Tag: healthcare

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Accountability folly general freedom ideological culture moral hazard nannyism national politics & policies property rights responsibility too much government

The Worst Is the Enemy of the Cure

Obamacare, healthcare, single payer, Ryancare, Trumpcare, government, Affordable Care Act

You’ve heard the adage: “the perfect is the enemy of the good.” This can be true in politics, where opposing an ameliorating reform because it is not ideal means, sometimes, getting stuck with unmitigated policy disasters.

But there’s a corollary: in politics the worst is likely to emerge . . . when practiced compromisers succumb to fearing the best, because unpalatable, or perhaps not in line with political interests.* Trying to avoid the “best is the enemy of the good,” we’re left with the outrageously awful.

Cures worse than the disease are not uncommon. The Democrats’ “Affordable Care Act” (ObamaCare) was a clumsy, badly drafted hodgepodge designed to fix problems by doing the opposite of what made sense.

And it immediately started having ill effects, pushing up costs for many, many health-care and medical insurance consumers.

No wonder Republicans ran year after year promising repeal.

But now that Republicans have the chance for a real cure, they’re chickening out. The Senate just debuted their ObamaCare replacement. And Senator Rand Paul (R-Ky) calls it “worse than ObamaCare.”

Why worse?

Because Republican politicians are better at promising than delivering. Fearing how those who directly benefited from ObamaCare might squawk, and how badly the GOP would be treated in the media because of this, moderates went with what they know: snake oil.

Fortunately, Rand Paul’s opposition may kill the bill. If one other senator joins Dr. Paul — and Sen. Susan Collins (R-Maine) who announced her opposition for other reasons — in not voting for the monster, it will not pass.

Which is great, because going for a cure worse than the previous cure leaves us all with the worst possible outcome.

This is Common Sense. I’m Paul Jacob.

 

* Like many cures. Politicians these days no longer have the knack for the necessary “spoonful of sugar” to help medicine go down. They prefer distributing just sugar pills.

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Accountability folly general freedom ideological culture moral hazard nannyism national politics & policies privacy responsibility too much government

UK Death Panel

healthcare, socialism, rationing, government

Six days ago, the European Court of Human Rights sided against the parents of Charlie Gard, a severely ill boy, refusing to allow them to take their infant son to America where he could receive full (and privately funded) experimental treatment. The court ruled that removing the child from the hospital would cause him “significant harm” — and authorized the termination of life support.

Yesterday, this site quoted Ben Shapiro on the case. Shapiro sees this sad story as a grand demonstration of what is wrong with government-funded and -managed health care:

Bernie Sanders tweets about how nobody should be denied care because they can’t afford it? But that’s what happens all the time under socialized medicine — the difference being, it’s not about you not being able to afford it, it is about the government not being able to afford it.

Economists tell us that, in a world of scarcity, there will be rationing, willy nilly: either by price (according to consumer and producer choices) or else by government diktat.

Last week, the European Court of Human Rights did its due diligence to ration resources — serving as a Death Panel.

The scheduled to pull the plug on Charlie last Friday, but there’s been a last-minute reprieve — no doubt a result of pressure from America and the Vatican.

Though the doctor who testified before the court insisted that any American medical institution would have provided the treatment he offers, the best the Gards can apparently hope for, now, is to be allowed to take Charlie home to die.

Think of it as socialized medicine in action.

This is Common Sense. I’m Paul Jacob.

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free trade & free markets moral hazard nannyism national politics & policies property rights responsibility subsidy too much government

TrumpCare Trumped

Trumpcare, Ryancare, healthcare, Obamacare, Freedom Caucus, socialism

It took awhile for the Obama Administration to accept the term “ObamaCare.” Nancy Pelosi was the initial driver of the massive scheme to permanently alter American medicine and insurance, and “PelosiCare” would have been a fit moniker for the wildly mis-named “Affordable Care Act.” But the administration put the whole of the new president’s political capital behind it, and the ACA went into law popularly known as “ObamaCare.”

The Republicans pledged to repeal it, from Day One. And repeatedly passed repeal bills, certain to be vetoed by the president named Obama. They needed a Republican in the White House.

Donald Trump ran, in part, on the promise of getting rid of ObamaCare. But upon taking the reins, two things became obvious: Republicans in Congress lacked the guts to repeal the ACA, and even lacked a coherent scheme to alter it.

The new president could hardly be expected to possess the plan they lacked, though on the campaign trail he suggested* the best approach: repeal, then open up insurance markets across state lines. The GOP Congress, on the other hand, was all promise and no clue.

So Speaker of the House Paul Ryan hastily cooked up what was to be the new TrumpCare — a ridiculous reform package with nothing much to say for it.

He failed to gain support from Democrats (of course) and Freedom Caucus representatives.

TrumpCare, trumped, became RyanCare. A failure.

The Freedom Caucus representatives? They breathe freely.

Sure, they “betrayed” the new president, “robbing” him of glory. But they also saved the country from a “reform” in many ways worse than ObamaCare.

This is Common Sense. I’m Paul Jacob.

 

* It’s worth keeping in mind that Trump had been for socialized medicine before running for office. This is why there was no reason to expect policy leadership on his part.

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Accountability folly free trade & free markets general freedom moral hazard nannyism national politics & policies responsibility too much government

DumpCare

healthcare, Trumpcare, Obamacare, medicine, costs, regulations, Medicaid, single payer

Speaker of the House Paul Ryan insists that his “TrumpCare” plan to replace ObamaCare will decrease medical insurance rates. Others argue that his American Health Care Act will increase those rates. Likewise, he expects it to reduce strain on federal budgets; others deny this outright. The “coverage” issue is just as contentious.

