The Undeniable Facts on Universal Healthcare

The past month has witnessed intense, sometimes rabid, debate surrounding President Obama’s healthcare plan. Much of the discourse on both sides has been marked by emotion, fear, and banal rhetoric. It is time Americans consider the facts on universal care.

Fortunately for us, universal care has been tested for decades in countries similar to our own. We need not debate the hypothetical or theoretical about what might happen—our counterparts in Britain, Canada, and Europe serve as examples of what will happen:

Access

Access to quality care in countries with socialized medicine is markedly worse than in the United States. According to Scott W. Atlas, a senior fellow at the Hoover Institution and a professor at Stanford University’s Medical Center, Canadian and British patients wait twice as long as U.S. patients to see a specialist, have elective surgery (knee or hip replacements), or get radiation treatment for canhospital signcer. Many of these patients must wait for over a year, sitting on long, backlogged lists to receive government care.

According to economist Thomas Sowell, 27% of people who require surgery in Canada, and 38% in Britain, must wait four months or more to be treated. By contrast, only 5% of Americans must wait that long. Additionally, the incidence of colon cancer is 25% higher in Canada, a result of the fact that patients must wait an average of four months simply to receive a routine colonoscopy. A recent report from the Fraser Institute in Canada also shows that Canadian patients wait an average of ten weeks to receive an MRI, just to discover what is wrong with them. As Mr. Sowell points out, that is an exceptionally long time for a suffering patient to wait.

With regard to certain specialty services, the statistics are similarly disconcerting. The U.K., for example, offers a public-option dentistry plan for all of its citizens. The British National Health Service recently reported that 20% of patients were unable to get a basic dental checkup in the last two years due to rationing quotas.

Cost

The total cost per patient is believed by most experts to be about 40% less in the U.K. and Canada than in the United States. This is to be expected, as U.S. care is of much higher quality technologically and pharmaceutically. Consider, for example, that there are more than four times as many MRIs per capita in the United States than in Britain or Canada. The cost calculation also does not account for President Obama’s proposed initial outlay of over $1.3 trillion to fund the program.

More importantly, however, the majority of the cost savings come through rationing, as government chooses the most cost-effective, rather than the highest quality treatment for its citizens. In Canada, 44% percent of the drugs approved by Canadian health authorities are not allowed by the healthcare system due to their high cost. The mortality rate for Canadians with colon cancer is 10% higher than in the United States, in large part due to the fact that the top two chemotherapy medicines used in the U.S. to treat the disease are not available in Canada. Why? Because they have been deemed “too expensive” (RCP – Rationing Healthcare).

As reported by the Wall Street Journal, Britain’s National Institute for Health and Clinical Excellence (NICE) recently ruled against the use of Lapatinib, Stutent, and Aricept because they were not seen as “cost effective.” Despite outrage from doctors in the U.K. over the importance of the drugs, Peter Littlejohns, NICE’s clinical and public health director, stated that “there is a limited pot of money” which might be better spent elsewhere. This is just one in a long string of examples surrounding rationing by cost.

As Thomas Sowell poignantly noted, monetary costs may be lower “in countries with government-run medical systems—if you count only the money cost, and not the time the patients have to endure the ailments that require surgery, or the fact that some conditions become worse, or even fatal, while waiting.”

Survival Rates

The impact of limited access and government rationing is decreased quality of care. Mr. Atlas reports that breast cancer mortality is 88% higher and prostate cancer mortality is 604% higher in the U.K. than in the U.S. In Canada, the total cancer death rate is 16% higher than in the United States.

Satisfaction

The majority of Americans are happy with the care they currently receive, while the vast majority of people in countries with universal programs are dissatisfied. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either “fundamental change” or “complete rebuilding” (Health Affairs Journal). That number is the exact opposite for Americans. According to the Wall Street Journal and Rasmussen Reports, 74% of voters rate the quality of care they now receive as good or excellent. Perhaps this is why, as a McKinsey Co. study reports, 40% of all medical travelers come to the United States for medical treatment.

The bottom line is that we need not look far for examples of universal healthcare’s failure. The statistics are telling, and Americans deserve to be made aware of what they are facing.

