Why Universal Health Care will not destroy our nation.

November 24th, 2008 Posted in Rants

This previous election cycle was filled with a plethora of topics, most of which are divisive issues that will not likely be “settled” in the realm of politics (Gun rights, Religious freedom/protection, Gay rights, etc.).  These divisive issues however, tend to be what our politicos want to argue about, regardless of the reality that they may not be solved any time soon.

However, there was one subject that was brought up, mainly by the left and particularly during the primaries, that I feel there should be no real debate on: Health Care, particularly, Universal Health Care.

It is my belief that the goals of an advanced society is to ensure that it’s people are fed, have access to affordable housing, have access to safe jobs and that it’s people are able to go to the doctor when they are ill.

So what are the arguments against Universal Health Care? (From http://www.balancedpolitics.org/universal_health_care.htm)

  1. There isn’t a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?
  2. “Free” health care isn’t really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.
  3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.
  4. Government-controlled health care would lead to a decrease in patient flexibility.
  5. Patients aren’t likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.
  6. Just because Americans are uninsured doesn’t mean they can’t receive health care; nonprofits and government-run hospitals provide services to those who don’t have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.
  7. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.
  8. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.
  9. A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.
  10. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.
  11. Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
  12. Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.
  13. Like social security, any government benefit eventually is taken as a “right” by the public, meaning that it’s politically near impossible to remove or curtail it later on when costs get out of control.

Let me tackle these, one at a time.

There isn’t a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?

By this logic, we should completely disband the Government (Federal/State/Municipal) and move to a system without overhead (aka Anarchy), since there isn’t a single agency that runs efficiently.

This is just ridiculous.  For this nation to survive, there needs to be infrastructure: Roads, Police, Sewage, Fire, etc. One can make the argument that a line needs to be drawn somewhere, but to assume that a new government body will not be efficient because all government bodies are inefficient is just incorrect.  If you compare the public sector to the private sector, how much more efficient is the private sector?  I would argue that the private sector is just an (in)efficient as the public sector, it’s just that the private sector isn’t subject to the same transparency that most of the public sector is subject to.

“Free” health care isn’t really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.

This is at least partly true.  We would have to pay for UHC with taxes, which would mean higher taxes for everyone.  However, this would also mean no insurance premiums for anyone, and for most of America this would equate to almost no change with regards to how much we are paying (on a percentage basis) for healthcare.  It would also mean that the large out of pocket limits that current HMOs use would be a thing of the past, and when there is urgent and/or expensive care needed, the people will be able to get it and not be worried about how they are going to pay for it.

Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.

This again is partly true, but it ignores several things. First off, the other side of profit motives is greed.  As an example from 2002 to 2003 there was a 52% jump in profit for HMOs according to a Weiss Ratings study.  Even if you knock that down to say, I don’t know, 25%, does anyone seriously believe that with a 25% profit jump there would be a 25% jump in quality of care?  Usually profits are inversely proportional to the quality of care and breadth of services offered. 

I also find the statement that UHC would hinder individual ingenuity laughable.  How have Kaiser Permanente, Aetna, United Healthgroup et al advanced and improved healthcare?  They are obfuscating groups.  They are nothing more than the Tom Smykowskis of the world (“I’VE GOT PEOPLE SKILLS!!!”).

Government-controlled health care would lead to a decrease in patient flexibility.

Because the current HMO-ran system is completely flexible?  With my current HMO, I’m still given a list of people I can go to.  If I go to someone else, that’s my own damn problem.  What kind of flexibility would UHC negate?  If anything, those with smaller HMOs would see a huge increase in flexibility under a universal system.  They could find and use providers out of their local area (say if they fell ill while visiting family in another part of the country). 

Patients aren’t likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.

And this would be a bad thing?  OH NOES! SICK PEOPLES ARE GETTING THE MEDICINE THEY NEED!  I don’t really consider myself a Christian, but I was raised with Judeo-Christian morals, and I’m pretty sure the scriptures, from both the old and new testament are pretty explicit that when we have the ability to help the sick, we should do so, and to fail to do so, would be immoral, and I agree with that.

Just because Americans are uninsured doesn’t mean they can’t receive health care; nonprofits and government-run hospitals provide services to those who don’t have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.

This is true, but it doesn’t mean you will escape a potentially crippling bill from said institution.  Unfortunately, health care isn’t only about the service you receive from doctors and nurses, but how much you have to pay to get said service, and in the case of free-clinics, how long you may have to potentially wait for life-saving service.  Free clinics aren’t funded to the same levels as non-free-clinics, and thus, you pay a price by having to wait for care.

Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.

Like the poor care they receive in Canada, Great Britain, France, Germany…. Well the entire civilized western world?  Is our current system really the best care in the world?  Do we have the longest life-expectancy in America?  No, we are 46th, and on average have a life expectancy 3 years shorter than our neighbors to the north.  Do we have the lowest infant-mortality rate in America? No, last among western nations.  For the most part, the only direction is up.

Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.

Again, this is true, but us healthy folks will also be paying for accidents that healthy folks have, emergency procedures that normally healthy people have (appendicitis, tonsillitis, etc), and most of those fat smokers will be working and paying taxes as well.  To me this is another lower-my-taxes argument that doesn’t hold up really well.  As a tax paying citizen, there will often be many services that one does not use throughout their lifetime.  Heck, we all pay for public schools, but as tax payers, we aren’t currently attending public school, so why should we have to pay for that?  You know why:  Because the smarter our society is, the better off we are as a whole.  You know what uneducated folks do?  They either fill menial jobs, fill the ranks of welfare or turn to a life of crime.  Aside from the fulfillment of menial jobs, none of these make our society better. 

But I digress. We pay taxes for things that our society uses.  If you’re healthy and you don’t use it, consider yourself blessed.

Not to mention, under the HMO system, we already pay pay for the burden of those who smoke (unless, of course you don’t use medical insurance).

A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.

There would have to be a transition period, but it hardly has to be painful.  As far as lost jobs go, there could easily be an initiative to incorporate current HMO employees into a new UHC system, potentially limiting the job losses.  Any jobs lost on the whole should be considered a victory for those against UHC, because the government would be showing that it can trim the fat of the HMO. I kid of course, but it’s nice to point out the flawed logic when discussing the efficiency of our current HMO-based system.

Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.

This isn’t the case in other western nations with UHC, so why would we be damned to this fate?  It is my belief that many in our current medical system are pained by the current care that is offered to their patients.  Many procedures are dictated not by need, but by cost.  Should a patient needing two root canals need to wait until January for their dental insurance to reset to get the needed work done?  Does the dentist really want to see a patient turned away because of money, or does he/she want to see them with a healthy smile?

Most people get into medicine because they have a passion to help others.  Much like school teachers, they aren’t getting into it for the money (but if the money is there, that’s icing on the cake).  If one is getting into medicine solely for the amount of money that is to be made, I don’t believe I want that to be my doctor.

Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.

Without getting into a debate on “frivolous lawsuits”, I will say that malpractice is a concern, but this will always be a concern.  Right now, the HMOs and large hospital conglomerations already have deep pockets, so moving from one deep pocket to another is a negligible difference.  Hiring capable doctors and nurses should always be a priority, whether it be in the public sector or the private.

Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.

Cigarette smoking is already a pariah’s cause, as several states have already passed smoking bans, and this is without UHC.  Smoker’s rights are disappearing, and arguing that UHC will make it worse is laughable.

As far as fast food, this is a silly slippery slope argument.  What western nations have banned or increased taxes on fast food?  The only mentions I have seen are in the USA, and it’s to battle the out of control obesity problem this country is facing.  Increased taxes on fast food could happen in America without UHC.

Like social security, any government benefit eventually is taken as a “right” by the public, meaning that it’s politically near impossible to remove or curtail it later on when costs get out of control.

Well, this is true, at least the part before the comma.  Social Security is in trouble, but it’s not as simple as “costs are out of control”.  Population growth has declined, which is a huge factor.  Couple that with the idiotic choice to pool Social Security income with the general fund, and no nest egg kept to pay future retirees, and you have a recipe for disaster.

However, with UHC, we’re unlikely to have issues like that, as everyone is covered and any new group of covered people will likely have a large number of tax generating individuals.  Also population growth will likely stay flat. 

Some people are afraid of UHC, because of the bogeyman word, “Socialism”, which is of course, code for Communism, but the fact is that we already have elements of socialism in our nation (Social security, Medicare, Welfare, Unemployment Insurance) and this would just be another level of protection for those who need help.  It would cut the fat of middle men (HMOs) removing profitability from the equation, and concentrating on care over cost.

If you don’t want to pay higher taxes and don’t care that the young, the old, the sick and the poor are taken care of (and can afford it), then sure, our system is great.

But for everyone else, it’s a joke.

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