Why a Paper Cut May Soon Be Fatal
PICKING UP women at a trendy South Beach nightclub and debating health care . . . two times when it’s more difficult to be a conservative than a liberal.
Unless it’s articulated properly, the conservative argument on health care tends to come off as though you don’t care about children. When articulated poorly, it comes off like you want children to die. Either way, it isn’t exactly the quickest path to popularity.
On the other hand, the liberal position on health care comes off as the best thing to be created since the Creator started creating. It heals the sick! It lifts the poor from poverty! It’s like a governmental Moses parting the Red Sea . . . only without all that religion stuff.
As far as conservatives’ luck at dance clubs goes, I’ve found that attractive women don’t generally talk to guys whose “game” includes chit-chat about more restrictive tort reform. But that’s another chapter for another book.
Even when conservatives are somehow successful and actually stop the creation of another ineffective government behemoth, the fight still isn’t over. Given enough time, there’s always someone else who will step up to the table and argue that we need another new and giant government something or other. It’s like a game of multitrillion-dollar whack-a-mole.
To illustrate what I mean, look at this beautiful mountainside . . .
Let’s say that there’s agreement on both sides of the aisle that not enough people are willing to trek down an endless dirt road and hike for half an hour just to take in this spectacular view.
Conservative politicians suggest allowing a private company to come in, pave the road, add a viewing platform, and make the location more accessible to tourists. Liberals go the other way. They argue that there is a massive problem with the mountain itself. More people would surely come, they argue, if we just made the mountainside look like this . . .
If conservatives somehow win the argument over Mount Rushmore II, the mountainside gets a few intelligent, low-cost, targeted improvements. But, in a few years, everyone forgets the logic behind those decisions and another idiot shows up and suggests yet another massive overhaul that conservatives will once again try to stop.
MOUNT JOURNALISM TOURIST FACT: To artistically express Keith Olbermann’s ego and complete awesomeness, his head appears twice.
On the other hand, if liberals win the argument over Mount Rushmore II, the mountain gets carved, leaving Jimmy Carter or Keith Olbermann’s giant skull to creepily stare down on tourists for all eternity. We wind up spending infinitely more money, and we’re worse off than we were before.
Republicans in Congress need to remember one simple rule, a rule that George W. Bush forgot when pushing through Medicare Part D (aka “The Prescription Drug Plan,” “The Largest New Entitlement Since the Great Society,” or “The Biggest Nail in the Coffin of Bush’s Fiscal Conservatism”): Once Mount Rushmore II is carved, it can never be un-carved. Put simply, it’s easier to do something than it is to un-do it.
Universal health care is the ultimate un-carvable mountain.
I know Americans generally have pretty short memories, but didn’t conservatives already win this argument back in the ’90s? Didn’t we decide not to do it? Hillary Clinton? France? “You don’t want the same people who run the post office cutting your chest open for an angioplasty”? Hello? Doesn’t anyone else remember all of this?
The Jimmy Carter head that’s entirely made of stone in this illustration is actually more intelligent than the original.
Maybe instead of engaging in another debate we should just adopt the Al Gore philosophy of yelling “the debate is over” and see how that works out.
A little over a decade later, an issue that used to be a national embarrassment for the Democratic Party has been transformed into one that every major presidential candidate made part of their platform. In fact, the very same person who blew it with health care in the ’90s came within one Barackstar of being president. Even Mitt Romney, the top choice of many conservatives in 2008, enacted a version of universal health care in Massachusetts when he was governor.
So here we stand: a new decade, a new president, same old debate over universal health care. For those who missed all of this the first time around, let’s start at the beginning . . . again, by taking on idiotic arguments, like . . .
The claim that “we’re the richest country in the world” is typically left unchallenged. Sure, America is relatively well off, no one is arguing that, but this claim is specifically designed to make you believe that “we’re so rich, we can afford to spend a lot more.” Unfortunately, that’s not even remotely close to true. If your neighbor has a Porsche in the driveway of his McMansion, but can’t pay any of his bills—is he really the richest guy in the neighborhood? It’s not that we have no money as a nation—it’s that we have less than no money as a nation—and it’s only getting worse. Our balance sheet is deteriorating almost as quickly as NBC News’ credibility.
Almost.
To go back to our McMansion-Man analogy, adopting universal health care now would be like our bankrupt Porsche-owning neighbor pulling out his Capital One card and booking a monthlong excursion to Fiji. We don’t have the money for a trip to Fiji. We don’t even have the money for a bottle of Fiji water. I can promise you that we definitely don’t have the money for universal health care.
Since the economy has been just a little unstable recently, I’m hoping that Fiji water will retroactively compensate me for that very subtle mention of their product. Fiji, contact me at: me@glennbeck.com if you want to talk terms. Same address if you represent Capital One, Porsche, or Jimmy Carter.
Fortunately, it’s not all bad news. Our health-care system is actually much healthier than the media and some politicians would have you believe. Their claim about the number of uninsured is about as inflated as my stomach in a hotel room when someone else is paying for room service.
The figure “46 million uninsured” is a marquee argument for those advocating more government control of our health care. But, if you know the facts, it’s apparent that they are using that exaggerated, headline-grabbing number as a way to get America to spend tens of billions of dollars on a new entitlement for people who aren’t entitled to anything.
“The problem keeps getting worse. Health-care costs are rising fast as the number of those who lack insurance, pegged by the Census at 46 million in 2007, is swelling.”
—USA Today, May 31, 2009
To illustrate what I mean, let’s break down the 46 million into a few different groups. First, about 10 million of the uninsured are illegal aliens or other noncitizens who likely wouldn’t even qualify for “universal health care” if we had it.
That leaves us with around 36 million uninsured left—which is still a large group, but this is where the general concept of personal responsibility comes in. About 18 million people without insurance have a household income of over $50,000 per year. More than half of them have a household income of over $75,000 a year—certainly enough to afford health insurance if it were a top priority for them. (You can bet that very few of those people go without a cell phone, cable or satellite television, and/or a high-speed internet connection.) But isn’t that their choice? Until the government runs our lives like we’re a car company in decline, they shouldn’t be able to examine our budget line by line and tell us how to spend our money.
