Posts tagged with: socialized medicine

A new study by Grand Valley State University professors Leslie Muller and Paul Isely suggests that the Affordable Care Act has already cost West Michigan 1000 jobs. Muller summarized the results in a Wood TV story:

“Firms are actually holding off on hiring or their reducing their hiring that they were thinking they were going to be doing because of the ACA,” said Muller.

The 1,000 jobs lost does not include the number of workers in West Michigan that have lost hours to ensure that they are kept as part-time employees. Nearly one-third of companies said they have cut employees’ hours.

“We’re talking about a thousand jobs in West Michigan that would have been here absent the ACA,” Muller said.

The study found lower-skilled jobs tend to be suffering the most.

(more…)

In today’s Acton Commentary I explore how our hyper-regulated and increasingly statist healthcare system is chasing off good physicians.

A recent article in Forbes by Bruce Japsen provides some additional support for that argument:

Doctor and nurse vacancies are approaching nearly 20 percent at hospitals as these facilities prepare to be inundated by millions of patients who have the ability to pay for medical care thanks to the Affordable Care Act.

A survey by health care provider staffing firm AMN Healthcare shows the vacancy rate for physicians at hospitals near 18 percent in 2013 while the nurse vacancy rate is 17 percent. That vacancy rate is more than three times what it was just four years ago when vacancies for nurses were just 5.5 percent in 2009 while vacancies for doctors were 10.7 percent.

It’s not all doom and gloom. In an earlier Forbes piece, Scott Gottlieb, an internist and fellow at the American Enterprise Institute, argues that technological and organizational innovation will allow quality health care to be delivered using fewer physicians.

If allowed to proceed, these innovations may actually increase market freedom in one area. Physician organizations and medical schools often have replicated a pernicious feature of the traditional guild, namely, finding ways to limit the number of new physicians not purely as a quality control measure but, beyond this, as a way to ensure that existing physicians are in high demand. (more…)

Both the original and compromise versions of the Obama administration’s health insurance mandate (the HHS mandate) coerce people into paying, either directly or indirectly, for other people’s contraception. The policy may have been pushed along by exigencies of Democratic Party constituency politics, but I suspect there’s also a worldview dimension to the mandate, one embodied in one of President Obama’s more controversial appointments—Science and Technology Policy Director John Holdren.

Holdren, as far as I know, wasn’t involved in crafting President Obama’s healthcare plan or the HHS mandate, but the appointment and the mandate both fit the same anti-natalist pattern that has characterized President Obama’s political career at least as far back as his votes against the Born Alive Infant Protection Act when he was an Illinois state senator.

How the Holdren appointment fits the pattern comes to light with only a little digging. In the 1970s, Holdren pushed various population control schemes, not all of them voluntary. Here’s a sampling from his co-authored textbook Ecoscience: Population, Resources, Environment:

“It would even be possible to require pregnant single women to marry or have abortions, perhaps as an alternative to placement for adoption, depending on the society.” (P. 786)

“A program of sterilizing women after their second or third child, despite the relatively greater difficulty of the operation than vasectomy, might be easier to implement than trying to sterilize men. This of course would be feasible only in countries where the majority of births are medically assisted. Unfortunately, such a program therefore is not practical for most less developed countries.” (P. 787)

“The development of a long-term sterilizing capsule that could be implanted under the skin and removed when pregnancy is desired opens additional possibilities for coercive fertility control. The capsule could be implanted at puberty and might be removable, with official permission, for a limited number of births.” (P. 787)

According to Washington Times reporter Amanda Carpenter, Holdren’s office issued a statement distancing him from the forced sterilization policies outlined in the book, while Holdren’s co-authors defended him and themselves by saying the textbook was over 30 years old and that the many unsettling excerpts cited in the media were “description … misrepresented as endorsement.”

Yes, the book is 30 years old; but spending a little time in the pages of the book suggests that, at the time, Holdren and his co-authors meant what they said. Take page 838. If you have time, read the whole page, but here are three passages that stand out:

“Individual rights must be balanced against the power of the government to control human reproduction.”

“The law regulates other highly personal matters. For example, no one may lawfully have more than one spouse at a time. Why should the law not be able to prevent a person from having more than two children?”

