The Price of Solidarity: Costly ‘Affordable’ Health Care

John Stossel is right. Last week he wrote that the "Healthy Wisconsin" scheme, passed in that state's Senate and offering supposedly "free" socialized health care, is good for America because people apparently need bad examples. As Mr. Stossel says, "We need laboratories of failure to demonstrate what socialism is like. All we have now is Cuba, Venezuela, North Korea, the U.S. Post Office, and state motor-vehicle departments. It's not enough. Wisconsin can show the other 49 states what 'universal' [health] coverage is like. I feel bad for the people in Wisconsin [...] but it's better to experiment with one state than all of America."
 
More bad examples can be found in Europe. When the topic of health care crops up I always think of my grandfather. He was very old – 91 – when he died. In his family, longevity was not uncommon. My grandfather had never been ill. He had never needed medical treatment. Upon reaching his 90s, however, he began to have a prostate problem and had to go to the hospital for surgery. Like all Belgians, throughout his professional life my grandfather had paid wage-related contributions to cover health insurance. As he had never needed much health care, he had been a net contributor to the system. Now was the very first time he was going to claim something back.
 
My grandfather had his operation in May. In November he was dead. The prostate operation had gone well, but the hospital administered an antibiotic drug that caused complete deafness. Though there were other, but costlier, treatments possible, the hospital gave this drug to the old man. Hospital staff knew about the possible side effect, but it did not strike them as an unreasonable and unjust thing to do. A man who has already had 90 healthy years of his life surely has no right to complain about deafness when some people get more seriously ill or die at far younger ages.
 
When my grandfather left the hospital, he was completely deaf. But his prostate problem had been cured. According to the clinic, the prostate operation had been highly successful. As far as the Belgian health-care statistics were concerned, my grandfather's treatment raised the quality average. It also had been cheap. Statistics show that Belgium has a high quality of health care that is relatively cheap, available to all the country's inhabitants, and virtually free of charge for the patients. It is the kind of health care that Americans, looking for comparative statistics, would envy. My deaf grandfather, however, lost his will to live. Six months after the operation, he was dead.
 
His predicament is not unique. Certain medical treatments or drugs are no longer available to Europeans above a certain age. Studies of kidney dialysis, for example, show that more than a fifth of dialysis centers in Europe and almost half of those in England have refused to treat patients over 65 years of age.
 
My grandfather's deafness was the side effect of an antibiotic that was given to him because of budgetary constraints in a system providing "free" health care. More expensive drugs and treatments with fewer side effects are set aside for younger patients. Political authorities, claiming to be the guardians of solidarity in society, deem it less desirable for a young person to be deaf than for an old one. Hence my grandfather, after having paid heavy wage-related contributions as a young man to fulfill his solidarity with the sick and elderly, had to pay the price of deafness to fulfill his solidarity with the young.
 
In Europe, old people increasingly receive less care than young people do. In the United States, ironically, the situation is the reverse. Elderly Americans are entitled to universal health coverage via the Medicare program. In America, the bulk of government health-care expenditure goes to those over 65 years old, while in Europe most of the government money is spent on those under 65. If European governments continue this policy, soon euthanasia will be the price that the solidarity principle of the European welfare states imposes on the very old and the very sick. European doctors have already warned about "economic euthanasia."
 
If Americans need bad examples in order to know what to avoid, then Europe is a good place to learn from. America has now lost one of its states to socialism. In Wisconsin there will soon be grandfathers sharing the fate of my granddad.

 
This piece was originally published in
The Washington Times on August 15, 2007 .

In Reply to Gryphon

I generally agree with your points. Unfortunately, the healthcare debate is socio-political and not economic, unless of course one is describing the profit-oriented motives of American pharmaceutical and medical insurance companies and the AMA. Certain interests would have us believe that public healthcare is a mere step away from the StaSi, or in the case of Fox News, from Al-Qaeda. The truth is, some goods, services and regulations are better provided by the public than the private sector, including infrastructure, national defense, policing, basic education and yes, healthcare.

 

Soldiers and the police are merely glorified security personnel: if Americans value individual choice, why not leave this service to the private sector? The wealthy will be protected, some will free ride, others will be left defenseless, and foreigners will be better off, not unlike in the American medical system. Furthermore, each individual can be responsible for their own infrastructure - the diversity of which will reflect the triumph of personal choice.