-Matt Benchener from TruPolitics.net

ObamaCare’s Opposition Comports With Reality

This post is written by guest author Edward Mahee. Mr. Mahee boasts an extensive legal background, and is an emerging conservative thinker. Expect articles from Mr. Mahee every other week. This is his fourth posting for the site.

Recently, supporters of President Obama’s healthcare plan have claimed that the rising tide of opposition to the plan is the work of hucksters, conspirators, and other malefactors.  The protestors, we are told with assurance, are either toothless and witless hicks, or are too well-dressed and well-spoken to be real protestors.  The healthcare escapade has been very revealing, both of the Obama Administration and of its opposition. 

President Obama’s swift rise to power was built on, more than anything else, air—the power of his rhetoric.  Unfortunately for him and his supporters, however, actual policy initiative must comport with reality.  His healthcare proposal simply does not, and people have finally woken up to the danger. 

Liberalism holds itself as an ideology that deals with problems empirically, dealing with facts and reality, while it claims its opponents deal with problems beyond the cloud of unknowing.  Yet, with healthcare, as with so many other things, the promises of liberalism cannot be kept. 

Mr. Obama and his acolytes are right when they say that the current healthcare system is broken and financially unsustainable.  Medicare and Medicaid are financial black holes, which if not dealt with will destroy the federal budget, and by consequence, the currency and the economy. 

However, Mr. Obama’s solution is to make millions more people dependent on the federal government for health insurance and to increase federal expenditures on healthcare by trillions of dollars. Mr. Obama risibly claims that his plan will increase coverage (and quality) and decrease costs.  He might as well try and convince people that 2+2=5 (if he did try, CNN or The New York Times would be quoting some mathematician somewhere saying that 2+2 can in some instances equal 5).

Because people have finally caught on to this, they have begun to move in great numbers to voice their opposition to Mr. Obama’s healthcare plan.  Mr. Obama is learning the hard way that “hopey-changey” talk is powerless against the immutable laws of arithmetic, especially when ordinary people have a much sounder grasp of the concepts than the administration, the sycophantic media, or the hapless politicians who are trying to argue with people who have actually read the bills in question.

Mr. Obama and his friends in Congress and the media have done their best to quash the opposition.  They have resorted to ridicule and insult, even bussing in their own counter-opposition to town hall meetings (paid for by ACORN).  But the great thing about the American people is that once moved, they will not be intimidated by cheap insults or threats.  The counter-opposition may have fancy signs and misinformed bumper-sticker slogans, but the real opposition has passion—a genuine passion whose source is the fear that this administration is bent on taking away their cherished freedom, while at the same time spending the country into bankruptcy. 

No doubt in the days ahead we will hear more tales from the media of the heroic Mr. Obama standing athwart the great unwashed, bravely facing the tide of shallow closed-mindedness.  We will see more stories of healthcare protestors who are bringing arms into these meetings to intimidate the brave liberals who are only trying to do good by their constituents.  None of it will be true. 

The people who have been showing their spirit at these meetings, and voicing their opposition to Mr. Obama’s healthcare plan, are simply free citizens exercising their rights.  They are genuine opposition, and their passion comes from their understanding of a very simple truth: Flowery rhetoric and heart-wrenching sob stories cannot make 2+2=5, and any policy that tries to make that equation work will only end in disaster.

-Edward Mahee from TruPolitics.net

The Politics of Compassion

This article was featured in the The Bulletin (Philadelphia-area newspaper) on 8/26/09. You can read the newspaper version online here, or read the print column each week.

“You know, there’s a lot of talk in this country about the federal deficit. But I think we should talk more about our empathy deficit.”

-President Barack Obama

A friend of mine, after reading an article I recently wrote against universal healthcare, asked me a poignant question: “As a Christian, don’t you care about the millions of people without health insurance?” My friend was presenting me with a false choice—I supposedly had to choose between conservatism, which speaks of limited government and personal responsibility, and my faith, which speaks of love and compassion.we shall rise

As a Christian, I care deeply about the plight of the poor and underprivileged.  It is reprehensible that in a nation where close to 33% are obese, that others cannot afford to eat at all; where 80% receive high-quality healthcare, that millions do not have access to the most basic of such care; where many worry where they should vacation, that others worry where they will sleep.

