Saturday, March 1, 2008

Health Care Myth #3 - "Socialized" medicine is bad for you

Chrissy asked "why are you writing about health care, folks don't seem that interested?" Good question! I've been wondering why the comments have thinned out recently (is health care boring?). Bear with me, readers, I am almost done with the Health Care Myth series. Let's wrap it up by taking on Myth #3 - that universal, single-payer government-regulated health care plans like those found in western Europe and Canada (and which we've partially implemented here in the US in Medicaid and Medicare) result in lower quality & higher costs. The vast majority of Americans believe this unquestioningly, but does it make sense?

We're just not that rational (by the way, this podcast at Cato on the myth of the rational voter is brilliant - http://www.cato-at-liberty.org/2008/01/15/irrational-voters/) when it comes to health care. I began to think this a couple of months ago when a friend criticized Hillary's mandated universal coverage plan. I wondered why Hillary would propose something so distasteful as mandated coverage for all, and found that universal coverage lowers costs for everyone (not that I am all that enamored of Hillary's plan, since she lacks the cujones to propose a single-payer universal plan). But still Hillary is taking a big risk, because we Live-Free-Or-Die-Hards automatically reject any and all mandated behavior, no matter how beneficial that behavior might be.

The more I researched, the clearer became the disappointing realities of our hodge-podge "free market" American health care system. So why do so many Americans cling to this crappy, costly "free market" choice ("You can have my Blue Cross ID card when you can pry it from my cold, dead fingers.")? The only conclusion I can draw is that we Americans are (how do I put this gently?) - dumkopfs! American voters (along with the herd of poll driven politicians) are resolutely clinging to a "free market" health care system that costs us too much (see Myth #1), that delivers things we don't need (see Myth #2), and which provides a lower quality of health care than most any other western nation (see Myth #3). We absolutely refuse to consider a single-payer, universal health care plan, because...well, socialism is bad. Right?

We know that socialism is bad. The proof goes like this:
* The USSR was socialist.
* The USSR built lousy cars, baked crappy bread, and every comrade had bad teeth.
* All the bad bread and bad teeth led to the USSR's collapse.
* Ergo socialism is bad. QED.

It stands to reason that if socialism is bad, then socialized medicine must be bad. To which I say, "Not so fast, capitalism breath". There are a bunch of countries that have socialized medicine that provide much better health care than we have here in the US of A. Let's take a look at some statistics: (from http://www.oecd.org/dataoecd/46/33/38979719.pdf):

Country Life expect-
ancy
Infant mortality rate MDs per 1000 people Nurses per 1000 people Per capita spending on health (USD) Health-
care costs
as a percent of GDP



Australia 80.9 5.0 2.7 10.4 3,128 9.5


Canada 80.2 5.3 2.2 10.0 3,326 9.8


France 80.3 4.0 3.4 7.7 3,374 11.1


Germany 79.0 3.9 3.4 9.7 3,287 10.7


Japan 82.0 2.8 2.0 9.0 2,358 8.0


Sweden 80.6 2.4 3.4 10.6 3,149 9.1


UK 79.0 5.1 2.4 9.1 2,724 8.3


US 77.8 6.8 2.4 7.9 6,401 15.3



Every industrialized country on this list (except us) has a form of socialized medicine. They spend half what we do on health care, and they have higher quality as measured by life expectancy, infant mortality (and a bunch of other statistics you can find on the OECD site), etc. Hmmm, all those politicians and voters who scream that socialized medicine bites the stethoscope seem to be ignoring the facts!

I even went to the Heritage Foundation (motto - "Government Sucks") to look at their statistics on government run health care (Medicare), and here's what I found - http://www.heritage.org/Research/HealthCare/wm250.cfm

  • Spending for hospital and physician services by private insurance grew 18.1 percent faster than comparable Medicare spending between 1970 and 1999.
  • Spending trends began to diverge in the late 1980s, coincident with Medicare’s move to price schedules and crackdowns on fraud and abuse in the traditional fee-for-service program.

Talk about cognitive dissonance. Imagine how those Heritage neo-cons must feel when their own statistics show a government regulated health care program provides better cost controls than the free market. Leapin' lizards, Ayn Rand!

And here's more, on the relative overhead of Medicare and private insurance (from
http://www.medicareadvocacy.org/FAQ):

Medicare
administrative costs
2% of expenditures

2004 CMS statistics (10/2004)

Private health insurance
administrative costs
15% of expenditures
Kaiser, 4/2003
HMO
administrative costs
20% of expenditures
Kaiser, 4/2003

Can it be, that socialized medicine might be a major improvement for us? I have come to think that it would be. Our American "free-market" for health care is an abject failure no matter how you measure it. It pales in comparision to socialized medicine, in costs and quality. So why isn't every American (Michael Moore doesn't count, in fact I get a little nervous when I find myself agreeing with him) screaming for Medicare for all of us? Why is it so hard to change, when it is this clear that single-payer, government regulated universal coverage is far superior to the quasi-free market morass of medicine we have now? Why are all the presidential candidates (the ones left standing) offering watery privatized health care recipes made from a pinch of Medicare, a drop of government finger-wagging but four cups of big pharma freedom and three pounds of private insurance? Do we voters have any clue what is best for us?