TrumpCare is a mess because it is isn’t “DumpCare.” What’s needed is not yet another regulation-plus-subsidy system. We need repeal and then . . . more repeals.

Unfortunately, President Donald Trump has never really been on board with this. He has promised that no one would lose “coverage,” assuming that “coverage” is “health care.”

It is not. State charity programs like Medicaid (upon which ObamaCare relied way too much) are merely ways to pay for services. Dumping a gimcrack payment system is not the same as decreasing medical services. “DumpCare” wouldn’t dump care, only insane government.

For example, we know that health care outcomes for poor folks without Medicaid turn out to be better than poor folks with Medicaid.* Increasing the number of people on formalized subsidy programs is no panacea.

Besides, ObamaCare severely under-delivered on “coverage.”

New programs, nevertheless, are traps, regardless of demerit: once you provide a benefit, folks come to rely on it and demand more — objecting when it’s taken away. Which is why few programs are ever repealed, despite failing to meet original expectations.

So far, the “small government party” hasn’t found the courage to actually limit government. Do Republicans really believe what they say, that fewer regulations and subsidies will lead to lower costs and better service?

It seems Republicans won’t take their own prescription.

This is Common Sense. I’m Paul Jacob.

 

* Oregon’s 2008 Medicaid “natural experiment” provides reasons to question the merits of the program. As the initial, randomized, controlled study found, “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services. . . .”

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free trade & free markets general freedom moral hazard nannyism national politics & policies

Best Plan Is No Plan

Obamacare, ACA, Healthcare, reform, replace, policy, insurance

“Republicans would create chaos in the health care system because they are stuck,” Senate Minority Leader Chuck Schumer says, “between a rock and a cliché.”

Oh. Off by a word or two. But I don’t need to fix it.

What needs to be fixed is the whole system. “Head clown”* Schumer gloats that it cannot be done. The “delicate balance” that is the Affordable Care Act makes it impregnable. For all Republicans’ talk of repeal, “for five years now they’ve had nothing to put in its place.”

Schumer sees the trap. He set it when he and his comrades voted Obamacare in without reading it. Any new program with any new constituency always presents a set of . . . political hurdles . . . that quickly become “impossible” to jump.

The President-elect, he notes, has supported three of the “most popular” regulations in Obamacare: “pre-existing conditions,” “26-year-olds on parents’ plans,” and sex equality re: insurance rates.

What Schumer fails to mention is that these are three huge drivers of spiraling insurance prices. The Affordable Care Act “delicately balances” medical markets by shifting who pays for what, hoping that the biggest losers† don’t complain too much and the obvious winners never cease protesting‡ any change.

The truth? Obamacare can be repealed. But replacing it would be a disaster. The best plan is no plan. Repeal all the regulations. The federal government should completely deregulate the markets, and prevent states from ruining interstate markets in insurance and health care.

Do what the Commerce clause was designed to do.

Schumer is counting on Republicans to do nothing. Despite signs they’re cooking up something.

This is Common Sense. I’m Paul Jacob.

 

*What Trump called Schumer. And in the same tweet dubbed Obamacare “a lie.” Truer words never spoken?

† Obamacare presents a huge burden on the self-employed, self-insured, and on the previously insured, since it is these people who most obviously pay for all the newly insureds. Of course, in the end, everybody pays . . . from increasing prices and decreasing rates of progress.

‡ At least they are the focus of advocacy groups. The poor neatly serve as innocent shields of the spoliators.

N. B. Adapted from this weekend’s Townhall column.

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Obamacare, ACA, Healthcare, reform, replace, policy, insurance

 

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ideological culture individual achievement national politics & policies

Ditch Your Male Doctor

woman, female, doctor, gender, medicine, illsutration

It’s the Christmas season, so wait to do this until the New Year, but . . . be sure to fire your male doctor.

He’s a quack.

At least, that seems to be the gist of James Hamblin’s “Evidence of the Superiority of Female Doctors,” a report in The Atlantic on a new Harvard School of Public Health study.

“Patients cared for by female physicians,” Hamblin writes, “had lower 30-day mortality than did patients treated by male physicians.” The rate for female physicians was 11.07 percent and for males 11.49 percent.

Though a “modest” difference, it’s still “clinically meaningful.”

The study (conducted by an all-male team) tracked more than 1.5 million Medicare patients treated by nearly 60,000 general internists.

“If male physicians were as adept as females, some 32,000 fewer Americans would die every year — among Medicare patients alone,” concludes Hamblin. “[T]hese numbers may be what it takes to spur equal (or better) compensation and opportunity for female physicians.”

NBC News played the equal pay angle as well: “Many hope the new study pushes hospitals to promote and pay women equally.”

Still, in a poignant moment of concern for the lesser sex, correspondent Kristen Dahlgren advised, “Maybe not a reason to ditch your male doctor, but there might be lessons to learn from his female colleagues.”

Indeed, the study explained that “physician sex by itself does not determine patient outcomes,” arguing instead that “differences in practice patterns between male and female physicians” must be investigated.

Smart.

The other thing, of course, is that every doctor, male or female, is an individual — not merely an XX- or XY-chromosome carbon copy.

Sex isn’t everything.

This is Common Sense. I’m Paul Jacob.

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woman, female, doctor, gender, medicine, illsutration