The Title Of Liberty

Making its way into the current discussion on healthcare is a recent article in The Washington Post by T.R. Reid, entitled, 5 Myths About Health Care Around the World.

The article itself makes no obvious arguments for or against the currently proposed House and Senate bills on “insurance reform.” It is, however, being cited and passed about among blogs, social networking sites, and etc., by those who directly or indirectly infer that it bolsters the argument for the current progressive agenda for healthcare reform.

However it fails to address the most important concerns of conservatives, constitutionalists and many moderates, regarding the inherent threats to liberty which the current proposed bills represent. In addition, while researching the facts behind Mr. Reid’s claims, I found them lacking even in effectively supporting the points that he does attempt to address.

I should first point out that I am not opposed to adopting any methods by other nations which improve quality of care and reduce costs, which would not infringe on constitutional freedoms, and do not require an increase in federal power and influence to do so.

The overall point which Mr. Reid seems to be making is that the opposition to healthcare reform in America stems from Americans who are dismissing the means by which other nations are attempting to address their healthcare issues. He essentially attributes this to ignorance on the part of those Americans, and summarizes their apparent ignorance into 5 misconceptions:

1. It's all socialized medicine out there.
2. Overseas, care is rationed through limited choices or long lines.
3. Foreign health-care systems are inefficient, bloated bureaucracies.
4. Cost controls stifle innovation.
5. Health insurance has to be cruel.

To address Mr. Reid’s overall premise, let me say briefly that conservatives who cite deficiencies in Canadian and European healthcare systems are doing so as corroborative and supplemental points behind their main arguments, which are more concerned with, for example, the constitutionality of the healthcare models proposed by progressives.

So, keeping in mind that only his first point comes near the same ballpark as the main arguments against the currently proposed “reforms,” let’s look at each of his arguments:

1. It's all socialized medicine out there.

Frankly, conservatives (and many true moderates) are less concerned about whether other nations already have socialized and more concerned about whether America is about to be socialized. While Mr. Reid may correctly point out that only a handful of nation’s plans fit the pure idealized model of socialized government-run care, and that other nations only have varying degrees of socialization in their model, this does not address the reality that Obama, Barney Frank, and others have stated in the public record that a single-payer government-run healthcare is their long-term goal and that their current strategy represented by the proposed bills is their best means of reaching that goal. This is the crux of most conservative and moderate objections to the current “reform” proposal. Everything else is essentially supplemental.

Reid also correctly points to Medicare and the Veterans Administration as more pure examples of socialized medicine than other models around the world—as if that makes accepting additional socialization desirable? He fails to point out however, that Medicare is neither adequately funded, nor sustainable, nor constitutional.

2. Overseas, care is rationed through limited choices or long lines.

This point is often listed by conservatives, in a supplemental way, as a known side-effect of a bureaucratic socialized medicine system. That is, that the compromise of constitutional freedoms (the original champion of human rights) represented by socialized care are not justified by the resulting quality of care, even if that quality is marginally improved. But, it is still true that some socialized nations do see a decline in quality after surrendering, as Franklin would say, a little of their liberty to obtain a little security.

That being said, let’s look at the nations which Mr. Reid holds up as shining examples: Germany fares best in his estimation, which is not surprising when you consider that Germany started addressing the healthcare issue at a government level in the late 1800’s. They’ve had a little time to tweak the system, and it’s not surprising that they’d have gotten some things right after more than 100 years.

Somehow, I hold little hope that we can attain the same kind of results from House Bill which was drafted by a committee under threat by Speaker Pelosi that if any member of the committee so much as spoke to a Republican in the process, they would be kicked out of the committee. I have little hope in obtaining the same kind of results from a 1018 page house bill which takes nearly twice the number of pages to say many of the same things, and yet manages to be more vague in many important respects than the 600+ page Senate bill. And I have little hope that we’ll achieve the same results from a healthcare reform effort that has started receiving impatient criticism from the left for not being finalized already—in a time period less than what the Obamas took to pick the Whitehouse dog.

So, under current conditions, we can hardly expect positive results from our bill on par with positive aspects resulting from over a century of German healthcare reform.

Mr. Reid also has high praise for, among others, Canada (which he does admit has issues with waiting lines), France and Japan’s systems, which I will address in points to follow.

Overall however, you would be hard-pressed to find a conservative who would pick longer lines as his or her primary objection to government-run healthcare.

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Again, a supplemental issue, another issue cited as a possible outcome to surrendering our liberties for promised securities which may or may not be fully realized as promised.

No one is arguing that we should cling to inefficiencies. But Canada, for example, which Mr. Reid touts as a model of efficiency for using only 6 percent of every healthcare dollar on administration. Nevertheless, according to their incoming President of the Canadian Medical Association, their healthcare system is financially “imploding” and “more precarious than perhaps Canadians realize” and “is not sustainable.”

Reid frequently peppers each of his points with statistics regarding France’s healthcare system as well. But as Investors Business Daily and City Journal point out, “the French would also love to have the low-cost, high-service system some Americans gush about. Unfortunately, they don't. France's system isn't that cheap and is financed by high taxes on labor that have heavy economic consequences.”