As a conservative, I also care deeply about the principles that have differentiated our country since its founding. Liberty is woven into the framework of our nation, and is predicated on personal responsibility, constrained government, and private property. Individuals should keep what they earn, use their wealth at their own discretion, and be free to guide their own outcomes. Where government must intervene and spend, it must do so within strict Constitutional constraints. America was founded on the pursuit, not the governmental provision of happiness—our founders recognized this as the defining line between capitalism and socialism.

So, are compassion and conservatism in opposition to one other? For many, compassion necessitates increased government intervention and support. President Obama recently passed the mortgage relief plan to help struggling homeowners, built $56 billion into the stimulus for expanded welfare programs, and proposed a government option healthcare plan to fund the uninsured. Each was wrapped carefully in rhetoric of empathy, redistribution, and duty.

Nearly every liberal thinker I’ve talked to holds similar views. Those that support universal healthcare, for example, do so because of sympathy for the uninsured. The statistics regarding inefficiency, rationing, and expanded bureaucracy are undeniable, but seemingly do not matter when juxtaposed with empathy. I am yet to hear a cogent argument in support of nationalized healthcare regarding increased quality or effectiveness—I’ve heard hundreds regarding compassion for the uninsured.

The idea of empathetic policy is admirable. Most who believe in it have honest intentions and place great faith in government. But charity should be a personal choice, and government should not legislate specific values on behalf of individual citizens.

The problem is that not all people define compassion the same way. A member of People for the Ethical Treatment of Animals (PETA) may believe that compassion means using taxpayer money to rescue abandoned animals. A member of the Association of Community Organizers for Reform Now (ACORN) may believe that compassion means providing housing and job opportunities for poor, urban African-Americans. A representative from ChoiceOne Pregnancy may believe that compassion means providing a viable alternative to abortion for unwed pregnant mothers. A representative from Planned Parenthood may believe that compassion means offering guidance, support, and assistance through the process of abortion.Constitution

This incongruity is why our founders wanted government to be limited. If government takes a citizen’s money and spends it on another’s special interest, government is simply the pass-through agent for theft and redistribution of private property.

As such, the Constitution provides the government with power to ensure certain explicit rights, and these rights are wholly separate from notions of sympathy and empathy. The rights to private property, free speech, and due process, for example, are not derived from compassion; they are derived from fundamental inalienable human rights. If liberals want to fund mortgage bailouts, welfare, and socialized medicine, they should provide Constitutional justification for the massive expansion of government. As yet, none has surfaced.

In conservatism, faith, liberty, and compassion align within Constitutional constraints. Individuals, not the government, give to those organizations or causes they support. As Christians, my wife and I choose to give a significant portion of our income to our church, which in turn provides key services to support the poor and needy in our community. Among other things, we also sponsor a child in Africa, providing the resources necessary for her to attend school, eat regularly, and receive medical attention. We give freely from our earned income without the hand of government—an expression of liberty—to care for those in need.

From a Christian perspective, Jesus never asked the Roman government to care for the poor, nor did he compel government intervention into private life. Instead, he asked that each individual, and by consequence the church, give, serve, and care for the community. Forced charity is no charity at all, and compassion should be bred of love, not compulsion.

There is a fundamental difference between charity and redistribution. Imagine a nation with a 100% tax deduction for charitable giving—perhaps there would be no need for Mr. Obama’s “change.” The intersection of conservatism and compassion is found in giving by choice, and it is perhaps the most beautiful and unifying expression of liberty we have yet seen.

-Matt Benchener is the founder of TruPolitics.net and a candidate for Newtown Township Supervisor. Learn more at www.benchener09.com

Voters Deserve Fiscal Responsibility

This article was featured in The Bulletin (Philadelphia-area newspaper) on 8/19/09. You can read the online newspaper edition here, or check out the print column each week.

I serve on my township’s finance committee, and recently had the chance to review the tax revenue projections for the upcoming years. The projection for our township, which has not been hit nearly as hard as most of the country, is a revenue decline of approximately 10% over the next year and a half. Since tax proceeds typically trail the economy, we expect that rate to increase through 2010.