In their infinite wisdom, government subsidizes care even for the wealthy through various entitlement programs. In fact, they encourage the practice. Why else would states like Pennsylvania be running commercials that inform parents “No family makes too much money for low-cost CHIP [Children’s Health Insurance Program], so apply today. Don’t think you make too little or too much.”
Most rational people will argue that they aren’t looking to give their tax dollars to non-citizens and people making over $75,000 a year—they just want to help Americans who really need it. Can’t the government get involved to support people like that?
Well, they sure can. And they sure do. In the supposedly free-market world of American health insurance, 83 million people already benefit from some sort of government health care. Think about that. While we were looking the other way arguing the pros and cons of government health care, close to 30 percent of our country is already living under it! In addition, another 14 million of America’s “uninsured” already qualify for government insurance; they just haven’t applied for it yet.
That brings our original group of 46 million down dramatically, although it’s impossible to know exactly how far because there are overlaps between the categories and different studies measure different things. In this country, you can be sure there are at least a few illegal immigrants who make over $75,000 and still qualify for government assistance.
The real size of the group that is chronically uninsured is likely in the area of three percent of our population. Still too large? Of course, but it’s vastly smaller than the number portrayed by the media, which routinely quotes “experts” who refer to the problem as “worse than an epidemic.”
Our health-care system is far from perfect. But when politicians yell “46 million!” without context, they do it for only one reason: to make you think about a gigantic group of nameless, faceless Americans and ignore all of the subtleties that make their claim ridiculous. That way, you’ll feel like it’s not only a problem, but also one that only the government can solve.
That makes universal health care the perfect issue for those who want to grow the government. It relies on compassion, has billions of dollars at stake, and is the last great issue standing in the way of all Americans, regardless of economic status, becoming reliant on Washington. After all, once you give the government control over whether your heart is beating or not, you’re destined to also become dependent on them for just about everything else.
I agree with you on principle, but it’s hard to have an honest debate on this topic when people are so intent on manipulating the numbers for their own benefit. For example, let’s assume that you have health insurance through your job. One day you hit the lottery for $300 million and quit. While you’re waiting for the first lotto check to cash (so you can waste your money on something that will later make you the subject of a Conan O’Brien monologue), you let your insurance lapse for a month. Then, once the check clears, you buy the greatest health-insurance policy in human history. Given that scenario, how do you think you should get categorized?
Well, if it’s up to the major advocacy groups (you know, the ones the media loves to quote), you’re now one of the “millions of uninsured” in America.
More than half of those who are considered to be “uninsured” are in that state for less than a year as they move between jobs or deal with other temporary changes in their lives. Yes, that opens them up to a short period of risk, but the overwhelming majority of those people are lucky enough to avoid falling off a roller coaster or picking up a nasty case of the rickets over that period.
Insurance is supposed to manage risk, but different people have different ideas about how much of it they are willing to take on at any given point in time. Close to two-thirds of uninsured Americans are between the ages of 18 and 34. They’re overwhelmingly young, healthy people who have consciously decided that it’s worth the relatively small chance that they get very sick. Many also figure, correctly or not, that they have their parents to back them up in case the worst-case scenario becomes the real-life scenario. As you would expect, most of them are simply playing the odds—and they usually win.
Blue Cross/Blue Shield, Aetna, Humana, and many other insurers offer basic youth-oriented health-insurance plans for around $50 a month, depending on your home state. (Don’t get me started on the ridiculous restrictions on buying across state lines. Eliminating those would go a long way toward ending these problems.)
You can do even better on price if you’re a full-time student. Rates on those plans are often lower than the average cell-phone plan (and the difference is even more dramatic once you factor in ringtone downloads).
ALTERNATE BIPARTISAN PUNCH LINES
Instead of “National Endowment for the Arts,” how about:
Libertarians: See: Everything that we’ve ever spent any money on.
Democrats: See: The war in Iraq that we were duped into voting for! He lied, they died!
Communists: All money is government money. There is no joke here.
This is all part of the idiocy that is the idea of universal health care. When you give “free” insurance to someone who can afford it, but who instead chooses to spend their money on other things, you are in effect paying for those other things. I refuse to have our government subsidize anyone’s Pussycat Dolls ringtone . . . although that wouldn’t be the worst way the federal government has ever spent money. (For that see: National Endowment for the Arts.)
We all know by now that just one person who can’t get access to health care is too many, but, outside of a complete government takeover, there is no way to get everyone covered—it’s just not practical. Remember, about 15 percent of drivers have no auto insurance despite the fact that it is required in 48 states and costs less than health insurance, and despite the fact that jail time is a possible punishment.
Flying in the face of all facts and evidence, some will still claim that the government is capable of doing . . . well, anything correctly. What government service are people truly happy with? Is it the never-ending road construction, the thousands of pages of tax code, the tens of trillions of dollars in debt, or the peachy demeanor of the average DMV or USPS employee? I know it’s a cliché, but where does anyone get the idiotic idea that government could run health care better than anything else it already runs?
Perhaps it’s the American spirit of optimism. We are the people who faced the Rocky Mountains with nothing but horses, carriages, and extra-long oldtimey beards and said, “Let’s see what’s on the other side.”
For better or worse, Americans believe we can accomplish anything, apparently including expecting competent surgery from a multilayered bureaucracy related to the same people who made me wade through two years of paperwork just to build a fence around my own yard.
After we found out what was on the other side of the Rockies, we came back, grabbed a cable car to the top, and strapped a couple of boards to our feet so we could go back down for fun.
My pessimistic side (yes, it’s true, I have one!) tells me that this country, founded by people who risked sailing off the end of the earth just to have the right to hold their destiny in their own hands, has transformed itself into a nation of people who think they now need a government forklift to hold their destiny for them.
That worries me a lot, but maybe it’s why so many people are willing to overlook the embarrassing failures around the world of universal government health care. The next time someone tries to claim that the grass is greener across the pond, ask them if they’re ready to import any of these classics from universal health care in the UK.
Remember, the UK isn’t some poor incompetent country filled with maniacal socialists. While they’re farther down the road than we are, they still share many of our same values, strengths, and weaknesses—and they have the fifth-largest economy on earth.