I'm not confident that we'll figure it out, but hey, maybe we'll wake up and smell the sodium pentathol. Or we can move, en masse, to Canada...

7 comments:

lisajpetrie said...

Americans have been fiercely independent and "anti-tax" ever since they threw all of that tea in the harbor. It's just gonna be hard to change that mindset. Still, I'm holding out hope that we'll come to our senses, and agree to buy into a solid universal health care plan.

But I'm not so sure that's the answer to all of our health care problems. Consider who we are as Americans. We eat too much, and most of what we eat is unhealthy. We work too much. We don't spend enough time with our families away from the telly. We don't play outside. We're not nearly physical enough. We don't sauna. We don't value education. We take too many drugs, legal & illegal. We buy too much shit, and all of that stuff stresses us out. We ignore the poverty-stricken in this country, and they and their children suffer as a result of hopelessness and neglect, and we're left to tend to the crack-babies, family members in prison, and violence on the streets. *This* is why we're not healthy; not because we don't have universal health coverage. This is why our children are obese and suffering from ADHD. This is why adults and children both are fearful and anxious and depressed. So, John, when you use statistics to "prove" that socialized medicine will make us healthier, I'll have to disagree. Socializied medicine can't save us from ourselves. I think we have a lot of bad habits to break before it's "single payer to the rescue".

Still, I'm all for it, and appreciate all I have learned from these health care blog posts.

:)

Lisa

Christine said...

Just a small correction. My question was not why are you writing about this but why aren't more people interested.

I think Lisa is right, socialized medicine will not make us healthier since most of our disease is due to unhealthy habits. Will socialized medicine lead to more decisions like "we won't cover you, you took illegal drugs once or eat doughnuts or smoke cigarettes". Or, "we're saving healthcare dollars for the young so no healthcare after you're 80?" Will taxes for healthcare be based on your lifestyle? Shouldn't it?

Christine

Christine

Cynthia said...

Lisa, you make a very well-stated point. There are lots of ways to engineer social behavior -- taxes being the most obvious and commonly used. If we would agree to it, the same technique could be used to steer us toward healthier, more economical, behavior. That would be nice.

lisajpetrie said...

Cynthia and Chrissy's points bring to mind something I just read yesterday. One of the candidate's (I think it came from a candidate...?) ideas is to put a $2 health care tax on a pack of cigarettes to pay for universal health care costs.

Part of me thinks that's fair. Then part of me thinks that the Fast Food tax should be increased just as much. And the gas tax (wouldn't it be healthier to walk or bike...?), etc. Seems like smokers are always the easiest target. Not defending smokers necessarily, but in a way, I guess I am...?

In a way, it's like counting on gambling revenues to fund education. Should we just do it because it's the right thing to do...?

lisajpetrie said...

Oops. I meant to say "shouldn't" we just do it because it's the right thing to do...?

:)

Cynthia said...

might that candidate have been Huckabee?

pcs said...

I have learned alot from the healthcare series, too. The links have been fun to explore.

I think one reason Americans are not interested in socialized medicine because of what was implied in John's list of USSR horrors: long lines. There is a credit card ad on tv with a very glorious/triumphant jingle proclaiming "I want it all, I want it all, I want it all, and I want it now." Capitalists don't have to be so egocentric, do they? I'm confused by those that feel their ability to make tons of money has nothing to do with the good fortune of being born here and therefore does not obligate them to give anything back. I'm not saying hard work has nothing to do with it (although sometimes it really doesn't), just that the hard work has not happened in a vacuum. And is it so hard to see how taking care of everyone, even just a little bit, would benefit us all? The "hopelessness and neglect" that Lisa mentions create an ever-widening whirlpool of bitter desperation from which people will do anything to claw their way out. So while it may be "inconvenient" (pronounced as Dana Carvey's Church Lady would) to take a look at how to help people with fewer resources, it would reduce the conditions that lead to the crime, violence, drug addiction, etc that are even more inconvenient to us individually and as a society. The antipathy exists on both ends of the financial divide to be sure, but which side can overcome it more easily? Adding healthcare to the basic services provided (education, infrastructure, etc) only makes sense: the stronger the bridge is to get from poverty to being a productive member of society, the healthier we all will be.