Government Does Stuff Great
A fun video on “free” health care in Canada:
Nader Supports Health Savings Accounts?
In a recent article Ralph Nader attacks several critics of Obama’s health care reform proposal, including Cato:
Now enters the well-insured libertarian Cato Institute with full-page ads in the Washington Post and The New York Times charging Obama with pursuing government-run health care. A picture of Uncle Sam pointing under the headline “Your New Doctor.” Nonsense. The well-insured people at Cato should know better than to declare that this “government takeover” would “reduce health care quality.”
I agree that Cato employees are “well-insured” – a description so appropriate that Nader used it twice in a single paragraph. At Cato we have Health Savings Accounts, which are probably the closest thing to free market health insurance allowed by law.
It’s nice to see Nader, a proponent of socialized medicine, praise HSAs. But it’s unfortunate that his preferred options for health care would abolish HSAs entirely.
Filed under: Government and Politics; Health, Welfare & Entitlements
CBS News Reports on the Risks of Obama’s Health Care Plan
CBS News reports that if you choose Obama’s government-run health plan, you may be able to keep your doctor, but your doctor might not want to keep you.
CBS sat down with Cato health care expert Michael C. Cannon to discuss why doctors might be reluctant to accept patients who are insured under the government plan.
Ponnuru: Stop Socialized Medicine, in All Its Forms
As usual, National Review’s Ramesh Ponnuru offers sound advice on how Republicans, etc., should approach the Democrats’ health care reforms:
Karl Rove’s WSJ op-ed on health care reflects the thinking of a lot of Republicans. He concludes, “Defeating the public option should be a top priority for the GOP this year. Otherwise, our nation will be changed in damaging ways almost impossible to reverse.” In my view, Rove is defining Republican goals too narrowly.
Congress and the president can expand federal control of the health-care system a great deal without a “public option” (that is, a new government program to provide health insurance to people who choose it). They could set mandatory minimum standards for health insurance, impose price controls, mandate that individuals or employers buy insurance, and so forth. If Republicans say that the public option is the chief defect of liberals’ approach to health care, they may be leaving themselves with no rationale for opposing these steps if the Democrats drop it—which they might just do. (Or they might cosmetically weaken the public option in various ways. They could, for example, set up a “trigger” that brings the option into being only if certain conditions in the health market are met, and then design those conditions so that they will be met.)
The public option appears to be one of the biggest political vulnerabilities of the Democrats’ emerging health-care plan, but it isn’t the only one, and it shouldn’t be targeted to the exclusion of the plan’s other features—or of its general government-first orientation. Republicans ought to be making the case against individual mandates and employer mandates as well, both of which are disguised tax increases.
It isn’t incumbent on Republicans to see that a health-care bill passes Congress. To warrant conservative support, a bill should have no public option—but also no mandates and no price controls. Which is to say: No government-directed health-care system.
Ezra Klein: Socialized Medicine = Slavery
The Church of Universal Coverage really, really, really wants you to think that the Democratic health care reforms moving through Congress are not “socialized medicine.” Last year, I wrote a paper about why they’re wrong. On June 25, I’ll be debating the issue at a Cato policy forum with the Urban Institute’s Stan Dorn.
Today, The Washington Post’s Ezra Klein lends his voice to the chorus of socialized-medicine deniers. Klein doesn’t add much to the discussion, except for this: Klein (correctly) observes, “Socialized medicine is a system in which the government owns the means of providing medicine” (emphasis his). Single-payer systems, like the U.S. Medicare program or France’s health care system, are not socialized medicine because “the payer does not own the doctors.”
That’s right. Under socialized medicine, the government owns the doctors. When human beings can be owned, we call that slavery. Klein was probably just trying to do what other Church of Universal Coverage faithful have done over the past few years: narrow the definition of socialized medicine to the point where it has no meaning at all. (Duh, Canada doesn’t have socialized medicine — they don’t put Canadian doctors in chains, do they??)
Instead, Klein was inadvertently helpful because he clarified that the reforms he supports, and the reforms before Congress, would give the government ownership over the human capital of doctors and other clinicians. Whether we’re talking about wages, insurers’ assets, medical facilities, medical products, or even clinicians’ labor, ownership is a bundle of rights. If health care reform gives government the right to exclude people from using those resources in forbidden ways (e.g., retainer medicine, balance-billing, pure fee-for-service, whatever), then government gains control over a larger share of each bundle of ownership rights. That equals more state ownership — of financial, physical, and even human capital — which is the very yardstick Klein uses to define socialized medicine.