 

So long as human beings are social and reside in communities, one cannot have a wholly laissez-faire or libertarian society, and some things are better off left to the people as a whole rather than individuals. One can accuse social democrats of being power-hungry bureaucrats or neo-conservatives of being the pawns of greedy fat cats, but neither is constructive.

health care

I myself don't think the issue is socialized medicine vs. open market medicine anymore. The real problem getting medical care in the future will be the increasing anarchy of certain communities in the West and that anarchy filtering into the medical profession and attacking those with the least ability to defend themselves. It won't matter whether the political organization is left or right although I would suggest that the precincts with central planning warrant more concern. Many hospitals in left-wing minority jurisdictions in the US are closing down these days from corruption and sheer incompetence.

If you did some further digging you might find that the hospitals in minority areas are vast sink-holes of government funding. Trauma and drug problems. There are wide disparities in health care in the US but I would say the general trend is two-tier. If you can afford it and live in the right ethnic area you may be protected, if not, good luck.

I would also suggest that if Dr. Belien's grandfather were a member of a "victim group" and that group or even one prominent member of it could be galvanized into action and (among other things) threaten a lawsuit describing this hospital's action as a violation of their rights and thus racist, and if the hospital staff were to anticipate all of this (not difficult) then I would suggest that Dr. Belien's grandfather would have been treated somewhat differently.

Bad Example? Look to the United States

Before the Brussels Journal engages in knee-jerk reactions to public healthcare, perhaps it needs to examine FACTS rather than merely relying upon personal anecdotes:

 

1. US government contribution to total national healthcare spending is 44.4% of the total, whereas it is 78.5% for other industrialised states

2. 15.4% of US GDP is spent on healthcare, as opposed to 9.25% for other industrialised states (and even lower for Canada)

3. 15% of Americans do not have health insurance and the number is increasing by 0.4% annually

4. Medicare, which is not unlike a national public healthcare system has very low administrative costs (3% ACR), whereas private healthcare companies have ACRs at approx. 25%

5. $333 billion is spent annually on administrative costs (e.g. medical coders) and services that do not have any direct benefits to the patient

6. Billing and coding personnel from US medical clinics are in an adversarial relationship with those at insurance companies, which seek to deny payment where possible

7. Employer-provided healthcare coverage is actually a burden to corporate competitiveness given that companies in other industrialised states do not have to provide it (although they can provide dental, optical, etc.)

8. General Motors spends more on health benefits than it does on inputs

9. Does the United States have better health? No. In terms of infant mortality, f.e., it is just ahead of Belarus and Lithuania

 

Should public healthcare be reformed to better prevent free-ridership, especially in light of an obesity epidemic? Yes. Could the government increase medical insurance premiums slightly (if possible)? Yes. Should unionized nurses and support staff be prevented from arbitrarily striking and sabotaging for increased pay where it is unwarranted and a drag on services? Yes. Should the world embrace the inefficient, ineffective, costly and profit-oriented American healthcare system? No.

re: bad example

André, I agree with your points. Also my own experience with US health care is that it is qualitatively the same as in the Benelux, but much more expensive. The attention the US health care had for my wallet is sickening, especially when one is in need for medical attention.

The more educated and healthier a society, the better it is for everyone. Healthy educated people tend to live happier lives together. It is only the people who take the free ride who are to blame: not going to school, not getting an education and then blaming others for their situation.

Concerning the fate of Paul's grandfather: it is the very sad and dirty consequence of a socialist minister going after the pharmaceutical companies in stead of going after the free riders. Your grandfather should have gotten especially good care just for having contributed so much and taken so little. In stead, he most probably got a generic drug with the wrong consequences. Your grandfather paid some people's free ride very dearly. But that's how socialists get their votes.

The main reason for me to contribute to the public health care is religious: 'take care of the ill and you will be ...(I don't now what anymore but it was something good and yet different from 72 virgins)'.

personal experience in Parisian hospital

I was hospitalized for three weeks at the American Hospital in Paris a few years ago. The French doctors and lab were excellent. Overall, I felt the indigenous French nurses were more sympathetic to me (I'm a mid-50s American of scandinavian background speaking a little French) with one or two exceptions, while the foreign born were less sympathetic or in some cases slyly hostile, also with one or two exceptions. One orderly from the Caribbean was especially kind. My French physical therapist told me darkly that I would be a "number" in the larger state-run hospitals around Paris. The American Hospital is also known for the disproportionately large number of wealthy Muslims who use the facilities. The only other hospital stay I've had in my life was at a private one in Shanghai, China. A very different experience, indeed. What I learned from both encounters (as I slide into the years of lengthening shadows) is that when the chips are down I want the most Judaic-Christian, Western-educated medical practitioners I and my loved ones can afford.




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