Wednesday, April 11, 2007


Vivisecting A Health Care Nay-Sayer

For those Americans who care about the welfare of their fellow citizens, there's nothing more enfuriating than reading the devil's advocates of Tech Central Station. At the link below, you will find a guest bloviator launching one plummy argument after another at the straw man of that "single payer" health care system we will probably never have.

He responds to the well-known statistic that Americans spend more than any other Western democracy on health care, but our life expectancy is no greater or even less than that of other such nations. True enough. He appears to protest this statement by lamely agreeing with it, citing a study that demonstrated that each 1 percent change in health care spending improved a nation's collective health by just 0.03 to 0.05 percent. Meanwhile, a similar increase in leisure improved health 0.25 to 0.65 percent. However, the nations that experience that leisure are - quel surprise! - the same Western democracies that have socialized medicine. Both socialized medicine and longer vacations stem from the same source, a wise culture that is not as insanely focused on the profit motive as the United States of America. The rat race, the treadmill, the crack of our masters' whips - whatever you choose to call it - is making us sick. We grind away out of fear, because we have no safety net. Whether our life expectancy suffers more from a lack of socialized medicine or from not enough vacation time, our hypercompetitive, dog-eat-dog capitalism is still to blame.

He responds to the contention that a single payer system will spend much less on the same amount of health care than do private insurance companies by, again, lamely agreeing with the statement. But, he says, we would pay for health care with our income taxes. Horrors! Considering that we all still pay for our health care one way or another - if we can afford it - I fail to see the difference. Our fearless author, on the other hand, believes that supporting health care with taxes constitutes a "deadweight loss", apparently because the money is being paid to a government bureaucracy and not into the pockets of an oligarchy of billionaires. According to him, 20 percent of tax dollars are lost in the bureaucratic process of simply determining how the money should be spent. According to me, an even larger proportion of corporate profits end up in the offshore bank accounts of greedy executives who make no effort to determine anything other than when they will take tee-time in Bermuda. Once again I ask, what is the difference?

He also makes the laughable mistake of comparing socialized medicine to HMOs, which are simply another type of profit-making organization that makes its money by selectively denying its customers treatment. He says that customers who have expressed dissatisfaction with HMOs would be equally dissatisfied with "single payer" health care. True enough, a good single payer system would strive to keep costs down and impose some restrictions. But true socialized medicine does not support the rampant conflicts of interest that have resulted in some of the worst abuses of the HMO system. The current system compels doctors, clinics and hospitals to become profit-making entities that milk the HMOs by billing them for whole rafts of unnecessary treatments, tests and procedures, while the HMOs themselves, even more dedicated to making a profit, pass on the expense to their customers by increasing premiums and denying coverage. The ideal single payer system would be literally that - one single, cohesive, integrated system in which more restrictions would be placed on how much money each part of that system could make off the others than on what treatments the patient was allowed.

The author continues to focus on "customer demand" for more and more health care, claiming that American consumers will be dissatisfied if they get less. He seems to think this is a good thing, or at least something that originates from the authentic needs and desires of the consumer. Health care in the United States is to a large degree driven by marketing, just like everything else in this country. Corporations and institutions with a vested interest in making huge piles of cash convince Americans that they need more than they really do. Pharmaceutical companies bombard the media with exhortations to spend hundreds of dollars a month taking pills to cure restless leg syndrome or to make yourself less shy at public gatherings. The nightly news devotes as much air time to medical maladies as to foreign affairs, and the commercials try to reap profits from the anxiety the news has sown. It is sophistry to claim that the American consumer will necessarily be disappointed by a health care system that is not profit-centered, as the current profit-centered system is largely responsible for creating the demands it satisfies. What we need ultimately is not more "products", but better health. A health care system that focuses more on fundamental prevention in the form of improved fitness and diet is infinitely preferable to leaving our health in the hands of profit-mad sociopaths that offer us overpriced drugs with one hand and bacon-cheese-and-sausage burgers (or video games for sedentary children) with the other.

"Health To Pay" from Tech Central Station

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