This got me thinking. If we expect a decline of over 10% in revenues, shouldn’t we be cutting spending at the same rate?

In business, decreased earnings mean decreased spending and investment. Budgetary control is the core of financially sound organizations. In personal finance, decreased wages mean decreased consumption. Families across the nation are facing the harsh reality of a prolonged recession, and wise families are reducing spending, scaling back lifestyle, and investing for the future. The most prudent saved enough during times of prosperity to sustain during the downturn. If principles of financial prudence are clear for business and personal finance, why don’t we expect the same from government?Government Spending

In reality, quite the opposite has occurred. Across the country, local and state governments are scrambling to raise emergency taxes to prevent bankruptcy. They failed to plan and save, and locked themselves into unsustainable spend heavy budgets. The federal government, similarly, has a projected year-end deficit of $1.84 trillion, in spite of which the current administration forwarded the largest non-wartime budget in U.S. history. That $3 trillion budget does not yet include the President’s proposed $1.6 trillion health overhaul. Tax-and-spend policies have always been controversial, but massive spending without regard to mounting debt is more than controversial, it’s foolish.

Why does fiscal irresponsibility persist with such severity in government? Though varied and complex, there are two primary causes. The first is best summed up by a classic political science axiom: Government spends money for political purposes; citizens spend money for economic purposes. That is, a politician is incentivized by the political outcomes of his spending, while an individual is incentivized by the personal outcomes of his spending.

In a democracy, the desired political outcome is often reelection or increased power. Politicians face a near constant cycle of elections, and often make promises to secure voter loyalty. Political action, not stagnation, draws attention and votes, and politicians feel they must spend to demonstrate that action. As a result, the local politician who promises $150,000 to improve local parks will spend that $150,000 even in a downturn. He dare not slash it from the budget, or he breaks his promise and faces voter backlash. So, rather than constrain spending like a wise family or business, he will simply raise taxes. I see it firsthand in local government all the time.

On a national level, the examples are too numerous to recount. An obvious and egregious example, however, occurred recently in the passage of the so-called stimulus package. Only 35% of stimulus money was allocated toward growth producing spending (tax cuts plus infrastructure investment), while the remainder was simply earmarked for political agenda items ($4 billion for ACORN; $400 million for global warming research; $150 million for the Smithsonian, to name a few). Not to mention the projected $2.5 million being spent on new temporary road signs with the red, blue, and green stimulus logo, touting construction projects funded by the bill. Why do you think the Obama Administration wants to use taxpayer money to advertise its construction projects? For political purposes, or for economic purposes?

The second issue is in part a cause of governmental structure. Politicians are in the unique position of spending someone else’s money without significant accountability. Because of the nature of funding through taxation, politicians draw from an extremely large pool of payers. So, when the stimulus authorizes $2.5 million for propaganda road signs, it averages out to approximately 20 cents per taxpayer—hardly enough to stage a protest over.

The taxation process also separates taxpayers from feeling the direct impact of government spending. The money comes from you (often automatically deducted), goes to the IRS, is sent to thousands of government agencies, and is then sent back out the door. Imagine what it would be like if instead you were directly and proportionately billed for each government spending initiative. You would feel the impact directly—that would certainly be cause for protest.

In the end, most politicians will spend money out of personal political interest, the affects of which will not be directly felt by taxpayers. They have little incentive to adhere to fundamental budgetary principles, and extraordinary incentive not to. The resulting action is an intellectually dishonest process of political finance. When revenue increases, government claims it can afford to increase spending. But when revenue decreases, rather than decrease spending at the same rate, government claims it must raise taxes.

Simply because this process exists, however, does not mean that it should. Government officials have a responsibility to act in the interests of their constituents. No voter ever casted a vote to serve the self-interests of a candidate. Elected officials have a fiduciary duty to serve those they represent, and that duty ought to compel fiscal responsibility and budgetary prudence.

We need leaders committed to constrain spending, who treat each dollar as if it is their own. We need leaders that realize every dollar they spend is a dollar taken from their constituents. We need leaders that save, rather than spend, during times of prosperity in order to prepare for times of scarcity. It is time we demand fiscal responsibility.  

