April 13, 2007

Anti Social Patient

Jed was kind enough to post about the attempt to socialize medicine in Colorado.

Aside from the automatic revulsion of anything Marxian being proposed let alone considered my objections to socialized medicine are pragmatic. No matter how the scheme is set in place you have government control of the medical profession. Currently we have a quasi-socialized medical system in place & I'm not happy with the government having as much control as it does now. There are some thing government does well & perhaps better than any other system. Medicine isn't one of them. Let me give you a few anecdotal examples:

Kim du Toit has a tale of how a cat & a human get treated in a "single payer" environment. While I know of some folks that should come way behind any feline to receive any sort of attention I'm thinking most of the time it's the wrong way to prioritize (course that also depends on the cat...). Of course that wasn't the intended consequence, but a predictable & perhaps unavoidable one when government takes such control of the medical field.

Let me ask you this - would you want the government to take over (to a substantial degree) the auto repair industry? Of course the prices would be lower or maybe there'd be no direct payment involved, but if you don't like walking for a few weeks while you're car waits in line for service then you probably wouldn't want to imagine such a situation. & with good reason. Look at what a government does when it comes to merely registration of vehicles:

"Vehicle registration meltdown Colo. pulls plug on computer for licensing vehicles"

I've said it many times; do you really want the same folks who put together the DMV putting together the staff that will make a life or death decision for your kid? To give an example of a poor staffing choice by a government agency I offer the following:

"DPS Social Worker Accused Of Sexual Assault"

Now let me clarify something: I don't like doctors. I think the health care system is flawed & one of the biggest flaws is that doctors don't realize how little they know. It's arrogance on an occupational level. It was less than 200 years ago that we were still using leeches for a wide range of illnesses. Less than 150 years ago we were amputating limbs with a bullet in them. We didn't even figure out that moldy bread was a good thing until the last 100 years. So to think that modern medicine is as exact a science as most docs seem to think is almost laughable. Not that modern medicine is all bad - not by any means, but it's not perfect either. & part of that imperfection is the believe that it is as exacting as it could be. In a few hundred years I wouldn't be surprised if docs looked back at the way we treat cancer with poisons the same way we look back on folks treating with smallpox (though there do seem to be some modern uses for leeches). To give an example of how a doc's attitude can effect things:

"Religious bias colors doctors' views: survey" Hmm What about the ones who think they're God? (Though I should note that the article seems to discount the idea that a person's attitude will influence their ability to heal & strong religious views are very good for keeping up morale while sick or injured. It's really not as damning of docs as the article makes it out to be, but it was a good chance to take a cheap shot at docs so I couldn't pass it by.)

Getting back to the point though - while the medical system has inherent problems they'd be exasperated by government intervention. In fact the level of government intervention we have now is too great for the system to work as effectively as it could. No matter how noble the goal of getting everyone the medical attention they need once you let government's foot in the door things will go to hell. & for a "single payer" system to be implemented would mean government slips more than its foot past the door.

Again I offer you example of government control, not directly in health care, but from a place where a "single payer" health care system (& mindset) has been entrenched for some decades:

"Couple fights to name baby 'Metallica"

Sweden has had a high level of government involvement in the health care system for a long time. In the 50's & 60's it was one of the most economically vibrant countries around, so by the 70's they had a cradle to grave type welfare system (which of course included health care).

Now here's the big lie about most Marxian social programs - that they're "free" to the proletariat. That's bullshit. What you get is a system where payment is not demanded at the time the service is rendered, which is much different than "free". Take a look at the tax rates for Sweden:

"Since the late 1960s, Sweden has had the highest tax quota (as percentage of GDP) in the industrialized world, although today the difference between other high-tax countries such as France, Belgium and Denmark has narrowed. Sweden has a two step progressive tax scale with a municipal income tax of about 30% and an additional high-income state tax of 2025% when a salary exceeds roughly 300 000 SEK per year. The employing company pays an additional 32% of an "employer's fee". In addition, a national VAT of 25% or 18% is added to many things bought by private citizens, with the exception of food (12% VAT), transportation, and books (6% VAT). Certain items are taxed at higher rates, e.g. petrol/diesel and alcoholic beverages."

If the Krona to Dollars calculator I just used is accurate 300,000 SEK trades for $43,557. If you make less than that then you have 20% taken from you (which is comparable to our own freakin' progressive tax). However the employer here only pays about 7% of what you make whereas The Swedes have to pay 32% of an employee's wages in taxes ("fee" my ass. Let me break that down for you, if I have to pay any percent of your wage in taxes that means your wage will be lower than it otherwise would be because I ain't paying you top dollar when I have ot pay taxes on it, so its main effect on you is that you'll be making less the higher the percentage of the tax is). On top of all that there's a national sales tax of up to 25% to deal with.

Next time you go shopping imagine you had 2% less income (as an employer would adjust at least that much to compensate for the 32% per employee tax) & had to pay a 12% tax on food & a 25% tax on alcohol. Now total that up & tell me if you'd be better off paying for health insurance on your own or relying on a "single payer" system.

But here's where it gets real fun: if you made over that 300,000 SEK then 30% + 20% = 50% before you get the 6% to 25% sales tax when making purchases or renting services... Yep. "Free".

Now I am open to arguments that government should have a very, very minimal role in the healthcare industry & some would point to the following story as an example:

"Lawmakers in Rhode Island and eight other states are now considering bills that would allow physicians to apologize when things go wrong without having to fear that their words will be used against them in court." (h/t View From The Porch)

However the problem being solved is another one created by government - the courts. Tort law in the medical field has been a very big contributor to the increasing cost of health care. Tort reform is much needed but let us not forget that the courts are a part of the government, & the government stepping in to solve a problem it created is not a good argument for government involvement.

If the government retracted its grubby fingers from our health care system things would improve. They would not be perfect & there would be problems, but not on the scale there is now, not to the degree that those problems would multiply if government intruded even more into the health care system.

Looking at other nations there can be found some examples of socialized medicine that seems to be working as advertised. But a closer look will show the problems inherent with such a practice. But for the sake of argument if we allow that a Marxian health care system could actually work without the gliches we keep seeing then it's still reduced to a cost effectiveness argument. If government stopped interfering with the market in health care would it be cheaper for us to pay our own damn way or would it be beneficial to pay a greatly increased amount of taxes & deal with intense government control on the health care market?

I never claimed to be an economist or an analyst but I cannot see how it'd be less expensive to have government interference in health care to the degree necessary to have a "single payer" type system. It's certainly not worth 50% of my income or even 25% of my income when for a few percent I could get health insurance or just pay as I go. & again I cannot see how those folks who put together the DMV can administer anything to do with my health better than my doctor & I could.

It shouldn't be any surprise to any regular reader that I oppose any socialization of health care, even to the degree we have it now. Colorado has disappointed me to the point where I'm thinking hard of leaving. I just hope they won't further diminish my hopes of them by forcing us into a system of health care that is both ideologically immoral & economically inefficient.Not that I have any faith in the legislature, but a fellow can hope can't he?

Posted by Publicola at April 13, 2007 02:22 AM | TrackBack