“Thus, while the due-process and equal-protection limitations preclude the passage of capricious or discriminatory laws, neither guarantees anyone the right to have more than his or her fair share of children, if such a right is shown to conflict with other rights and freedoms.”

The chapter title that contains this page: “The Human Predicament: Finding a Way Out.”
I realize the HHS mandate is a far cry from the extreme measures suggested in these quotations, but the policy proposals then and now do seem to flow out of the same view of the human person—as a burden rather than as a blessing and potential creator who is able to solve problems and create new wealth and resources.

If you view fertility as a “human predicament” from which we desperately need to find “a way out,” you’re more likely to go looking for some politically feasible policy to limit the number of mouths. The Obama administration may have found just such a politically feasible policy in the mandate to coerce Americans to cover the costs of other people’s contraception. Time will tell.

HT: http://zombietime.com/john_holdren/

Despite a promise of “complete and fair coverage of health care for everyone for free,” the Greek state-controlled system is broken and corrupt, the Athens daily ekathimerini.com reports. Predictably, Greeks have taken it upon themselves to build a private health care sector:

Despite hikes in Greece’s health spending between 2000 to 2008 being among the highest of all OECD countries, this has not been matched by growing life expectancy rates, the report added. Turning to the hospital system, corruption has grown due to poorly run operations and an improper organisation structure with about one in five Greeks admitting to having paid a bribe in order to receive medical treatment at a state hospital. These problems have contributed to growth in the private healthcare industry which provides crucial services but also enjoys the benefit of not having any competition, the report added.

In the UK, the National Health Service has been using hospital beds as housing for senior care, to the detriment of people who actually need hospital beds. From the Telegraph:

If current trends continue, almost 100,000 of 170,000 NHS beds will end up being filled by elderly people who are well enough to be in residential care. This will cost the health service millions of pounds and throw its day-to-day operations into chaos, says the report by Bupa, the health insurance and care provider. It blames the looming crisis on a “17-year legacy of under-funding in the care home sector”. The next few years will see the problem getting progressively worse, the report’s authors predict, despite a Coalition pledge that local authorities will have an extra £2 billion to spend on adult social care over the next four years.

For more on this issue, see Acton’s Health Care resource page.

drdog-2In August, the Wall Street Journal Europe published an article exploring the difference in health care received by domesticated animals and humans. (see “Man Vs. Mutt: Who Gets the Better Treatment?” in WSJ Europe, August 8, 2009) The editorialist, Theodore Dalrymple (pen name for outspoken British physician and NHS critic, Dr. Anthony Daniels) argued that dogs and other human pets in his country receive much better routine and critical healthcare than humans: their treatment is “much more pleasant than British humans have to endure.”

Dalrymple outlines just why this is so: pets in the U.K. actually have it better than their owners since: a) they receive immediate treatment with no waitlists or postponed operations “(and) not because hamsters come first”; b) there is no fear that somehow they are being denied the proper treatment for economic reasons: there is “no tension, no feeling that one more patient will bring the whole system to collapse…; (no one is) terrified that someone is getting more out of the system than they.”; and c) pets in veterinary facilities have more options and flexibility for choosing a healthcare practitioner: “if you don’t like him, you can pick up your leash and go elsewhere.”

British humans, on the other hand, have to deal with navigating the rapids and swells of NHS bureaucracy, which requires the skills of a “white-water canoeist”. They must also endure interminable wait-times for prostheses and life-improving operations. Often they receive sub-standard administrative services, nursing assistance and meal provisions.

As President Obama continues to promote a Europeanization of the American healthcare model, the WSJ Europe editorialist beckons us to listen to such howling in the twilight of the Old Continent’s rapidly aging nationalized healthcare systems. Part of this howling is caused in the less dignified forms of public health services and treatment of human patients. Yet, there is plenty of loud barking over the mismanagement and abuse within nationalized healthcare across Western Europe, particularly in terms of mishandling budgets and sources of revenue. (more…)

Blog author: jwitt
posted by on Friday, September 18, 2009

If it doesn’t faze you that

  1. Uncle Sam badly mishandled the stimulus porkanaza
  2. Congress would have directed bazillions to a surreally corrupt Acorn but for these two young heroes
  3. Michael Moore’s Sicko is Wacko
  4. Canadians will no longer have a free market healthcare system to flee to
  5. Government-run health care will look and smell and feel like the Department of Motor Vehicles … with sharp needles and bedpans
  6. If none of this has convinced you that a government-run healthcare system is a bad idea, then spend some time perusing Jay Richards’ thoughtful blogging work on health care here at The Enterprise Blog.