-Matt Benchener from TruPolitics.net

Liberalism and Feudalism

TruPolitics.net is proud to welcome writer Edward Mahee. Mr. Mahee boasts an extensive legal background, and is an emerging conservative thinker. Expect articles from Mr. Mahee every other week. This is his third posting for the site.

Since the beginning of its movement in the late 19th century, liberal thought has claimed to be progressive, forwarding thinking, and innovative. Its proponents state that humanity can achieve greater prosperity by embracing new solutions to age-old problems. As Barack Obama said during last year’s presidential campaign, “We are the ones we have been waiting for.”  More poignantly, Hubert Humphrey once noted that, “Liberalism, above all, means emancipation – emancipation from one’s fears, his inadequacies, from prejudice, from discrimination, from poverty.”

When observing liberalism in practice, however, what surfaces is not a philosophy of innovation and change. Rather, it becomes increasingly clear that liberalism is simply a reiteration of tried and failed ideals, which may explain its inability to accomplish its stated goal.Medieval Feudalism

At this point you may be saying, “Come on Mahee, get a grip.  We’ve already been over liberalism as socialism or liberalism as soft totalitarianism.  It’s not liberalism that is rehashing old ideas, it’s you.”  And that I understand.  The truth, however, is that liberalism is not simply a reiteration of socialism or totalitarianism.  Rather, liberalism’s antecedents can be found in feudalism.

Feudalism was a method of societal organization which had its apogee in medieval Europe and Japan.  While there were many variations of feudalism, the basic structure was as follows:  On the top of society was the king; below him was his retinue of barons; below them were knights, below them were yeoman (free peasants); and below them were the serfs (peasants tied to the land on which they lived and worked).

The hallmark of any feudal society was a system of two-way obligations of payment and fealty in exchange for protection.  In other words, a serf owed his lord taxes, labor and obedience, all in exchange for his lord’s protection.  The same was true for knights with barons and barons with the king. Of course, these mutual obligations were not of equal value. When a serf was dependent on the noble lord for protection, the serf lived at the mercy of his lord, and the lord ultimately lived at the mercy of the king. 

The basic principal underlying feudalism was that ordinary people were incapable of governing themselves—they had to rely on the kindness of their lords to protect them and to govern them.  Ordinary people were therefore unable to live and work for themselves.  For centuries, men and women lived and died under the eye of another.  They were not free to choose to live outside the bounds of the feudal world. 

So how does modern liberalism relate to feudalism? Liberalism presents itself as a philosophy that, if applied, will free individuals from fear and want.  Under the guiding hand of a benevolent elite (in our case, a politician or government official), individuals will be protected from life’s dangers and granted a certain degree of prosperity.  

In return, of course, the elite demands support, votes, and taxes.  That is, they demand control.  Liberals, in the name of the protection and happiness of the collective, will control what one eats, how much one can save, whether or not one gets medical care, what kind of car one may drive, and where and how children are educated. A free person is useless to a liberal elite because a free person does not need to be governed.   The parallels to our current administration are exceedingly clear.

One reason America was so attractive, even before Independence, is that individuals could conduct their lives without explicit oversight and control. They could organize and govern themselves as they chose. But now, in the name of protecting people from themselves, liberals will promise you the moon if only you surrender your freedom to them.

For 100 years, liberals have been asking American citizens to surrender their freedom, all the while ridiculing those who resists for their “lack of compassion” or “selfishness.”  The time has come for Americans to decide that our natural born rights as free people be respected. Otherwise, we will continue to surrender our liberty to elites—as our ancestors did to their noble lords—who have convinced us that we are incapable of governing ourselves.  Liberals demand our fealty for protection.  Will we give them our fealty, or will we, as free people, say no?

-Edward Mahee from TruPolitics.net

Liberty and ObamaCare

This article was featured in The Bulletin (Philadelphia-area newspaper) on 8/10/09, and The Bucks County Courier Times on 9/6/09. You can see The Bulletin version here, or check out the print column each week.