The wonderful world of “patient stacking”
Wait times in emergency rooms were so long that the government created a target mandating that patients be seen in less than four hours.
Close your eyes for a second and just imagine the convenience of being able to see a doctor in about the time it takes to watch the Super Bowl (including the halftime and pregame shows). Ahh, dare to dream. Of course, mandate or not, the government still couldn’t hit those embarrassingly feeble targets. So now, tens of thousands of people who call the equivalent of 911 are held outside the hospital in a parked ambulance, sometimes for five hours or more, before being let into the emergency room. Why? Because the government-mandated four-hour clock doesn’t officially start until they actually come through the doors.
It’s a clever way to cheat the system, but while ambulances sit idling (global-warming activists beware, universal health care is killing the environment!), they’re unable to go pick up some other poor schlub who really needs it. Of course, since the patient would be going to a government hospital anyway, it might be better for them to roll the dice with Web MD, some vodka, and a dirty steak knife.
You have to appreciate the irony of the government artificially creating a problem and then trying to solve it through even more regulations. It’d be like them installing a single toll booth on a major highway and then, when traffic backs up, mandating that all cars must get through it in 30 minutes. Huh? Why not just get rid of the toll booth?
When hospitals resemble amusement parks
The four-hour-emergency-room target led to patients’ starting to feel like they were at a really boring government version of a Six Flags amusement park. When you get in line for the newest, most-hyped roller coaster, you inevitably stand for hours in an everlasting snaking line of sweaty tourists before finally approaching what you think is the finish line. But when you walk into that room you realize that it’s just another everlasting line snaking through even more sweaty over-weight tourists wearing spandex, fanny packs, and Crocs.
Senator Harry Reid recently complained, “In the summertime, because [of] the high humidity and how hot it gets here, you could literally smell the tourists coming into the Capitol.” While I’m sure he’s right—people do stink—the stench can’t possibly approach the job he’s doing as Senate majority leader. Hey, Harry, how about getting your approval rating higher than the speed limit in most cul-de-sacs before complaining about the odor of the people who employ you?
That’s basically what was happening in UK emergency rooms. To hit their targets, hospitals were waiting until just before the four-hour deadline was up before admitting patients, only to then make them suffer through another interminable wait once inside. Problem solved! The effect was the government target being hit, but without an actual improvement in quality of care, and at ten times the cost.
This scheme worked especially well in combination with another government incentive that offered hospitals close to $1,000 for every patient admitted. Hospitals smartly figured, “Why treat patients without admitting them when we can walk them a few feet down the hall and get some free government cash?”
The result was that patients who didn’t even need hospital admission were admitted anyway (and usually released the same day), making wait times worse for people who really did need it. Only in the world of government could we figure out a way to actually pay people more for worse service.
Dirty laundry about dirty laundry
At Good Hope, a government-run hospital in the UK, members of the housekeeping staff were reminded that washing bedsheets would cost 0.275 pence each (about 40 cents). Their solution? Don’t wash the sheets in between visitors, just turn them over! Surely, those killer bacteria could never find their way all the way through the cotton!
This policy was implemented soon after another government-run hospital found itself in trouble for sending a memo to the staff about saving $5 per day by “prescribing cheaper medicines, reducing the number of sterile packs used, cutting hospital tests and asking patients to bring drugs in from home.”
On a positive note, this marked the first time in recorded history that a government program tried to save money.
Like pulling teeth to get teeth pulled
How bad is dental insurance in the UK? Almost half of dentists say that they won’t accept any patients using government health care. That has led to about 1 in 5 people deciding against getting any dental care because the cost is so high (wasn’t it supposed to be free?). Six percent of patients have even resorted to “self-treatment,” like pulling their own teeth and using superglue to reattach crowns.
Based on dismal scenarios like these, the government negotiated new contracts with dentists to improve dental care and make it more available. The result? Fifty-eight percent said the changes made care worse, and 84 percent said it didn’t get any easier to find a dentist. The truth is that dental coverage in the UK is an absolute, complete disaster. You can judge that by the statistics, or by a less scientific but just as effective method: their smiles.
Waiting times for operations are “shorter than ever”!
This quote, from a self-congratulatory 2006 government press release, was unsurprisingly optimistic. It was the result of yet another grand government target promising that you would be able to get that surgery you need within—wait for it . . . just six months! It’s like a big twenty-six-week hug from the government!
While this target did help some of those who were waiting several years for surgeries, it actually made the delays for the typical person even longer. Across the board, wait times increased by about 20 percent, with waits for certain types of care, such as orthopedics, increasing by 143 percent. Given that result, perhaps a more accurate press release from the government might have been: “We’ve reduced waiting times for some procedures from several years to a half a year, while making almost everyone else wait longer! And if you need a new hip—wow, are you screwed.”
NICE: Not So Nice
NICE, or the National Institute for Health and Clinical Excellence, is quite possibly the most misleading acronym in world history. Why? Because it’s their job to let you know if your life is worth living. I don’t mean that in some ethereal “meaning of the universe” sort of way, I mean it in actual dollars and cents (i.e., How much currency is it worth to keep you alive?). The idea that our system is portrayed as brutally cold and uncaring is laughable when you look at what citizens of the UK are forced to deal with.
NICE has been around for ten years and its target mission has always been front and center: to develop what The New York Times calls a “standard method of rationing.” That standard method has concluded that if you have breast cancer, the drug Tykerb, which has been shown in clinical tests to delay the progression of the disease, is worth more than your life.
Another candidate for the worst acronym in world history is the: Hebrew Institute of Tolerance, Learning, Excellence, and Respect.
In fact, so is the average two-bedroom apartment in Manhattan.
Newspapers in the UK are littered with similar stories of drugs and treatments deemed too pricey to extend life. Yet, somehow NICE isn’t seen as an embarrassment to the UK, it’s actually the envy of the world! Top health officials from around the globe closely watch the decisions and mimic the procedures of NICE.