Highlights of their findings include:

• French workers get in excess of 10% deducted from their monthly wages to fund their coverage, PLUS an additional employer-contributed amount 4 times the individual’s deductions, PLUS an additional tax levy imposed to cover deficits that the national health insurance system consistently runs.
• This levy is raised by French parliament every year, and their entitlement system alone claims 25% of the French national income.
• The mandatory employer-contributed share of insurance raises the cost of labor prohibitively and hampers business growth. If you think that the American economy is currently in dire straits over a 9.5% unemployment rate, consider that the French unemployment rate consistently hovers around 10%. Employers simply can’t afford to hire.
• Drugs cost less in France because the government fixes the prices. American drug companies who don’t want to lose the French market simply subsidize their costs by charging more in America for those drugs. In other words, that portion of American healthcare costs is higher because we are already bearing the burden of socialized medicine—of other nations. (Incidentally, France is not the only country with much-touted lower fixed healthcare costs, the true burden of which America ultimately ends up bearing.)
• Some touted health statistics for France, such as infant mortality rates, are skewed by the fact that France and the US measure them differently. With infant mortality rates in particular, the US counts any infant born that shows any sign of life for any period of time; while for France and most of the European Union, any baby born prior to 26 weeks’ gestation is not considered alive and therefore does not “count.”
• France reimburses doctors far less than US doctors would accept for their labors, and France has seen disastrous results on occasions when shortages of available doctors coincided with unlivable conditions in French hospitals: Like during an August 2003 heat wave, when 15,000 elderly died for lack of quality care.(http://www.ibdeditorials.com/IBDArticles.aspx?id=336178343967257)

But Reid’s shining star in this section, the “world champion at controlling medical costs” is Japan, even though “its aging population is a profligate consumer of medical care.”

What he doesn’t tell you in this article, however, is how Japan manages to keep those costs low. It’s not a means which Mr. Reid is ignorant of, however. He just chose not to mention it in this article.

In another article he’s written specifically on Japanese healthcare, he reveals how they keep costs low: “The Japanese Health Ministry tightly controls the price of health care down to the smallest detail. Every two years, the health care industry and the health ministry negotiate a fixed price for every procedure and every drug.” In other words, the “cost” is low because the government determines the “cost” they will allow. How does this impact the financial health of the Japanese health industry? I’ll explore that momentarily. (But note that this is yet another “low-cost system” offloading their true drug costs on the one nation who has not gone completely to artificial price-fixing: America.)  

Let me first address one factor which Reid consistently infers is a by-product of Japan’s superior healthcare system—which, given Mr. Reid’s lengthy tenure as a journalist on healthcare issues, he should know better.

It is a well-researched fact that Japanese national heath statistics are superior to American health statistics because of a significantly healthier diet and lifestyle. Similar comparisons could be made between America and almost any other industrialized nation. America is the leader in excessive diet and lifestyle.

As an example of personal experience, if I were to order the largest possible size soda in an American fast food restaurant, I’m likely to get a whopping 44 ounces of carbonated high fructose corn syrup and caffeine. The smallest cup is likely to be 16 ounces. I notice very quickly a difference when I travel abroad.

When I order the largest soda available (even in a western fast food chain like McDonald’s) in the Philippines, I’ll be lucky to get 16 ounces of soda, but more likely 12. The smallest size comes in at about half that size. (And their soda uses pure cane sugar, which has less impact on the body’s management of blood sugar than high fructose corn syrup.)

In his book, The China Study, T. Colin Campbell, PhD examined the diets and resulting health statistics throughout Asia, including Japan, the Philippines and particularly in China, the study from which the book publishing his findings is named. In it, he states,

“Here in America, we are affluent, and we die certain deaths because of it. We eat like feasting kings and queens every day of the week, and it kills us. You probably know people who suffer from heart disease, cancer, stroke, Alzheimer’s, obesity, or diabetes. There’s a good chance that you suffer from one of these problems, or that one of these diseases runs in your family … [T]hese diseases are relatively unknown in traditional cultures that subsist mostly on whole plant food, as in rural China. But these ailments arrive when a traditional culture starts accumulating wealth and starts eating more and more meat, dairy and refined plant products (like crackers, cookies and soda.)”

Further, he says, “the same diet that is good for the prevention of cancer is also good for the prevention of heart disease, as well as obesity, diabetes, cataracts, macular degeneration, Alzheimer’s, cognitive dysfunction, multiple sclerosis, osteoporosis, and other diseases.

“All these diseases and others, spring forth from the same influence: an unhealthy, largely toxic diet and lifestyle that has an excess of sickness-promoting factors and a deficiency of health-promoting factors. In other words, the Western Diet.” (pg. 109-110)

It is very unlikely that Mr. Reid, as a veteran healthcare reporter, is unaware of studies such as this. That he appears to attribute the difference in healthcare expenditures between the US and other countries as simply a healthcare system issue, is disingenuous on his part.