And have a blessed weekend.

ABC is refusing to air a national ad by The League of American Voters, featuring a neurosurgeon asking the question, “How can Obama’s plan cover over 50 million new patients without any new doctors?”

ABC justified the decision by pointing to a long-standing policy against running partisan commercials. Dick Morris, a onetime advisor to former President Bill Clinton and chief strategist for the League of American Voters, called the ABC decision “the ultimate act of chutzpah.” As he explains:

“ABC is the network that turned itself over completely to Obama for a daylong propaganda fest about health care reform,” he said. “For them to be pious and say they will not accept advertising on health care shuts their viewers out from any possible understanding of both sides of this issue.”

Fox News reports that NBC may also choose not to run the ad.

I suggest we respond to this abuse of the public airwaves by creating a little homegrown balance. Forward the commercial to friends and family, and while you’re at it, steer them to Acton’s health care page, which includes this piece on “The Problem with Socialized Government Healthcare.”

History shows us that civil rights can exist as nothing more than legal fiction. Take, for example, the right to vote. Although suffrage was extended to African-Americans under the Constitution in 1870, that right was little more than a nice idea until the Voting Rights Act of 1965. With many activists and politicians calling for America to recognize the “right” to health care, it is well worth looking at what this means. Making promises that cannot be met is a betrayal of the public trust, and the integrity of the government depends on its ability to hold to its word. In many other economically-developed countries, the “right” to health care coverage exists, and nearly everyone is enrolled in some sort of insurance or public plan. Unfortunately, coverage is not the same as health care procedures. Many governments insure nearly everyone, but cannot deliver the health care that those insured people need. These governments leave a broken promise in the place of the right that exists in their laws.

Take serious diseases, for example. Although Great Britain professes to treat health care as a right, there is no right to an oncologist. In fact, John Goodman of the Cato Institute reports that only 40% of British cancer patients even see an oncologist. This has had devastating results on their health: 70% more cancer patients in Great Britain die than in the United States. In addition, wait times for free health care in that country are so extreme that 20% of colon cancer cases diagnosed as curable are incurable by the time treatment is available. Great Britain is not the only country that falls short when it comes to treating major health problems. The Heritage Foundation recently created a laundry list of places where Americans, despite lacking the “right” to treatment, still have better health outcomes than other countries with universal health care: “Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher. Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher (in Canada) than in the United States.” Whether it is cancer, pneumonia, heart disease, or AIDS, Americans have better chances at surviving than Europeans and Canadians. If enshrining a right to health care in the law only eases consciences and not human suffering, then it is a lie on the part of government.

One of the major reasons for America’s advantage in treating major diseases is that our patients have far more access to modern medical technology and diagnostic procedures than other countries. The Heritage report shows that Americans are more likely to get mammograms, pap smears, colonoscopies, and PSA tests than Canadians. Americans have better access to drugs than Europeans: “44 percent of Americans who could benefit from statins, lipid-lowering medication that reduces cholesterol and protects against heart disease, take the drug. That number seems low until compared with the 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians who could both benefit from the drug and receive it. Similarly, 60 percent of Americans taking anti-psychotic medication for the treatment of schizophrenia or other mental illnesses are taking the most recent generation of drugs, which have fewer side effects. But just 20 percent of Spanish patients and 10 percent of Germans receive the most recent drugs.” We also have far more CT scanners, dialysis machines, and MRI machines than Europeans and Canadians, despite the fact that the first two pieces of technology were developed in Great Britain. Here again, the abstract right to health care does not translate into meeting the needs of the sick. It is far more honest and humane to establish a system that delivers health care than to write laws that promise it.

Waiting for necessary procedures also has a lethal toll on the populations of Europe and Canada. Greenwood writes that, “During one 12-month period in Ontario, Canada, 71 patients died waiting for coronary bypass surgery while 121 patients were removed from the list because they had become too sick to undergo surgery with a reasonable chance of survival.” The Canadian Supreme Court recognized this problem. Overturning Quebec’s ban on private health insurance, Chief Justice Beverly McLachlin stated: “The evidence shows that, in the case of certain surgical procedures, the delays that are the necessary result of waiting lists increase the patient’s risk of mortality or the risk that his or her injuries will become irreparable. The evidence also shows that many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life.” Any time that a “right” to health care means artificially lowering or eliminating its costs, there will be too much demand for too few services. There is nothing moral about a system that trades in real efficiency and comfort for imagined equality.