While all of this UK bashing might make us feel good, it’s important to remember that we aren’t doing much better. Take Medicare, for instance. After a New York investigator discovered millions of dollars in false state Medicare claims (for such things as pregnancy treatments for men, 450 fake eyeballs for people who didn’t need them, and medicine for people who were already dead), she unleashed a quote that can be found only in the world of government-run health care:
“It just seems to me that a pharmacist should know if his patient is dead or not. There are a lot of patients in New York who are getting treated when they’re dead.”
Former Senate Majority Leader Tom Daschle praised many NICE-ish policies in his 2008 book Critical: What We Can Do About the Health-Care Crisis. He advocated the creation of a “super board” to tell doctors how they should and should not be treating you. “In choosing what it will cover and how much it will pay,” Daschle wrote that this “super board” of “government experts” “could steer providers to the services that are the most clinically valuable and cost-effective, and dissuade them from wasting time and money on those that are neither.” That sounds totally different from the framework that leads to rationing expensive and experimental care, doesn’t it?
Daschle further explained: “The federal government could exert tremendous leverage with its decisions on covered benefits and payment incentives.” If you’re wondering what it’s like to be on the wrong side of a government version of “tremendous leverage” backed up with “payment incentives,” then just ask Rick Wagoner, who, thanks to the administration, is now the former CEO of General Motors.
And if you think that all of these ideas from Daschle are too radical to ever work their way into our system, then just remember that Daschle was Barack Obama’s first choice as secretary of Health and Human Services.
But while the antics of Obama/Daschle may not surprise you, this might: the government has already tried to implement many of NICE’s policies—and it happened under a president with an “(R)” after his name.
Dr. Sean Tunis, who served as the Chief Medical Officer of the Center for Medicare and Medicaid Services under George W. Bush, said he spent a lot of his time in government “learning about NICE and trying to adopt the processes and mechanisms they used, and we just couldn’t.”
While we’ve looked at the UK for problems, it’s also important to listen to those who live there for solutions. Daniel Hannan, a British politician, made a three-minute speech excoriating Prime Minister Gordon Brown over the ridiculous amounts of debt that his country had acquired in their attempt to solve their spending problems with more spending. While the British press largely ignored it, the video went viral and, in just one day, became the most watched video in the country. A few days later I invited Hannan, who isn’t exactly a tool of the right—he supported Barack Obama for president and opposed the Iraq War—on my radio program.
ON THE RECORD
“If I were designing a system from scratch, then I’d probably set up the single-payer system [but] making that transition in a rapid way, I think would be very difficult.”
“There was a lot of resistance to a single-payer system . . . Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered . . . I don’t want to wait for that perfect system.”
“I happen to be a proponent of the single-payer universal-health-care plan . . . That’s what I’d like to see. But as all of you know, we may not get there immediately because first we have to take back the White House and we have to take back the Senate and we have to take back the House.”
“You should learn from our mistakes,” Hannan told my audience. “I mean, the single biggest area where I could see you making this mistake is on this thing of the nationalized health-care system. I mean, I hope that sanity is going to prevail. I know it’s been kicked around before and it hasn’t happened. I love my country even more than I love yours, you know, but God, I would love to get rid of our system and have something that puts patients in charge rather than putting doctors’ unions and bureaucrats in charge. That’s the single biggest thing.”
Plus, he said it in an English accent. So it sounded even cooler than it reads.
Of the six biggest* documentaries of all time, one of them features Al Gore, one of them features penguins marching, and three of them feature Michael Moore.
Moore has become the largest figure in the genre* and his influence on idiots in this country cannot be understated. While his movie Sicko was somewhat of a disappointment commercially, it included almost every tired argument about health care that’s ever been made. So let’s go through a few of them one by one:
MOORE: “The United States slipped to number thirty-seven in health care around the world, just slightly ahead of Slovenia.”
You can tell a lot about someone by the company they keep. Therefore I assume Emperor Penguins are extremely liberal.
As Moore says this line in the movie, a graphic pops up on the screen showing the United States just one slot ahead of the happy-fun-land of Slovenia, and two slots above the island paradise of Cuba. Seemingly damning evidence of our disastrous health-care system, right?
Wrong—because what Moore doesn’t tell the audience is where those statistics come from, and, more important, how they’re calculated. The truth is that Moore’s prized statistics come from an all-time favorite media source: the report card of the best health-care systems in the world, dutifully delivered on a silver platter by the World Health Organization/United Nations.
You might be thinking that the U.N. isn’t exactly a fair arbiter of the policies of the United States . . . and you’d be right—but it’s actually much worse than that. They admit their data has been (and this is a direct quote, though I didn’t see it used in the movie) “hampered by the weakness of routine information systems and insufficient attention to research.” At times when good numbers weren’t available, they “developed [data] through a variety of techniques.”
Mostly though, they just blindly accepted what governments all around the world told them, including the always reliable Castro regime in Cuba. I guess the U.N. thinks that the best place to get good information on the likelihood of drug addiction is from a pamphlet given to you by a crack dealer.
This man should not be making movies about health care.
The WHO/U.N. study is little more than a political how-to guide on the best way to run the most U.N.-like government. For example, the U.S. gets punished in the study for not having a progressive enough tax system. What does that have to do with health care?
The most damaging category that contributes to America’s overall ranking is our 54th-place finish in the oh-so-objective category of “fairness,” something they define as “the smallest feasible differences among individuals and groups.”
To truly understand the absurdity of that definition, consider this scenario: Let’s say you have two patients (one rich and one poor) who can be cured only by an expensive or experimental treatment. By the U.N.’s standard, a country that lets both patients die is superior to one that manages to keep one alive.
After this, some accused Michael Moore of being a tool of Cuban propaganda (I accuse him of just being a tool in general). I’m pretty sure they’re right, but doesn’t that make the U.N. one also?
I’m sure the United Nations’ opinion of what constitutes fairness is completely rational and consistent with American values. After all, any organization that gives Russia and China lifetime privileges to unilaterally veto anything they want should always be trusted.
What the U.N. sees as so undesirable and unfair actually works fairly well. In America, rich people could likely buy whatever treatment they need. Those who aren’t rich still have lots of options: They can get a loan, ask family members or charities for assistance, or they can search for a doctor or company willing to work with them at a reduced rate. Those scenarios are all quite common in America.
