my coherently composed essay…a guest post
Who knew. There are people out there that read this blog. Better yet, Dr. Miller of Mad Scientists took up my challenge of defending ObamaCare and wrote a guest post. As promised, I am posting it below. (And just when I was going to write a light-hearted, non-political post to break up the recent trend)… In an effort to respect the flow of his post, I have refrained from inserting comments directly in the middle of the text and instead reference my come-backs thoughts at the end of the post. Take it away, Dr. Miller:
We can (and most likely will) argue about this forever and never agree, but here is the best case I can make for universal healthcare. There are two reasons to change the current healthcare system, moral and economical. The moral case is that healthcare is a BASIC right and we should feel ashamed to live in a country where ANYONE is denied adequate healthcare due to the lack of money. [1]
The calculation in your previous post assumes 10-15 million involuntary uninsured American citizens, which I would say is a lot of people who could potentially suffer due to the current system. While I find this reason compelling, many (i.e. Tim) don’t. [2] So let’s consider the economic case for universal healthcare. Here are some facts:
- The US spends more per capita on healthcare than any other country in the world (Source: Human Development Report, 2007, United Nations, http://www.infoplease.com/ipa/A0934556.html)
- The US has a lower quality of care than many industrialized countries who spend much less per capita. The US ranks 29th in infant mortality and 24th in Disability Adjusted Life Expectancy (Center for Disease Control, http://www.webmd.com/parenting/baby/news/20081015/infant-mortality-us-ranks-29th; WHO, http://www.photius.com/rankings/healthy_life_table2.html) [3,4]
- Much of this cost disparity is a result of administrative costs of private insurance companies (I am working on a reference for this one, but it seems to make sense since virtually all industrialized nations have universal care, spend less, and have a higher quality of care). [5]
Some argue that we should not insure the 47 million people currently living in the US (many of whom are undocumented) who are currently uninsured. Let me remind them that they are already paying for their healthcare. The uninsured are given care in clinics and hospitals and the bill is payed by tax dollars. The center for American Progress estimates that 8% of healthcare premiums are to cover the uninsured (http://www.americanprogressaction.org/issues/2009/03/cost_shift.html). If we could offer these uninsured people preventative care, studies have shown that the savings would be very significant (http://www.newamerica.net/publications/policy/estimating_the_hidden_tax; http://www.newamerica.net/blog/new-health-dialogue/2009/cost-emergency-room-utilization-rise-13225). [6] So the conservatives are offering a false choice between paying for the uninsured or not. The real choice is between maintaining the current, broken, expensive system or replacing it with a system that will result in universal care and reduced costs for all Americans. [7]
[end] The boxing match begins…
[1] I disagree. I suppose this is what separates the left from the right, but think about this comment from an NRO article:
"The fundamental problem with the idea of a right to health care is that it turns the idea of individual rights on its head. Individual rights don’t infringe on the rights of others. Smith’s right to free speech takes nothing away from Jones. The only obligation Jones owes to Smith is not to interfere with Smith’s exercise of her rights. A right to health care, however, says that Smith has a right to Jones’ labor. That turns the concept of individual rights from a shield into a sword. The underlying goal of a legally enforceable right to health care is to provide quality medical care to the greatest number possible. Perversely, making health care a "right" would make that goal harder to attain."
Furthermore, if healthcare were a right, wouldn’t I also have the right to deny it? The current house bill would tax me 2.5% of my income if my health insurance fails to meet a government determined standard.
[2] It’s not that this number doesn’t compel me to action, it’s that I don’t think it takes $1 trillion to insure 10 million or 50 million!
[3] Quoting this policy analysis:
"[the infant mortality statistic is not] a good indicator of the quality of a country’s health care system…Overall, the chances that an infant will die at birth vary widely according to such factors as race, geography, income, and education. These factors have nothing to do with the quality of (or access to) health care. A better measure of a country’s health care system is mortality rates for those diseases that modern medicine can treat effectively…The annual rate of cancer deaths is 70% higher in the UK than in the US. Slightly fewer than [20% of men] in the United States diagnosed with prostate cancer dies of the disease. In the UK, 57% die…At 30 percent and 25 percent, respectively, death rates from prostate cancer in New Zealand and Canada are still well above that of the US."
That same WHO study rates Singapore, Oman, Portugal, Colombia, Israel, and Costa Rica higher than the U.S. I bet no citizen of those countries has ever come to the United States in search of better health care. If your baby gets sick, would you take her to a Colombian hospital?
[4] To quote an analysis of the same WHO report: "To use the existing WHO rankings to justify more government involvement in health care is to engage in circular reasoning because the rankings are designed in a manner that favors greater government involvement."
[5] Administrative costs are necessary to reduce the overall cost of health insurance. This is addressed here:
"The traditional fee-for-service Medicare program does relatively little to manage benefits, which tends to reduce its administrative costs but may raise its overall spending relative to a more tightly managed approach."
[6] You admit that the uninsured are getting care when they need it. I agree that we could cover them more cheaply, but why does this have to cost $1 trillion? We’re already paying for them. Why do we have to spend an additional $1 trillion to keep covering them? Additionally, what’s to say that the uninsured will all receive coverage? The public option will still collect premiums. Why does anyone believe that they will be willing to pay the government insurance premiums?
[7] We have more than 2 choices. NOBODY is proposing that we keep the existing system. Instead of ‘replacing’ the system, reform it by encouraging competion in the free market (and not through the introduction of a government option). There are other options. I support Senator Tom Coburn’s proposal, briefly summarized here. IMHO, this would achieve all that you hope for in health care reform and more, all at a much lower cost. Why is this superior bill not up for debate?
Anyway, thanks for the post, Dr. Miller. I think we both agree that reform is needed, and I hope that you agree with me that our representatives should both (a) read the bill before making a vote and (b) listen to their constituents. Anyone else? I’ll post any other guest posts that come in, at my discretion.
I really didn’t want to get involved with this but you people have been pushing my buttons way to long.
Comment by Brandon — August 15, 2009 @ 11:28 am