Even where America does recognize the right of the poor and the elderly to health care, it tends to restrict rather than liberate the sick, as Sue Blevins documented in 2003: “Before Medicare was passed, seniors were promised that the program would not interfere with their choice of insurance. However, existing rules force most seniors to rely on Medicare Part A to pay their hospital bills — even if they can afford to pay for private insurance. Additionally, today’s seniors and doctors must abide by more than 100,000 pages of Medicare rules and regulations dictating what types of services are covered or not under the program.” Even the privacy and family rights of patients in the “care” of the government are violated in the name of the right to health care: “Under Medicare rules established in 1999, patients receiving home health care are required to divulge personal medical, sexual, and emotional information. Government contractors — mainly home health nurses — are directed to record such things as whether a senior has expressed ‘depressed feelings’ or has used ‘excessive profanity.’ If seniors refuse to share medical and lifestyle information, their health care workers are required to act as proxies. This means total strangers will be permitted to speak for seniors.” Rights cannot contradict each other. The “right” to health care means a loss of the rights to privacy, family, and consumer choice. This is no right at all.

Health care is not a right. Since we have such a murky understanding of what rights are in today’s world, many governments still pretend that it is, only to see increased regulation and bureaucracy stifle the delivery of good care. Outdated technology, rationing of time and services, and intrusive government follow the “right” to health care. Declaring health care to be a right puts it under the government’s supervision. Unfortunately, health care itself can never be a right. Coverage might be, as evidenced by how many countries have insurance rates near 100%, but there are still limited health care resources out there. The best that we can do is to let them be distributed in the most efficient way possible, which remains the free market. Trying to follow in the steps of Europe and Canada by making health care a civil right is a nice intention, but it will never amount to anything more than another broken promise by the government.

The Radio Free Acton crew is back in the studio! On today’s broadcast, Dr. Donald P. Condit and Dr. Kevin Schmiesing join our host Marc VanderMaas for a discussion of the ins and outs of the US health care system. Dr. Condit gives us some background on how the current system came into being, the problems associated with it, and the pitfalls of the current healthcare reform proposals in Washington.

Next week RFA will be back for part 2, bringing us alternate ideas for reforming the system in ways that will both increase the availability of care for all who need it and make economic sense.

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[update below] British physician Theodore Dalrymple weighs in on government healthcare and “the right to health care” in a new Wall Street Journal piece. A few choice passages:

Where does the right to health care come from? Did it exist in, say, 250 B.C., or in A.D. 1750? If it did, how was it that our ancestors, who were no less intelligent than we, failed completely to notice it?

When the supposed right to health care is widely recognized, as in the United Kingdom, it tends to reduce moral imagination. Whenever I deny the existence of a right to health care to a Briton who asserts it, he replies, “So you think it is all right for people to be left to die in the street?”

When I then ask my interlocutor whether he can think of any reason why people should not be left to die in the street, other than that they have a right to health care, he is generally reduced to silence. He cannot think of one.

Not coincidentally, the U.K. is by far the most unpleasant country in which to be ill in the Western world. Even Greeks living in Britain return home for medical treatment if they are physically able to do so.

The government-run health-care system—which in the U.K. is believed to be the necessary institutional corollary to an inalienable right to health care—has pauperized the entire population. This is not to say that in every last case the treatment is bad: A pauper may be well or badly treated, according to the inclination, temperament and abilities of those providing the treatment. But a pauper must accept what he is given.

After 60 years of universal health care, free at the point of usage and funded by taxation, inequalities between the richest and poorest sections of the population have not been reduced. But Britain does have the dirtiest, most broken-down hospitals in Europe.

[update] Also, later today we’ll be posting the first part of a conversation our multimedia manager, Marc Vander Maas, had with Kevin Schmiesing and physician Donald Condit on healthcare reform. Schmiesing is an Acton research fellow and has posted regularly on health care topics here on the PowerBlog. Condit is the author of Acton’s new monograph, A Prescription for Health Care Reform.