Over time, the rich people end up subsidizing the majority of the research and development costs by paying big fees early on. Companies are then able to make profits, which brings prices down and makes that treatment more affordable for everyone (including the socialist countries that wouldn’t pay for it before).
It’s not perfect, nothing is—but it’s a lot better than the U.N.’s way of thinking, which would result in a country like the United States ranking behind an entire nation filled with doctors who act like Jason Voorhees and murder each patient with a machete whenever they schedule an appointment. “Sure, all patients are brutally slaughtered, but at least everyone is treated equally!”
The report claims there are only two ways to achieve their version of “fairness”:
1. “The healthy subsidize those who are sick.” This is, of course, a basic tenet of health insurance.
2. “The rich subsidize those who are poor.” This is, of course, a basic tenet of socialism.
Thus, Michael Moore and others use a study that requires socialism to have a good health-care system to prove that socialists have good health-care systems. It’s like citing a report done by Burger King on hamburger quality that heavily depends on such objective measures as “Prominence of Flame Broiling.” My guess is that McDonald’s wouldn’t do that well.
How did the WHO/U.N. come up with how the “fairness” category would be figured? Simple . . . they asked themselves. Here’s how they explain it: “To derive a set of weights for the different achievements that compose overall attainment, WHO conducted a survey of 1,006 respondents from 125 countries, half from among its own staff.”
After the survey was “checked for consistency and bias,” the U.N. then came up with a set of measures that put 62.5 percent of the weight of the entire study on some type of “equality” (as defined by, you guessed it . . . the U.N.). Knowing the U.N. like we do, does that really sound like a recipe for an honest critique of the U.S. health-care system?
To translate: “How did we at Burger King come up with the category of ‘Prominence of Flame Broiling’? We asked our own employees!”
Knowing Michael Moore like we do, does Sicko seem like it would be an honest critique of the U.S. health-care system?
But the WHO/U.N. doesn’t just care about who has appropriately high taxes or whose system is the most socialized—they have other goals as well: “better health” (nice of them to include that) and “responsiveness to people’s expectations in regard to non-health matters.” (Huh?)
The study reports that “several poor African and Asian countries rank fairly high on the level of responsiveness [to people’s expectations].” I assume they mean that doctors respond to patients right away to tell them that they’re screwed.
MOORE: “All independent health organizations in the world, and even our own CIA, believes that the Cubans have a pretty good health system. And they do, in fact, live longer than we do.”
The climax of Sicko shows Michael Moore defying the laws of physics by remaining afloat in a boat to Cuba* as he accompanies 9/11 rescue workers who, he says, need health care and are unable to afford it in the United States.
While his actual point is ridiculous (see below), he does prove one important thing: A liberal filmmaker who brings a camera crew into a communist country with the intent to show that they are superior to the United States has a reasonably good chance of getting halfway decent health care. Shocking, I know. Fortunately, the idea that Cuba was giving an accurate picture of how the average Cuban is treated isn’t taken seriously by anyone.
Except for those who really want to believe it’s true . . . like Michael Moore. He told ABC’s John Stossel, “I asked them to give us the same exact care they give their fellow Cuban citizens. No more, no less. And that’s what they did.”
Moore’s stunt could be dismissed as a humorous attempt at exaggerating a point, except for one thing: He’s not joking. In interview after interview he’s made specific statements trying to back up the claims in his movie. For example, Moore has said that the CIA agrees with him. He couldn’t be lying about that, right? Riiiiiight?
Well, unfortunately for Mike, the CIA isn’t some mythical organization from another dimension that sends statistics about health care through secret telepathy. In fact, if you want to know their opinion, you can just ask them—which is exactly what 20/20 did after hearing Moore’s claims. The CIA’s response? “We don’t say that Cuba has a pretty good system or that Cubans live longer than Americans.”
I wish they would be a little less ambiguous. Maybe Moore was talking about a different CIA . . . like the “Cuban Information Agency,” perhaps?
Maybe Moore could try the oh-so-convincing Nancy Pelosi technique of just accusing the CIA of lying?
But, misleading sources aside, is life expectancy even a fair way to judge a health-care system? Most people probably think yes. For example, if location A has a life expectancy of 78.7 years and location B has an expectancy of 75.8 years, you can reasonably assume that location A has a better overall health-care system, right?
Nope. In fact, the numbers in the above example are real, and they represent a much starker difference than the one between America and other countries. Location A is actually Utah and location B is Nevada—two states that literally border each other. So why would one state have a life expectancy nearly three years longer than the other, especially considering that their health-care systems are essentially identical? Who knows (my guess is the killer Bs: buffets, booze, and brothels)—but one thing is for sure: Utah doesn’t have a higher life expectancy because they have universal government health care.
Life expectancy is actually a terrible way to judge a health-care system. Why? Because a lot of people die for reasons that can’t be controlled by doctors. To understand what I mean, let’s look at the two things that come to mind when you think about Detroit: cars and murder.
We love our cars, and Detroit is (or at least was) the automobile capital of the world. Other countries don’t drive nearly as much or as far as we do (or put on their makeup while texting, road raging, and eating an Egg McMuffin). More driving means more accidents, which unfortunately leads to more early deaths.
Detroit is unfortunately also illustrative of America’s affinity for homicide. You’re about eight times more likely to be murdered in Detroit than in America as a whole, and their 2007 murder rate was roughly equal to Venezuela’s. Long-term corruption and incompetence in Detroit and other major cities drives America’s national murder rate to a point that can be up to four times greater than that of some European countries.
But neither murder nor car accidents, two factors that lower overall life expectancy, have anything to do with the quality of our health-care system. In fact, if you control for the higher number of homicides and accidents, some studies have shown that the U.S. ranks number one worldwide in life expectancy.
In January of 2009, the average home price in Detroit was $7,000. I wonder why?
Unless countries like Cuba have somehow developed a way to un-slash the neck of a murder victim, or de-telephone-pole a car after an accident, it’s clear that the longer-life-expectancy claim is as bogus as a photo of Michael Moore eating tofu.* Which brings us to another huge* factor affecting life expectancy that Michael Moore is very closely acquainted with:* We have food. Lots of it.
