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August 23, 2007

Death by Government

Today’s Downsizer Dispatch . . .

Evangelize the Downsize DC message. Forward this to friends . . .

Quote of the Day:

“One death is a tragedy. Six million is a statistic.”
— attributed to Joseph Stalin

Subject: Death by government

When real market prices are unavailable to balance supply and demand in the health care sector — when prices are set by government decree, or distorted by government funding — the consequence can be death.

It’s easy to miss this truth if we only focus on anecdotal personal testimony. Talk to people from Canada and the U.K. and you’re likely to hear glowing praise for their national health services. Alas, there are fundamental problems with this kind of testimony . . .

  • People living under national health services have little or nothing to compare them to.
  • Small medical problems, easily fixed, are far more common than those that are life threatening — thus, most personal testimony tells us little about how well major procedures are handled.
  • Patients that survive major medical problems in such systems tend to assume the system works.
  • While those who die because of the system’s failure are unavailable to testify.
  • This is the familiar economic problem of the “seen and the unseen” — the successes are seen, walking among us, while the failures lie buried, unseen and silent.

Michael Moore, in his film “Sicko,” makes dramatic use of horrifying anecdotes of failure in the American system. We say, “Good for him!” We too reject America’s current system, precisely because it is already half-way to the type of system Moore advocates. We applaud him for exposing the failures of America’s half-socialized system, but . . .

We must criticize him for not telling the whole story. If you watch another movie, “Dead Meat,” you’ll hear equally horrifying anecdotes about the fully socialized Canadian system, which is the kind of system Moore wants for America. Though Moore favors the French socialist system, future messages will show that there is really no fundamental difference between France and Canada. For now we just want to compare movie-anecdote to move-anecdote, and “Dead Meat” is about Canada . . .

  • A Canadian woman waited TWO YEARS for “free” cancer surgery, only to have her appointments canceled, twice. Death came before her surgery did.
  • A Calgary woman was in excruciating pain from worn-out knee cartilage. She had to wait 16 months for her “free” surgery. It took so long that she became addicted to “free” Oxycontin. The result? More time on another long list, waiting for “free” drug rehab.
  • Another man needed urgent neck surgery. His “free” doctor told him there was a TWO-YEAR WAIT for a FREE INITIAL CONSULTATION!

Moore doesn’t really cover the anecdotal horrors of the various socialist systems, even though there are plenty of such stories available.

But if both sides in a controversy can each produce horrifying anecdotes, then what have we really learned? How can we choose between the competing stories to arrive at an optimal policy? We would submit that anecdotes can tell us little more than this . . .

  • The American system of half-socialized medicine has big problems
  • Foreign systems of fully-socialized medicine also have big problems

But what the anecdotes can’t tell us is how the half-socialized American system compares to the fully socialized foreign systems, or how either approach would compare to a totally free market system.

What we need instead of anecdotes is statistical information that can give us a well-rounded picture. Statistics may lack the emotional impact to get your blood pumping, but they could provide the crucial evidence you need to KEEP your blood pumping. We’re talking about statistics likes these . . .

  • British colon cancer patients had to wait so long for medical attention that 20 percent of the cases considered curable at the time of diagnosis, were incurable by the time of treatment. (Source: Anthony Browne, London Observer, December 16, 2001)
  • 71 patients in Ontario, Canada died while waiting for bypass surgery, and another 121 had to wait so long there was no longer any point in operating. (Richard F. Davis, Canadian Medical Association Journal 160, no. 10, May 18, 1999)

  • In Britain, on an annual basis, waiting lists cause a denial of treatment to 9,000 people for renal dialysis, 15,000 for cancer chemotherapy, and 17,000 for coronary artery surgery. (Source: Henry J. Aaron and William B. Schwartz, “The Painful Prescription: Rationing Hospital Care,” the Brookings Institution, 1984).

This is death by waiting list. Death by rationing. Death by government.

But how does the U.S. system of half-socialized medicine compare? The available statistics are so abundant, and so in favor of America’s half-messed-up system that it’s hard to pick what to show in this short message, but for just a taste of the available data, consider these comparisons of where we have been in comparison to Britain and Canada, and where we still are . . .

