Tuesday, August 4, 2009

Some Health Care Data

The income tax was passed in 1913. There were two rates, one percent and 7 percent. The politicians said that the tax would never go above 10 percent. In 1917, four years later, the top rate was 77 percent. Throughout American history broken political promises have been the norm. Obama denies that he intends to nationalize the entire health care system. He keeps saying that you can keep your private insurance if you like it. Of course he told the SEIU (Service Employees International Union) a while back that a plan of this sort is the first step towards a single payer system, and during the campaign he said that in 10 or more years out he hoped the government option would lead to single payer. Barney Frank admitted that if the Democrats passed health care with a public option it would lead to a single payer plan. So much for keeping your private insurance.

Also this week Larry Sommers repeated the fiction that economic recovery is dependent on health care reform. For anyone who believes him I have some oceanfront property in Arizona to sell. The new taxes required or the debt incurred would put tremendous pressure on the economy and do serious damage. There is nothing new with any of this. However, what is new is my discovery of some Heritage Foundation work that gives several interesting facts about the British national health care system and what we can look forward to if the health care bill passes.

Obama supporters like to point out that life expectancy in the US is below (slightly) 6 or 7 western nations that have national health care. They are factually correct, but the conclusion that this indicates that national health care programs are better than ours could not be more wrong. Life span is determined by many more things than the quality of health care. In fact overall health care is a relatively small item among those things determining lifespan. Diet, genetic predisposition, infant mortality etc. all are more important. For example if the statistics are normalized for murder (use a single murder rate in the calculation of all countries, rather that the differing ones where the US rate is sky high), the US lifespan moves much higher on the list. Do you think that the fish and rice dietary staples in Japan add to life expectancy when compared to a Quarter-Pounder and cheese fries or whatever it is that the 35 percent of our population who are obese are in the habit of eating?

But more enlightening is an examination of the life span of people who reach the age of 65. Certainly with this group the quality of health care becomes a far more important factor when determining longevity. Americans over 65 suffering from cancer, heart disease and most leading causes of death live longer, and overall Americans live far longer than the elderly from any other country in the world. Not surprisingly, America also has the shortest waiting time for treatment of any nation. Our system is far better than any other system anywhere, and it shows in the numbers.

When Medicare was passed in the 60s, congress projected the cost for several decades into the future. In 1990 the real costs had reached 20 times original projections. Estimates for the future are now up to a cool 100 times what the original projected numbers were. Admittedly it is difficult to project a year into the future, much less 50 years. Misses of this magnitude are not uncommon, and particularly when the government is involved. Yet everyone throws around numbers about what health care will cost 10 years from now as it they were predicting tomorrows sunrise. The fact is no one knows what an untested government run program will cost, but if history is any guide, it will be exponentially higher than the supporters say now.

Obama and the libs like to point to the rapid price increases of private insurance and claim it is out of control. In the last 7 years that rate has slowed from 15 percent to 7 percent annually. Maybe they are right, but in the government run program, Medicare, costs have increased 35 percent faster than private insurance. Also, during this period private insurance has progressively absorbed more and more of Medicare costs, thereby inflating its true cost and reducing Medicare's. Estimates range from 20 to 28 percent of Medicare costs are absorbed by private payers. No matter how you view the sustainability of the price increases, Medicare has increased dramatically faster. The question is why a government takeover of private insurance would be any different?

Another major administration fiction is that insuring the uninsured will save money. Wait a minute. How do we take 47,000,000 people (their number) onto the health care roles and save money. Do you buy it?

How many Americans are really uninsured anyway? In an earlier blog I pointed out that of the 47 million figure, 10 million are illegal immigrants, 10 million can afford health insurance (earn over $75,000 per year) but choose not to buy it, and 10 million already qualify for government health insurance but are too dysfunctional to get it. That leaves about 17 million. The CBO says that the house plan will knock 83 million people off the insured roles, and only 68 million will get back on, creating 15 million newly uninsured.

Uninsured does not mean untreated. No one in America is denied health care. By law the uninsured can not be denied treatment at any hospital emergency room. This is certainly not an ideal delivery system, but politics prevents many of the changes needed for improvments from becoming law.

All of the normal distortions resulting from central planning and political control (think nationalized health care) that occur in every government program, are happening in all of the countries with a national system. In Great Britain with a population of 55 million, 800,000 people are waiting for treatment. This is occurring while almost 20 percent of the hospital beds go unoccupied. It reminds me of the old Soviet Union. The people were starving while millions of tons of food rotted in the fields because the distribution system had failed, and there was no mechanism to make the needed adjustments.

Great Britain does have plenty of ambulances, and citizens can use them for such things as going to the doctor (not emergency), or going to the pharmacy. Of course these ambulances don't have a fraction of the life saving equipment that is standard in the US. What they do provide is votes from the people who use them like taxicabs for the politicians providing them. The young think the system is great. Why? Because they rarely use it. The people who understand the systemic failures are the ones who do use it, the elderly and the sick.

In Britain rationing occurs primarily in the areas with the smallest constituency because cuts and shortages are damaging politically. Renal failure is a relatively small group of people in Great Britain. Therefore there is a shortage of dialysis equipment. Who gets to use it and who doesn't is left up to the hospitals, leaving the impression the shortage is their fault. On average dialysis is denied in 25 percent of the cases for people over 55, 40 percent for people over 65, and 100 percent for people over 75. Renal failure over a certain age means death. Can you imagine the outcry if such rationing occurred here? And don't think this is an isolated example. Severe rationing (at least by our standards) occurs throughout the system.

Of course there are still many rules/ limits handed down from above. In Great Britain there is a dollar amount ($20,000 in 1990- I am sure it is higher now) which is the most hospitals are allowed to spend to extend a life 6 months. If someones dollar allotment runs out too soon, so does his life. The Obama plans know this problem will occur with us too if the bill passes, so what they did was budget a generous amount of money for end of life counseling. Now that is what Mom and Dad need; some bureaucrat helping them decide if they want an assisted suicide. On the other hand, it will save money.

I could go on but this whole debate is a joke. What we have is far from perfect. Still, it is the best the world has ever known. We could make vast improvements with a relatively small changes, but politics make those changes difficult, and are unlikely to occur soon. Therefore I beg the sane politicians..please.. first do no harm. Defeat this idiocy.

1 comment:

Morris Mosseri said...