While Cubans eat to stay alive, we eat to kill ourselves. Dr. Robert N. Butler, a Pulitzer Prize–winning author, thinks the Cuban health-care system does some things well, but he admitted to The New York Times that “some of Cuba’s shortcomings may actually improve its health profile.” Sounds counterintuitive, right? Sure, but Butler had a good explanation. “Because they don’t have up-to-date cars,” he said, “they tend to have to exercise more by walking. And they may not have a surfeit of food, which keeps them from problems like obesity, but they’re not starving, either.”
Wow, what a glorious endorsement of communism! If only we could be so lucky as to have just enough food to survive and no ability to travel easily, maybe we too could be as happy and healthy as Cubans!
Does the fact that we are a rich country with new cars that likes to indulge in unhealthy things to the point that no one would flinch if we added a Big Mac to our flag really tell us anything about our health-care system? Of course not. We’re a country that celebrates the hot dog and the apple pie as two of our national symbols. It’s amazing we live past twelve.
The bottom line is that obesity might be the yummiest of all diseases, but the vast number of American fatties isn’t easy on the eyes . . . or on our health-care statistics.
MOORE: “Cuba is a very poor country... yet, in spite of that, they are able to put together a health-care system that guarantees they have . . . a better infant-mortality rate [than we do].”
When Michael Moore went to a clinic to lose weight, he chose the privately run Pritikin Longevity Center & Spa. Looking at the results, I have to concede that not even the private sector is perfect.*
On January 2, 2009, the Cuban government made a fascinating announcement: They had lowered their infant-mortality rate to 4.7 of every 1,000 births in 2008. That’s one of the lowest in the world.
But what was truly amazing wasn’t the rate, it was the date. How exactly did Cuba, a country that has approximately one calculator for the entire miserable island, compute and release an exact infant mortality rate for their entire country in less than 48 hours when it can take the United States about two years to put together theirs? Medical records from thousands of hospitals must be compiled, checked, and rechecked. If you’ve ever been stuck gathering a bunch of email addresses to put together a birthday party Evite for an annoying coworker, you know how impossible a task that must be. Yet Cuba is somehow able to magically become the world’s most competent nation when it comes to this one singular task. How?
Maybe a better question is why? Why would Cuba be in such a rush to trumpet its low infant-mortality rate? The answer is that it’s all about marketing. The world looks at infant mortality as one of the most important measures of a health-care system—which is exactly why Cuba spends so much time manipulating theirs. Whether it’s direct misreporting or abortions at the first sign of possible trouble with a fetus, Cuba is about on par with Bernie Madoff when it comes to honest reporting.
But let’s play the Michael Moore game for a minute and assume that the Castro brothers would welcome a PriceWaterhouseCoopers audit of their infant-mortality rate. Would a global game of “My Babies Die Less Often Than Your Babies” really be a legitimate way to fairly compare health-care systems?
Not at all. The problem with the infant-mortality rate lies in the incredible disparity in the ways by which the statistic is measured around the world. For example, while 40 percent of America’s infant-mortality rate is attributable to infants who die on the day of their birth, some countries don’t “reliably register” those deaths at all. In the U.S., a baby that shows any sign of life whatsoever is counted as a live birth, but other countries laugh at that crazy standard of “life” and instead use “size” or “weight” to determine whether a birth is “live.” US News and World Report noted this phenomenon:
“In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless.”
Perhaps you’re a skeptic who doesn’t trust US News and World Report. “It has the letters US right in its title . . . why should we trust what they say about European health care!?” Well, how about the Organization for Economic Cooperation and Development (OECD) instead? They’re the ones that actually collect the European data and even they specifically warn against comparing infant-mortality rates around the world for precisely the same reasons.
In America, along with many developed nations, infant deaths don’t have nearly as much to do with the merits of a health-care system as they did decades ago. For example, America has a higher rate of “very pre-term” babies than most other countries. Very preterm babies are born at less than 32 weeks, and die at about 30 times the rate of our average. While they account for only two percent of births, they total more than half of all infant deaths. That’s why, once you adjust for birth weight, the U.S. ends up with an infant-mortality rate that’s about equal to Norway’s—which has one of the lowest rates on the planet.
But why do we have so many more pre-term births in the first place? Is it because our health-care system is so bad? Nope—in some respects it’s actually the other way around. Americans use far more fertility drugs than other countries and those drugs increase the possibility of multiple births and premature babies. In many other countries, couples don’t have access to all of our drugs and treatments. If they can’t conceive naturally, many people are forced to simply go without biological children.
If you asked an average “citizen of the world” (hat tip to President Obama for that) whether, after hearing the risks, they would choose to have advanced fertility options available, I have to believe that most would still say “yes.” Again, the point is that the fact that the United States is a relatively wealthy country that chooses to spend its money on incredibly innovative drugs that produce a higher proportion of premature babies doesn’t mean we have a bad health-care system. In fact, I would argue it means just the opposite.
One benefit of fertility drugs is that news channels get weeks of material every time a mother has a huge number of kids at once. Studies have shown that if “Octomom” didn’t exist, cable news would have had to shut down for much of early 2009.
I don’t blame Cuba for massaging their infant-mortality numbers a bit. I mean, their citizens are stuck dealing with the failure of their communist system, the bumbling brothers who have been running their country into the ground, defections of every kid with an ounce of baseball talent, and a daily UV index that would turn me into a dried cherry in nine minutes. (I don’t tan well.) But, by announcing annual numbers before the New Year’s champagne spoils, they are attempting to spread propaganda that Cuban health care, which was once an impressive and thriving system before it was destroyed by communism, is superior to America’s. They spoon-feed (or trough feed*) this information to idiots who can’t help but lap it up like a hungry pig in slop.*
I suppose the one morsel of solace we can take from Sicko is this: Michael Moore isn’t shy about begging for total government control. Unlike most of our politicians, at least he’s honest about it.
Capitalism has provided what any honest observer would conclude is the highest-quality health-care system on the planet. Market forces don’t just encourage innovation, they force it. Help people survive or your competition will make sure your company dies. That’s why U.S. companies have developed half of all new major medicines introduced worldwide over the last twenty years. For a country with only five percent of the world’s population, that’s not too bad.
