March 3, 2009

Health Care will kill America

Let's start with President Obama's vision on health care. On the campaign trail he said would create a National Health Care Exchange in order to ensure affordable health insurance plans for all Americans:

Sounds good right? Well the devil is in the details, and the details do not support viability of the Obama plan.

A new study out in Canada's most populated province of Ontario indicates some problems with it. Ontario has provincially funded health care for most everything, excluding items like elective surgery. In April 2002 patients living in the wealthiest 20% of the provincial neighborhoods were 25% more likely to receive an MRI scan than those living in the poorest 20% of neighborhoods. This problem was different than the bigger issue of intolerable wait times for anything medical, but it caught the attention of the liberal provincial government.

Their response, in what surely must be a lesson in what not to do, to every politician regardless of stripe, was to throw money at the problem. In what must seem trivial in this age of trillion dollar stimulus packages, the government in 2004 invested $118 million at the wait time issue. That was not an insignificant amount at a provincial level. It was supposed to resolve a myriad of problems including the access gap, of which the MRI problem was symptomatic.

Fast forward 2009 and to the study just released by the Institute for Clinical Evaluation Studies which found that over 5 years, the gap between the rich and poor segments for MRI scans that was 25% in 2002 had grown to 38% after 5 years. The lessons to be learned are twofold.

Firstly, throwing money at a problem is not always going to achieve success in alleviating the problem. In fact, it could worsen the situation (while that link is not to be directly inferred in the Ontario example since other factors such as an increasing population in the province also influenced the numbers). The typical liberal solution of spend more does not guarantee success, it only guarantees expense.

The second lesson may be a bit tougher to swallow for some liberal Democrats - socializing health care does not make everyone well. There will still be problems with equal distribution of services. Let's face it, providing free health care does not put more hospitals in poor neighborhoods. In fact it probably prevents construction of new hospitals as government medical dollars get spent on providing freebies - as it turns out in middle and upper class neighborhoods where hospitals already exist and are they able to have an MRI machine added and people can easily access medical facilities. No MRI machine is going to be set up in an underfunded clinic in Watts, sure they can go in for free and get band aids and gauze, but not the health care they really need. That's the reality of it and the disparity will only grow. No one wants to take a 2 hour bus ride to another neighborhood to get an MRI scan. In fact they may not know where to go to find the type of treatment they need, and the task may be too onerous on their time and financial resources.

There's a corollary lesson for conservatives. Once you start down the road to socializing anything, it's hard to turn back. It is evident with Medicare, Medicaid and Social Security in the United States, it's evident with socialized health care in Canada - once you've got something for free, it's hard to get weaned off of it. Despite the fact that you could be sucking the life out of the provider (government). Referring back to lesson two, you can add to the problem of America becoming glued to socialized health care, the fact that not only will it always be there - there will be a tendency to try to grow it when people realize there are further issues to solve because socialize health care didn't turn out to be the panacea it was promised to be. Now they've got to equalize access and start building more hospitals and buy more MRI machines so the disparity doesn't continue to grow.

To round it all out, let's go back to Obama's campaign promise. His plan mentions forcing health insurance companies to "issue every applicant a policy and charge fair and stable premiums". So it's not exactly socialized medicine, it's worse. Why? Because he's going to do to insurance companies what the Community Reinvestment Act did to the banks - destroy them. Who decides what a fair premium is? And a very sick applicant can't be charged much more than a healthy one. Either the government puts the burden on the backs of the insurance companies or it soaks up the extra costs itself. Given that Obama has set the bar on cutting the deficit from astronomical levels to the merely ridiculous, perhaps both options are still possible, but neither option is good.

If you are a conservative, or even a liberal and you care one iota about the financial viability of your country, you have to fight this. This is as an ill-conceived a plan as the 1100 page unreadable stimulus plan that got jammed through the Legislature and signed into law with no reasonable debate. This one will be the straw that breaks the camel's back.

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