Topic: Health Care
Health Redistribution If there are no more medical providers, what happens when there are 20% more patients?by Rimfrel
(libertarian)
Wednesday, August 19, 2009
Think about what the health care legislation proposes, basically: extending medical care and financial coverage to some number of people (ideally everyone) in a way that assures them they are all covered all the time forever.
This has to include illegal aliens because (a) if they show up at a hospital emergency room, bleeding to death, humanitarian concerns will assure they get treatment, and (b) they are part of the allegedly 47 million people that the liberals, at least, want to provide coverage for. It may be galling to be forced to share our resources with others who may have had a more deleterious than positive effect on society, but such a concern is not restricted to illegal aliens. There are people in prison who get medical care, too. There are long-term welfare recipients and the very poor, who get benefits of many kinds from society and are never able to provide much in return. Again, it is driven by humanitarian interests and the confidence that we, as the world's richest nation, can afford it and owe it to these unfortunates. And not all illegal aliens are necessarily undermining our society, aside from breaking our immigration laws. Some even achieve considerable success eventually and contribute greatly to society.
The real problem is that math doesn't support the goal of extending compensated medical care to everybody, all the time, forever, no matter how meritorious each individual is. There aren't enough doctors, there are an expanding number of patients, there are uneven population densities relative to the number of doctors, and there are places doctors don't want to go, for their own safety, or because they want to live near their friends, family, and so on.
What we are likely to end up with if health care coverage is legislated is "health redistribution". If we are set on controlling costs, then the only way to cover more people is to cover some people less. If we are going to cover 20% more people (300 million relative to 250 million), with no more doctors and without assuming we really can eliminate waste and fraud (I mean, it's a government program, so what are the odds?), then each person on average could receive 20% (I know the number isn't exact) less coverage for the same cost. If you insist on lowering the cost, the number gets worse.
Let's do an example where each person pays a dollar => 250,000,000 dollars in total. Now divide that by 300,000,000: 0.83. So each person gets about 17% less treatment. I know, medical treatment isn't like a handful of pennies that can be recounted and spread out, but that means really that in many cases the effects will be worse. What if all the 50 million people lived in the same place with 50 million of the currently insured? There would suddenly be double the number of patients but not double the number of doctors, so each current patient would take a 50% rather than 17% hit. The current patients would lose part of their health, as the health of the new patients improved, hence, health redistribution.
Admittedly this is an unrealistically simplified example. In real life, the effects are unpredictable in detail because there are too many variables. People live in densely populated areas, sparsely populated areas, in areas where people feel safe and in areas where they don't. If you are a medical professional and you get offered two jobs, one in a safe part of town and one in an area where a couple of people get shot every day, even if the pay is the same, which job would you take? The patients in the second area may well need you a lot more, but you won't be much help to them if you get shot, too.
The variability in how health care is provided prevents equal outcomes for everyone regardless of whether people have insurance coverage. If the patients are all shipped to the best hospital in town, to see the best doctors, then they wind up waiting (and perhaps dying) while waiting for that better treatment. It is impossible to remove all inequities from the system.
Can you really blame people for complaining when they see their circumstances about to be made worse? Whatever people have, the harder you try to take it, the more likely that they will hold onto it yet harder, in order to keep it. And if you succeed in taking what they value, don't expect them to be happy with you. Calling them un-American, evil, inhumane, or other derogatory names makes it worse.
Some people speak of the "moral imperative" of extending health care coverage to everyone. This boggles my mind, because the last thing I would expect people to support is government-dictated morality. And they say it with a straight face, too. They forget that morality is basically defined by religion, and their secularism is their religion, but the Constitution precludes it being used to drive the actions of the government.
Government-provided health care is not the best answer. It is doomed to make the majority of people less healthy and therefore less happy. It won't reach everyone, since some people won't sign up. It will include people that undermine society, which is kind of like providing additional snacks for a tick fastened to your skin. It will be hugely expensive, and it relies for its justification on what amounts to a state-imposed religious belief.
Who would want that?
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The views expressed in this
article are those of Rimfrel only and do not represent
the views of Nolan Chart, LLC or its affiliates. Rimfrel is
solely responsible for the contents of this article and is not an
employee or otherwise affiliated with Nolan Chart, LLC in his/her role as a columnist.
"Again, it is driven by humanitarian interests and the confidence that we, as the world's richest nation, can afford it and owe it to these unfortunates."
I'm sure you don't believe that but it does seem to be a common misconception. In truth we are over $11 trillion in debt and we face over $40 trillion in unfunded future liabilities because of Medicare and Social Security.
You are correct, but confidence isn't necessarily related to reality. Pity. The "confidence" does not reside in me (you are correct again) but does seem endemic with liberals.
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