If only all the socialists could be so helpful.
Filed under: Cato Publications; Government and Politics; Health, Welfare & Entitlements
Cohn vs. AFP
The New Republic’s Jonathan Cohn accuses Americans for Prosperity (AFP) of “lies” for running an ad that claims “Washington wants to bring Canadian-style healthcare to the U.S.”
AFP’s ad is more defensible than Cohn’s criticisms of it.
Cohn elides the question of whether Shana Holmes (the woman featured in the ad) was almost killed by Canada’s Medicare system. For a supporter of single-payer like Cohn, that is tantamount to admitting that, yeah, socialized medicine sometimes kills people.
Cohn argues that the ad is unfair because Canada has many advantages over the U.S. health care sector. That may be true, but the ad doesn’t appear to defend American health care. It merely says, “government should never come in between your family and your doctor” and “Don’t give up your rights.” That’s not pro-American health care or anti-reform. It’s just anti- the type of reform that Cohn wants. And it points to one area where our semi-socialized U.S. health care sector appears to be superior to Canada’s: quicker access to intensive treatments. Sometimes, that saves lives. In fact, AFP could go farther and say that the United States has another edge over Canada, in that we develop nearly all of the best new medical technologies. In fact, our medical technologies save Canadian lives, but Canada’s health care system (and its supporters) steal the credit.
Yet “the real lie,” Cohn claims, is that the ad suggests that “Washington” wants to impose a Canadian-style system on the United States. Cohn calls that claim “demonstrably false.” But consider:
- President Obama has said he would prefer single-payer and has hinted that he would like to make incremental changes in that direction.
- Many people who support a new public plan (e.g., Paul Krugman) do so because they believe it will lead to single-payer.
- Massachusetts, which has already implemented most of the reforms that Obama and congressional Democrats are considering, is now contemplating a large leap toward Canadian-style health care by imposing capitation on its entire health care sector.
- Government rationing becomes increasingly likely as government revenues fail to keep pace with the cost of government’s health care promises. (See again, Massachusetts.)
- The Left wants government to ration care. That’s the point of the comparative-effectiveness research funding. That draft House Appropriations Committee report committed a classic Washington gaffe when it said that certain treatments “would no longer be prescribed,” because it was admitting the truth.
Cohn is correct that no politician of influence is saying she wants to impose a Canadian-style system on the United States. But I prefer to pay attention to what they’re doing.
AFP: 1. Cohn: 0.
Filed under: Cato Publications; Health, Welfare & Entitlements
Full of Sound and Fury, Signifying Nothing
That’s an apt way to describe this week’s health-care-reform media blitz by the White House.
It’s probably also a good way to describe this debate over that media blitz:
We’re Not Talking about Socialized Medicine — I Swear
According to an unnamed “top White House official”:
It’s hard to talk about socialized medicine when the hospitals, doctors, insurers, the private sector players are working with us at the White House.
Let me get this straight. A president who is ideologically committed to socialized medicine is negotiating with an industry that’s committed to making as much money as possible off of socialized medicine.
But don’t worry. If there’s one thing they’re not discussing, it’s socialized medicine.
Filed under: Cato Publications; General; Health, Welfare & Entitlements
Getting Our Terminology Straight
Dave Hornstein takes Martha Gore to task for describing Barack Obama’s health care reform plan as “nationalized health care.” “Let’s get our terminology straight,” Hornstein argues. “Nationalized or socialized medicine is a health care system that is publicly financed and delivered, such as Great Britain’s National Health Service. That is not part of Obama’s proposal or the Single Payer plan.”
Yes, let’s get our terminology straight. Socialized medicine exists to the extent that government controls medical resources and socializes the costs. What matters is who controls the money. Whether we nominally call doctors or hospitals private or public doesn’t matter. If they’re getting most of their checks from the government, that’s who’s in control.
If government controls the resources, it’s socialized medicine. The government can funnel the money through insurers and keep all the doctors and hospitals private and it would still be socialized medicine. If they have the money, they run the show. Everything else is just window dressing.
For more, see here.
Filed under: Cato Publications; Health, Welfare & Entitlements
Does the GOP Recognize Socialized Medicine When They See It?