So after citing Japan as a model of efficiency for keeping “costs” low by blatantly artificially fixing the prices of goods and services, and after listing statistics of health expenditures in Japan vs. America as a symptom of a superior healthcare system rather than the reality of a superior diet, he goes on to repeat similar fallacies in his next point:

4. Cost controls stifle innovation.

Reid first correctly identifies the fact that America is not the sole source of medical innovation in the world-- as if anyone would seriously maintain the premise that it is. That other countries have produced some innovation, however, does not make them leaders of innovation, a claim which he carefully avoids making, nor does it make the other systems ideal for innovation. He simply carefully claims that some innovations do exist. That was never in debate.

He does, however, go on to double-up on his praise of Japanese price fixing, but attempts to lead the reader to believe that Japan’s low price on MRIs is a result of some innovative new way of doing the procedure. It’s not; it’s simply a result of artificially fixed prices due to government mandate. MRIs cost $98 dollars in Japan because the government will not allow charging any more for the procedure. Again, something of which Mr. Reid is well aware, because he himself has reported on it. He just chooses to give the reader a different impression in this article, in the height of the progressive push for “reform.”

And what is the economic result of Japan’s artificial price fixing on their healthcare industry? Again, Mr. Reid knows, but neglects to tell us. While personal bankruptcies for medical bills are almost unheard of in Japan, neither doctors nor hospitals fare so well:

:

• Like in France, doctors are paid far less in Japan than in the US. In T.R. Reid’s NPR story on Japanese healthcare, he reports of a doctor who gets paid “peanuts” for his efforts and attempts to supplement his income with vending machines in his office waiting room and by charging his patients as much per hour to park their cars as he is allowed to charge them for sewing up their stitches: about $4.
• Half of all Japanese hospitals are running at a deficit.(http://www.npr.org/templates/story/story.php?storyId=89626309)

5. Health insurance has to be cruel.

This is Mr. Reid’s most specious argument. Who in their right mind would actually fight to preserve the most unbearable aspects of a health insurance system because they think it’s somehow supposed to be unbearable? Seriously, who is out there deliberately arguing for this?

Regardless, having set up this straw man, Mr. Reid diligently labors to knock it down. During this attempt, his argument quickly reveals that his real objection: that medical insurance companies in the United States are the only ones who operate their companies for a profit. Those greedy bastards! How dare they expect a return for their investment, a reward for their risk, like every other American individual or company expects in compensation for providing their product or service?

So here we start to get insight on Mr. Reid’s motives. He apparently finds the American profit motive, the inalienable right to “the pursuit of happiness” as an objectionable thing.

The more I researched the questionable facts behind Mr. Reid’s claims, the more his motives behind writing the article came into question.

The 5 myths that Mr. Reid carefully sets up in order to knock down are not the main issues of concern that conservative or moderates have with ObamaCare. As I have already noted, he does not attempt to address these concerns directly, and progressive proponents of ObamaCare generally do not take on constitutional concerns either. Why is that? Why do they prefer to skirt around these supplemental issues?

Because a progressive cannot win when constitutionality is the standard against which their “reform” agenda is held. Because a progressive feels restrained by the limitations placed upon them, or their agenda promoted via powerful centralized government, by the Constitution. The arena in which they can more easily be convincing is, in the words of Msrk Twain, “lies, damned lies, and statistics.”

So Mr. Reid’s article only goes so far to say, in summary, that other nations have varying levels of socialization  and that, (thanks to his carefully picked statistics) there are systems that appear to have advantages over the US healthcare in some aspects.

Mr. Reid, by all my research, appears to be a highly respected source among some media outlets, for reporting on healthcare. While those organizations, (Public Radio and The Washington Post) have increasingly held, in both their reporting and particularly in their editorial opinion, a more leftward-leaning political ideology, I cannot automatically cast him among them. Just because, for example, politically contributing employees of both media outlets overwhelmingly donated to the campaigns of Hillary, Obama and other leftist politicians in 2008, does not mean that Mr. Reid did.

And even though politically contributing employees of the Kaiser Family Foundation, for which Mr. Reid is the Health Policy Fellow, also overwhelmingly donated to candidates on the left, I’m sure that this has no reflection on their untiring non-partisan work on shaping healthcare policy. No bearing on it, for example, when producing a summary of changes to the healthcare system proposed in H.R. 3200 (the House version of the healthcare bill) that they fail to mention any of the more objectionable or controversial provisions… Such as the fact that Americans who prefer their existing insurance plans will get grandfathered into the government-approved plans only as long as their plan doesn’t change in any details, upon which occurrence, they would be required to change to a government approved plan.

Again, one could not soundly argue that the shared ideology of Mr. Reid's colleagues at three of his employers would have any effect on his perspective when reporting.

One could not even state conclusively that the fact that his own household (wife Margaret McMahon) donated $500 to Obama’s 2008 general election campaign, would have any bearing on his choice of straw man arguments, or his selective use of statistics to buttress those arguments.