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Sunday, September 30, 2007

"Universal Health Care" (aka Socialist Health Care)

Hat Tip to Norman Hooben via email: GREAT questions/commentary

1. Our quasi-socialist health-care system in which the government pays almost half of all health-care costs (verses 12% of health-care costs paid out of pocket by individuals) is already killing and injuring Americans. Putting government in exclusive control of any service increases the costs and decreases the quality of the service provided. Why then would we want to put government in exclusive control of health-care as Hillary and the Democrats are proposing?

2. To those who say, "no American should go without health-care...." The U.S. Congress passed the Emergency Medical Treatment and Active Labor Act in 1986 which requires emergency rooms to treat any person who shows up seeking medical treatment, regardless of their ability to pay or whether they are a legal US citizen or an illegal alien. So, which citizens are you referring to that "go without" health-care?

3. To those who claim that, "universal health-care should be a guaranteed right for every American...." Since our Constitution only guarantees rights to take actions (i.e. the right to pursue happiness, the right to free speech, the right to self defense, the right to equal protection under the law, etc…) on what basis does our Constitution guarantee health-care insurance? Are you claiming that health-care insurance is an enumerated unalienable "right" in our Constitution? If it is then isn't car insurance, life insurance, and other forms of insurance also a "right" to which all Americans are entitled?

4. To those who claim that "too many Americans don't have health-care and hence there is a need for universal health-care...." First, by law no one residing in the United States -- legal or illegal -- can be denied treatment at any emergency room in America. Secondly of the 45 million uninsured Americans, according to the US Census Bureau, 37% live in households earning greater than $50,000 per year, 19% have incomes greater than $75,000 per year, 20% are not US citizens (aka "undocumented workers" or "potential Democrat voters"), and 33% are eligible for government programs but are not enrolled. Should tax-paying U.S. citizens be forced by the government to subsidize health-care insurance for 12-20 million illegal aliens who don't have coverage? And what about the 17 million Americans who make over $50,000 a year who can afford insurance but choose not to buy it? Don't they have this right? And why should the government force them to have health insurance if they chose to pay out of pocket? Wouldn't it make more sense to implement market based reforms -- to reduce the cost of health-care and increase the affordability and availability -- such as equalizing the tax treatment for businesses and individuals, increasing the availability of tax-free health savings accounts, nationalizing the 50-state insurance market, reducing expensive and onerous government insurance mandates, limiting Medicare and Medicaid for those at or below the poverty line, and ending "guaranteed issue" laws that enable people to put off purchasing insurance until they need it?

5. To those at the New York Times, which wrote "the United States is a laggard not a leader in providing good medical care verses other countries...." The World Health Organization and Commonwealth Fund Studies on which the Times based its statement judged a country's overall quality of health-care based on life expectancy. But is this really a fair basis for comparison given the fact that we have a significantly higher number of fatal car accidents, a higher homicide rate, and a higher obesity rate (that have nothing to do with the quality of our health-care) than other countries such as the "U.K. and Canada? When these things are taken into account the U.S. actually has a higher life expectancy rate than nearly every industrialized nation in the world. People come from all over the world to receive virtually every type of high-technology medical procedure and advanced drug therapy that they cannot obtain in their own country. If we are a "laggard", then why are people from all over the world coming here for inferior quality health-care?

6. To those who claim: "We need to ensure health-care for all Americans and need to institute a government health-care single-payer system like they have in Canada, France, the U.K. and Cuba so that all Americans can receive quality affordable health-care." Why would we want to do that given the fact that in these countries, patients who have "universal government" coverage face significantly longer waiting times, treatment times, rationing, and inferior health-care overall? Why are citizens from these countries flocking to the U.S. to receive high quality life saving treatment in virtually every area from neurosurgery, to cardiology, to organ transplant, to cancer treatment, to even routine MRIs?

7. To those who claim: "We need to invest more in health-care." How can one say this and also argue that American health-care is inferior to other socialist countries because we spend too much on health-care as a percentage of GDP? How will spending trillions of tax dollars on health-care actually reduce costs, empirically speaking? The only way that socialist countries have been able to "reduce" overall costs is through the rationing of health-care. Could we "reduce costs" without rationing? How would we do that? Where has it ever been done?

8. To those who say: "We need to roll back 'the Bush tax cuts for the rich' and 'invest' that money on health-care for the poor." Why can't we lower taxes across the board and institute competitive affordable health-care simultaneously? How would increasing taxes on the most productive workers (the "rich") in America enable more "poor" Americans to obtain health-care? Raising taxes on those making more than $200,000 (80% are small businesses who pay taxes at the individual rate) will leave many businesses with less money to expand and hire more workers. How will this help make insurance for the "poor" more affordable? Also, if having more money available to the government to "invest" in a national single-payer health-care plan is the goal, wouldn't it be preferable to actually reduce tax rates across the board since every time taxes have been reduced over the last century tax receipts to the treasury have increased significantly?

9. To those who say: "Health-Care Savings Accounts (HSAs) will only benefit the rich and will result in higher costs to those who wish to remain in the traditional program which will hurt the elderly and the poor." HSAs have enabled small businesses to realize an average savings of about forty percent on health-insurance premiums according to the Center for Health Transformation. What specific data shows that HSAs only benefit the "rich" and hurt the "poor?"

10. To those who say "the vaccine shortages in America prove that government has to be in control of health-care to ensure universal vaccinations -- that profits should not come before health for the children and the elderly...." In 1993 Congress passed Mrs. Clinton's "Vaccines for Children" program which gave the federal government the power to negotiate prices exclusively with drug companies to ensure universal vaccinations. The government agreed to purchase sixty percent of the national pediatric vaccine supply (Clinton pushed for 100%) at a forced discount of about 50% to be delivered to doctors, the poor, and the uninsured even though vaccines are already free for the needy through programs such as Medicaid and S-CHIP. Since government bureaucrats instead of doctors became the direct purchaser of vaccines and dictating prices below costs, many manufacturers were forced out of business (thirty years ago twenty-five companies produced vaccines. Today there are only five). Given that history, how will expanding government control make vaccines more abundant and affordable? Isn't the lesson here that government mandated price-controls limit competition which leads to rationing and shortages?

11. Mrs. Clinton, under your universal health-care proposal people would automatically be enrolled in a government-run "health alliance." Your plan specifically states: "It is the obligation of every eligible individual to enroll in a health plan. Anyone who does not meet the established deadline for enrollment automatically is enrolled in a health plan when he or she seeks medical care. Regional alliances assign patients who do not seek enrollment to a health plan; they automatically assign any newborn infant who is not enrolled through his or her parents to a plan." Once you are enrolled, "health-providing institutions... would send all patients through medical 'gatekeepers,' who would decide what care people really need." Can you please specify who these "gatekeepers" will be and what specific criteria they will use to determine what type of care "people really need?" Isn't the type of care a patient needs a decision best made by the patient and his physician?

12. To those who claim that a "single-payer system will save money because people will seek care earlier when it is easier and more affordable to treat diseases...." While it is true that we could significantly reduce health-care costs overall by focusing more on earlier state preventative care instead of advanced stage treatments and therapies, what would make one think that people would have easier access to health-care in a single-payer government run health-care system given the excessive long waits and difficulties getting appointments in the U.K., Canada, France, and Australia? Is there one example where a single-payer system actually saves money and increases access simultaneously?

Spin that.

UPDATES to follow, I am most sure...

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