford to receive better care do? How then does Obama propose to equalize healthcare using a public system? It can only be by banning the private system. In fact, a private system could not possibly survive the competition from a public system.

In Massachusetts, the Mitt Romney plan is touted as a paragon of public healthcare that works. However, only the arbitrarily defined poor have their premiums supplemented while the rest of the population is required to carry insurance. Just because you make it illegal not to carry insurance doesn’t mean you “provided” healthcare to everyone. Additionally, the same problem exists: people who make more and carry insurance are supplementing those who are not paying for their own insurance – just as the insured naturally pay the cost of those who can’t afford the medical treatment the receive by virtue of higher premiums. In addition, the choice afforded residents in Massachusetts has dwindled to 5 approved medical plans; meanwhile, premiums have soared in the state since the plan has been put into effect.

Anyone pretending private health plans will not disappear through competitive elimination or legislative power is sorely misguided. The cost of the public plan will necessarily be higher than the current costs of medical care and the only way to pay for it is through higher taxes or more deficit spending. Businesses and wealthy individuals will be stuck with the bill. In what fantasy land would those businesses and individuals pay the higher taxes while still providing a private health plan to their employees? As the privately insured decrease in numbers the burden on the public system will swell. At this point the government can only raise taxes more (which won’t work because there will be no marginal increase in revenue) or cut costs. Cutting costs will entail rationing, government regulation of your life, long waiting times, and lower quality of care.

The only solution to our healthcare problem is to attack the root causes of the high costs. Healthcare consumers are distanced from the cost of their treatment through the insulation of their insurance coverage (or their lack of payment for services). Therefore, there are no market forces controlling prices. However, there are solutions entering the marketplace in the form of low-cost Health Savings Account (HSA) plans that incentivize cost-conscious consumption. These plans address one root cause of our rising costs. Tort reform addresses another. One of the highest costs facing private practices is malpractice insurance. I do not condone imposing a cap on non-economic damages; rather, I believe our judges need greater latitude in dismissing cases that lack merit. Alternatively, mandatory arbitration before taking cases to trial may also help curtail some of the superfluous cases. States that have enacted tort reforms related to medical malpractice have already seen declines in medical costs resulting from lower insurance premiums. Finally, the government needs to do more to prevent illegal immigration. Our healthcare systems are being heavily taxed, especially in border states, by illegals who use our hospitals, but do not pay for the services they receive. In some cases these costs are borne by government and passed on to citizens through taxes (or future taxes); in other cases, the costs are passed on to citizens by distributing the realized losses through higher costs for those patients that do pay their bills (either through insurance or directly).

Many people claim that greedy doctors are part of the root cause of high medical care costs. If this is true, then government healthcare (Medicare) and 3rd party payers (i.e. medical insurance) have made their “unquenched greed” possible by removing market forces from the medical industry. However, it is simply not true. While doctors can, and sometimes do, make good money I must question the motivation of anyone who is opposed to their success. Becoming a doctor requires 16 years of school and residency beyond high school education – sometimes more depending upon their area of specialty. This education comes at considerable cost and meager, if any, income during their training. Most doctors begin practice heavily indebted. It takes them decades to repay the debt and become wealthy. They do this while working grueling hours and sacrificing much of their personal life. General practitioners, who make up the majority of doctors in our country, have more reasonable hours, but also make far less than their specialist counterparts; typically $120,000 per year. To claim that a doctor’s income is unjustified is foolish. Pragmatic benevolence can only motivate a few in the medical field and certainly doesn’t pay the medical school bills. Therefore, we must rely on personal satisfaction along with substantial financial compensation (a.k.a. greed) to motivate the best and brightest minds into life-saving practice. Dictating the incomes of medical practioners will absolutely result in a decline in the quality of care received and a marked reduction in the number of doctors thereby causing shortages and long waiting periods.

President Obama claimed in his speech to the American Medical Association that he wasn’t proposing a socialist healthcare system. Obama definitely understands the opposition to anything labeled socialist, but publicly saying something isn’t sufficient redefinition. Under no uncertain terms, Obama is proposing a socialized system of healthcare. Medical insurance for the poor at the expense of the wealthy under the control of the government – can you provide a better example of socialism? Like all attempts before throughout the World this one will fail to deliver on its promises. The poor will still be waiting in long lines for inferior care, the middle class will be paying for their care and everyone else’s while realizing a reduction in quality, and the wealthy (albeit a smaller proportion) will continue to pay out-of-pocket for the care they want and need. In the end, nothing will be solved but we will all be bearing the cost of further government intrusion. ObamaMed is nothing more than another liberal malfeasance intended to give a false sense of power to the theoretical proletariat for the sole purpose of political pontification.

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