Here is how it works: America develops new treatments, gets them first, and, yes, pays more for them. You know that fat, hairy rich guy with the hot young wife who was the first in town to buy a plasma screen when they still cost $30,000? That’s America—we’re the fat, hairy rich guy to the rest of the world. The left delights in vilifying the wealthiest one percent, but they forget the famous words of an anonymous fifth-grade philosopher: When you’re pointing at someone, there are three fingers pointing back at you. To the rest of the world, we are the wealthiest one percent.
That leaves those who attack the American health-care system with only one main argument: quantity versus quality. Sure, America has the best health-care system, they’ll say. For those who can afford it—but too many can’t.
Finally, an argument with some truth to it. For all of its unacknowledged virtue, our health-care system does still leave too many without coverage. The real question is what can rectify that more efficiently: a free market or a government monopoly?
Answer this question: What three letters can get you quality medical care for about half the price of a typical doctor’s appointment and provide a 90-day supply of most prescription medications for less than a movie and popcorn, all while giving you the opportunity to pick up Cheetos, Mentos, Oreos, Pepto, and probably even this book-o.
The answer is W-A-L. You can get all of these things at your local Walgreens and/or Wal-Mart.
Walgreens is leading the way in the development of retail health clinics, which means that you can basically see a medical professional right in the pharmacy. Wait times are minimal, the cost is low, and you can grab a Whatchamacallit bar on the way out.
Despite the fact that the economic downturn has slowed the rapid expansion of the clinics and caused some providers to close shop, the number of retail clinics still increased by over 30 percent in 2008. Walgreens plans to have 400 clinics open by 2010 and CVS, the other market leader, plans on having almost 500. Anyone can walk into these clinics, regardless of health-insurance status, and get medical care for about one-sixth the cost of a trip to the emergency room, and one-half the cost of a normal trip to the doctor’s office. The quality of care, usually given by a master’s-degree-educated nurse practitioner, is so good that two-thirds of visits are paid for by insurance. The bulk of their business comes from people with insurance going there by choice, not the uninsured going there by necessity.
If you listen to the media, you probably think that, besides selling economy-sized bags of Triple Barbecue Cheddar Mega Crisps, Wal-Mart’s main business line is assassinating helpless crippled runaway teenagers. Not so. Incredibly, they keep their profits churning with very little despotic evil or murder involved.
In 2006, Wal-Mart decided to lower their prescription drug prices to just $4 for a 30-day supply of most generic medications. That put the most popular vital medications within reach of just about everyone and launched what Bloomberg described as a “fierce” price war for prescription drugs, saving sick Americans literally billions of dollars.
In response to Wal-Mart’s price cut, Target followed suit. And then Krogers. First Giant, Giant Eagle, Food Lion, Publix, and Safeway have all adopted similar plans to compete. Walgreens also now offers a 90-day supply of 400 different drugs for just $12.
In 2008, Wal-Mart made an announcement: They had saved customers $1 billion in prescription drug costs—a number that is undoubtedly underestimated because it doesn’t count the savings at all of the other stores that followed their lead. So, what did Wal-Mart do next? They lowered prices again—this time to $10 for a 90-day supply. CVS jumped on the bandwagon too, offering hundreds of drugs for $9.99 for 90 days. The price war continued until Giant supermarkets actually began “selling” antibiotics for the unbeatable price of . . . nothing.
Given Wal-Mart’s entrepreneurial spirit, why did they issue a letter in support of Obamacare? Well, besides fear of retribution from the government, Reason Magazine says they did it because it’s “good from a competitive standpoint.” About 99 percent of businesses the size of Wal-Mart’s already offer their employees health care, while only 62 percent of smaller businesses do. Wal-Mart can handle the increased cost, smaller competitors can’t.
Did all of these companies cut their prices so dramatically because their managements are filled with altruistic do-gooders with a furious desire to help their fellow humans? Well, partially, yes—not every business owner is Tony Soprano. But the real reason is that management understood that if they forged relationships with customers by conveniently providing them with vital medicine as inexpensively as possible, those customers would likely come back and buy their Cap’n Crunch, Mr. Clean, and Pringles Cheezums there too. And when times are better, they’ll come back for their television, office furniture, and snowblower.
Charles Platt, a senior writer for Wired magazine, who has written about everything from cold fusion to nanotechnology, offered evidence of this kind of thinking when he applied for (and got) an entry-level job at a Wal-Mart in Flagstaff, Arizona. After an extremely thorough interview process, he had to give the Wal-Mart pledge: “If a customer comes within ten feet of me, I’m going to look him in the eye, smile, and greet him.” As Platt wrote: “The reason was clearly articulated. On average, anyone walking into Wal-Mart is likely to spend more than $200,000 at the store during the rest of his life. Therefore, any clueless employee who alienates that customer will cost the store around a quarter-million dollars.”
If Wal-Mart understands that one passing encounter with a customer is that important, imagine the value they see in curing someone’s gout for $3.33 a month. Sure, low drug prices are good for you, but they’re great for Wal-Mart, Walgreens, and CVS. Their motivation (outside of basic human decency) is capitalistic profit—and while it might not be popular to say this in today’s America . . . that’s good.
The pursuit of profits doesn’t just lower prices, it also fuels impressive innovation and provides access to health care in ways never before thought possible. For example, you know that crazy idea called the internet? It was a small computer-networking thing used by universities and geeks before capitalism turned it into a way to buy, watch, listen to, look at, and create almost anything.
The internet is fueling technological solutions and widespread information-sharing that’s acting like a massive health-care think tank. Here are just a few of the innovations now being developed by the private sector to serve those without insurance:
eHealthinsurance.com
The idea of buying your own health insurance has been so vilified that people tend to think that if you can’t get it through their job, you can’t get it at all. Enter ehealthinsurance.com. Put in your zip code and birth date and you’ll have dozens of quotes from insurance companies that want your business. They feature plans for small businesses and individuals, and short-term plans if you’re between jobs or just enjoy applying for health insurance every few months. I filled out the form and, believe it or not, there is a company out there willing to insure my 45-year-old-out-of-shape-coronary-in-waiting self for just $94 a month.