  • Back in 1978 the U.S. rate for pacemaker implants was more than four times higher than that of Britain, and 20 times that of Canada, plus the U.S. has three times more CAT scanners available per capita than Canada, and six times more than Britain. (Source: Mary-Ann Rozbicki, “Rationing British Health Care: The Cost/Benefit Approach,) Executive Seminar in National and International Affairs (U.S. Department of State, April 1978)
  • But have things changed over the years? Are government systems responsive to their deficiencies? The answer is no.

  • Today, Britain still has only half as many CT and MRI scanners per capita as the U.S., and the disparity with Canada is similar, not only with regard to scanners but numerous other treatments and diagnostic tools. Things really haven’t changed much over the years — national health services continue to lag behind in almost every category. (I’ve provided more detail and sources below my signature.)
  • Or how about this . . .

    In 2001, how many patients had to wait more than 4 months for surgery? The answer is . . .

    • 36% in Britain’s fully socialized system
    • 27% in Canada’s fully socialized system
    • 26% in New Zealand’s fully socialized system
    • 23% in Australia’s fully socialized system
    • And . . . drum roll . . . only 5% in America’s half-socialized system

    (Source: “Comparison of Health Care System Views and Experiences in Five Nations,” Commonwealth Fund Issue Brief, May, 2002)

    What a difference just half as much socialism can make.

    If the statistics show the fully socialized systems to be so much worse than America’s half-socialized system, isn’t it at least worth considering that we might solve many of America’s remaining health care problems by going even more in the direction of the free market?

    These are just a few snap-shots of what the statistical studies show, in comparison to mere anecdotes. There are many more such studies, tending strongly toward the same conclusion . . .

    “There ain’t no such thing as a free lunch. TANSTAFL!”

    TANSTAFL is a pithy way of saying that if you don’t pay a real free market price for health care, supply will fall short of demand, and so you will pay in another way . . . with waiting lists that could kill you.

    Plus, you’ll also pay BIG TAXES for your supposedly FREE system, on top of the potentially deadly waiting lists, and you’ll lose the power of free market competition to keep prices down (all of these things are already big problems in America).

    But the prospect of what we face in America is even worse than the harm countries like Britain and Canada have done to themselves with socialized medicine. Our country, if the trend continues, is much more likely to adopt a fascist, rather than socialist model of state health care.

    This will involve a lot of corporate welfare, monopoly partnerships between corporations and the state, with prices and terms of treatment set in consultation with corporate lobbyists. Or, in a word, fascism.

    Please, please, please, let us not do this. Because once it happens it will be nearly impossible to reverse.

    What should we do instead? It’s a big subject, and we will get to it, but the right place to start is where the physicians start, “First, do no harm.” Even if you think some kind of increased government involvement is needed in American health care, do not let it come at the federal level.

    Please send a message to Congress opposing any further funding of personal health care expenses at the federal level. Please cut and paste some of the above statistics (or those below) into your personal comments to Congress. If you’ve already sent a message on this issue, using the statistics justifies sending another one.

    And please, please, please, help us spread the word about the above facts, stories, and arguments, to counter the current drumbeat for federally funded health care. Please forward this message to other people. And if you received this message because someone forwarded it to you, please do the same and forward it to someone else. Spread the word!

    Thank you for your time and attention. Thank you to those of you who are DC Downsizers. And if possible, please make a contribution to further our work.

    Perry Willis
    Communications Director, Inc.

    PS: Our thanks to the Cato Institute and the Independent Institute for accumulating the studies used in this message.

    Additional stats and sources . . .

    • Britain has only half the number of CT scanners as the U.S. Source: Anderson, Reinhardt, Hussey, and Petrosyan, “It’s the Prices Stupid,” pages 89-105
    • Britain also has half as many MRI scanners per capita as the U.S. Source: “National Service Framework for Health,” UK Department of Health, London, 2000
    • For an extensive list of Canadian deficiencies in treatments and diagnostic tools see “Canada’s System Lacks Many Bells and Whistles,” by Tom Arnold, National Post, November 17, 2001
    • Also, see the Canadian Medical Association Journal 165, no. 4, August 21, 2001, 421-25

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