Rumor has it that Republicans in the House and Senate will soon decide whether their alternative to the Democrats’ health care reforms will include an “individual mandate” — a legal requirement that all Americans obtain health insurance.
A recent Consensus Group statement shows that the entire free-market health policy community — including scholars from the Heritage Foundation — opposes such a move.
The Cato Institute has published one study arguing against an individual mandate in itself, and two studies critical of its use in Massachusetts. Cato will soon publish additional studies showing how an individual mandate has — as predicted — led to exploding costs and government rationing efforts in Massachusetts, and arguing against its use at the federal level.
Worse, as I explain in this study, an individual mandate is in fact a large leap toward socialized medicine — regardless of the fact that health insurance would remain nominally “private.” Republicans may oppose creating a new government health insurance program. Yet if they are willing to force Americans to purchase insurance, they will effectively nationalize the health insurance industry.
Finally, as I explain in this op-ed, an individual mandate is always accompanied by taxpayer subsidies to people who may (or may not) need aid to comply. The more people who rely on government aid for their health care, the harder life will become for the party of tax cuts. Bill Clinton showed that the best way to defeat tax cuts is to paint them as a threat to YOUR health care. Just in case doing the right thing isn’t reason enough to reject this horrid idea, Republicans should know that by supporting an individual mandate, they will be slitting their own throats.
All for an idea that doesn’t even command support from a majority of the public.
More Reasons Not to Nationalize Health Care
Advocates of a government takeover of the health care system routinely offer up horror stories of American medicine, and no system yet has found a way around the problem of human imperfection, especially when operating in a system with such distorted incentives–most from ill-considered government policies. Yet the horror stories in nationalized health care systems are manifold and tend to be more intractable since they result from government policy.
For instance, consider the quality of care delivered by hospitals in one region in Great Britain (with a hat-tip to Philip Klein of the American Spectator for finding this story). According to the Daily Telegraph:
Sir Ian Kennedy, chairman of the Healthcare Commission, said the report is a ’shocking story’ and that there were failures at almost every stage of care of emergency patients. “There is no doubt that patients will have suffered and some of them will have died as a result,” he said.
The investigation of the trust now called the Mid-Staffordshire NHS Foundation Trust, found overstretched and poorly trained nurses who turned off equipment because they did not know how to work it, newly qualified doctors left to care for patients recovering from surgery at night, patients left for hours in soiled bedclothes, reception staff expected to judge how seriousness of patients arriving at A&E, patients left without food or drink, others who received the wrong medication or none at all, blood and faeces left on lavatories and floors, and doctors diverted away from seriously ill patients in order to treat minor ones who were in danger of breaching the four hour waiting time target.
When high mortality rates triggered questions, the trust board of directors ‘fobbed off’ investigators by saying the rates were a result of statistical errors but the Healthcare Commission found this was not that case.
The report said there was a ‘reluctance to acknowledge or even consider that the care of patients was poor’.
The trust was more concerned with hitting targets, gaining Foundation Trust status and marketing and had ‘lost sight’ of its responsibilities for patient care, the report said.
Sir Ian said: “The resulting report is a shocking story. Our report tells a story of appalling standards of care and chaotic systems for looking after patients.”
While Britain tends to be near the bottom in terms of health care system in industrialized states, there are plenty of horror stories elsewhere. Socialism doesn’t work, whether in health care or elsewhere. As Investor’s Business Daily reminds us:
The Swedish government system is no better. It also refuses to provide some expensive medication and, inhumanely, refuses to let patients buy the drugs themselves. Why? According to a Journal of American Physicians and Surgeons article, bureaucrats believe doing so “would set a bad precedent and lead to unequal access to medicine.”
Like Canadians, Swedes are subjected to long waits. They also have denial-of-care problems that sometimes lead to death.
A reasonable person would see the record of repeated failures in government-run medicine as evidence that such a system is not sustainable. Yet every central planner thinks he or she — or his or her immediate group — is smart enough to correct the flaws of socialist programs and therefore has the moral authority to force others to participate in his experiments. It is the same thinking that will move a person to say we are the ones we’ve been waiting for.
The Obama administration seems determined to waste a lot of money “stimulating” the economy. We can replace money lost. But if the administration succeeds in nationalizing the medical system directly or indirectly, the damage may prove irreversible–and deadly.
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