I assume that monthly rate would go up once they realize how much butter I actually consume.
Healthcarebluebook.com
Let’s say you walk into an electronics store, go right up to the manager, and say: “Hello, I want to buy a flat-screen TV. I have no idea what anything in this place costs and I don’t care because I’m not paying for it. Please remove all the price tags, and don’t give me a receipt after I buy.” Do you think he’d give you a good deal on the price?
That, of course, is basically the current state of health care in America. When you have insurance, you simply don’t care how much anything costs. Doctors don’t have to compete on price, so why would they bother trying to keep prices low?
Healthcarebluebook.com steps in to fill the void by disclosing reasonable prices for various procedures and treatments, thereby arming the patient with the ultimate medication for out-of-control costs: information. Once you know the going price, you can actually call around to find a doctor you like and then even negotiate the price with him or her. Believe me, when a doctor’s office realizes that you won’t be putting them through the nightmare of submitting claims to an insurance company (or worse, the government), they’re very likely to give you a good deal.
To avoid government paperwork, a doctor’s office quite possibly might throw in a pizza coupon, a Snuggie, and a few Vicodin, too.
Teladoc and American Well
Need to talk to a doctor at 3 AM because, after doing a few Google searches, you’re absolutely convinced that you’re afflicted with pseudopseudohypoparathyroidism? Good luck getting your actual doctor on the phone, insurance or not. Usually, the sort of phone services available at 3 AM include having an overweight, hairy woman with a raspy voice speak a collection of well-rehearsed and sexually explicit phrases in an unconvincing manner (so I’m told), or a quasi-German man soliciting the purchase of the most absorbent cloth ever created by scientists.
I don’t know if I want my doctor texting me. Seeing “yo gb u got da clap 4 eva!” on my iPhone would be a tad disturbing.
If you’ve ever thought that you wasted an hour driving to the doctor’s office just so they can ask you two questions and diagnose you with something they’ve seen 3,000 other times, then Teladoc is probably for you. For just $35 you can be on the phone with a licensed physician within 3 hours, guaranteed.
Two other companies go even further. For $45, American Well will let you talk with a doctor via webcam, instant message, phone, or text. And at Wal-Mart, some locations have now begun to offer “virtual clinics” where you not only get to talk to a medical professional—they can actually look into your ears, eyes, and throat remotely via a webcam.
Following the path of every technology on earth, the webcam became universal only after widespread (bad word in this context) usage in the porn industry. Consider the irony of that: The physical act originally intended by God to create life has popularized a technology now being used to help doctors extend it. Ahhhh . . . the circle of porn.
The No Insurance Club
While it might sound like the worst Facebook group in existence, The No Insurance Club is actually a way to prepay medical expenses and get an extremely low rate in return. For about $500 per year patients get priority access to up to 12 doctor appointments, extremely low-priced prescriptions, free tests and blood work, plus they pay no deductibles, no copays, and avoid all of the endless paperwork. Considering the average doctor’s appointment can run as high as $130, that’s a huge saving.
These are just some of the innovative ideas that capitalism is dreaming up even as we brainstorm ways to get rid of it. Some of these companies might revolutionize the way we think about our health, others will fail as miserably as Alex Rodriguez taking a steroid test. But, the truth is clear: Capitalism is in the middle of creating the tools that can alleviate many of our biggest health-care concerns. Isn’t it quintessential government to pick right now as the time to step in and “save the day”?
For a little extra, patients can cover their entire family and get up to 16 visits per year. If you have unused appointments in December I guess you can just drop your kids off at the doctor’s office, have them fake a cough, and save money on babysitters.
As we’ve looked at the state of health care in America, we’ve seen how things aren’t quite as bad as we think, how government can make things worse, and how capitalism can make things better. But the truth is that no one solution, from either side of the debate, can make health care what it needs to be.
If you’ve been on YouTube over the past couple of years, then, in addition to watching ugly English women sing, some kid named Charlie biting fingers, and my guests fainting midinterview, you probably saw me half in a coma and looking worse than usual after a quite intimate and painful surgery.
But(t), as bad as my experience under the knife was, it was far worse out in the waiting room. Without getting into details you don’t want, let’s just say the surgery didn’t go well, and no one seemed to care.
The powerful lesson that I learned was that the system that is capable of transplanting a heart had lost something far more basic: its soul. It’s not a lack of training, equipment, or technology that’s the problem—we just have to put the care back in health care.
Our insurance system is designed, whether through the government or our employers, to cut out the relationship between doctors and patients. Doctors are so overcome with threatened legal action and bureaucracy that it’s become expected that trips to the doctor’s office are exercises in paperwork, patience, and rude staff. Encouraging competition and removing the needless levels of regulation can free up our doctors to once again worry about their patients instead of politicians and attorneys.
That brings me to Dr. John Muney, a New York physician who recently started an amazing program: unlimited doctor’s appointments to anyone who wanted them for just $79 per month. His logic was simple: If he could avoid the mountains of paperwork that come with insurance, he could cut his costs and make sure health care was within reach of everyone.
That’s when the government stepped in. You see, despite the speeches from politicians, the government doesn’t really care if you’re able to see a doctor. What they care about is control. The State Insurance Department told Dr. Muney that he had to stop offering his low-cost, fixed-rate plan because it was too similar to insurance. To put it another way, a doctor’s effort to avoid the hassles of insurance could continue only if he started his own insurance company.
In the middle of the controversy, I brought Dr. Muney on the air to talk about it. After his appearance, the state told him that they would allow him to continue with a modified version of his plan, one that would, unfortunately, cover less and cost more. As Dr. Muney said: “I really don’t want to charge more. They’re forcing me.”
While the situation is still far from optimal, the truth is that his entire plan would have been destroyed if it weren’t for people all around America standing up and showing their outrage. That is why, despite how exhausting it is, we must continue arguing with every idiot at every opportunity.
When our freedoms aren’t our focus, our country becomes dangerously ill. Our Founders might not have been doctors, but they still outlined the proper prescription to keep America healthy and vibrant: a commonsense approach focusing on rights and responsibilities.
Now, take the two of those, and call Washington in the morning.