Government RationingPresident Obama may see resistance to his healthcare proposal from a group he was not expecting: Obese Americans. A new study in the journal Health Affairs found that obesity-related health spending costs $147 billion annually, and that obese Americans spend an average of $1,400 more per year on health expenses than those in a healthy weight range. The research ties closely with an earlier study in the Health Affairs Policy Journal showing that obesity creates a 36% increase in inpatient and outpatient spending, and a 77% increase in medication use. The findings led RTI health economist Eric Finkelstein to say, “Unless you address obesity, you’re never going to address rising health-care costs.”

So why should obese Americans worry about President Obama’s universal healthcare proposal? Shouldn’t they be happy that their increased costs will be paid for by the government? Not exactly.

ObamaCare rests on the idea of cost control through government intervention and regulation. By limiting extraneous tests or procedures and identifying cost-ballooning health risk factors, President Obama’s plan hopes to guide the healthcare market to greater efficiency, allowing the government to offer inexpensive care.

This theory of cost control through regulation is where the administration claims it will save money in the long run, or “bend the curve” of health spending.  Recently, Lawrence H. Summers, President Obama’s chief economic adviser, said it more poignantly:

“Whether it’s tonsillectomies or hysterectomies…there’s no benefit in terms of the health of the population…some experts…estimate that we could take as much as $700 billion a year out of our health care system.” What Mr. Summers is referring to is rationing and regulation: In order to control costs for the whole, government will control or limit care for individuals.

The foundation of ObamaCare is the idea of collectivism, that what is best for the whole (the collective) is what is just for the individual. So, if you choose to have a “needless” tonsillectomy for your child, and the procedure raises the overall cost of care for the nation, you’ve done something wrong. Your choice has hurt the collective, so your choice must be limited. Under ObamaCare, such indiscretion will be forced out of the system.

Fundamentally, collectivism shifts responsibility and choice away from you and onto the government. Currently, it is your choice what procedures and medicine are available to you and your family. Under ObamaCare, if a procedure falls outside of the government’s cost-efficient estimates, it will be disallowed. If a prescription is deemed “cost-ineffective,” it will be deemed unnecessary.

If you think rationing is unrealistic hyperbole, you need only to look to our Canadian and British counterparts. In Canada, 44% percent of the drugs approved by Canadian health authorities are not allowed by the healthcare system due to their high cost. In Britain, the National Institute for Health and Clinical Excellence (NICE) recently ruled against the use of Lapatinib (a drug that prolongs the life of those with certain forms of breast and stomach cancer), Stutent (a drug to help terminally ill kidney-cancer patients), and Aricept (an Alzheimer’s drug that delays dementia) because they were not seen as “cost effective.” Despite outrage from doctors in the U.K. over the importance of the drugs, Peter Littlejohns, NICE’s clinical and public health director, stated that “there is a limited pot of money” which might be better spent elsewhere.Rationing

So how does obesity factor in? Studies show that the vast majority of Obese Americans are overweight by choice (the remainder have genetic or thyroid conditions), and therefore raise costs drastically for the collective because of their personal lifestyle. Under ObamaCare, a preventable choice that damages the whole is simply unacceptable. Indeed, Democrats have already proposed a massive tax on sugary drinks and trans-fatty foods; it is easy to imagine caloric control limits or compulsory weight reduction programs for the obese.

And why stop there? The New England Journal of Medicine recently reported that “healthcare costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers.” Shouldn’t everyone that participates in ObamaCare be required to quit smoking? And what about alcohol consumption, high carbohydrate diets, or high stress jobs? Each has been linked to increased medical costs. In a collectivist system, such choices must be limited.

Addressing the prospects of universal care in the United States, Scott W. Atlas, a senior fellow at the Hoover Institution and a professor at Stanford University’s Medical Center put it best: “There is no mystery here—it has been proved the world over that when government dictates prices on services, those services become unavailable. And when bureaucrats dictate medical care, it is the patient who suffers most. Directly or indirectly, choice becomes limited, and health care becomes rationed.”

What the government provides, it also controls. What the government controls it also rations. Perhaps now more than ever, Thomas Jefferson’s words ring true: “Government big enough to supply everything you need is big enough to take everything you have… The course of history shows that as a government grows, liberty decreases.” On healthcare, we would be wise to heed this warning.

-Matt Benchener from TruPolitics.net

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