The truth about the truth about health care (Updated)

Robyn "Blumñata" Blumner is back at it again this week with another nonsensical foray into editorial journalism.

Not that Blumñata has been on vacation since the last time I dissected one of her granfalloonian offerings. She finally wrote something focused enough to warrant a relatively focused reply. Much of her work this year consists of laundry list attacks on either the Bush administration or conservatives in general.

This week she puts her abysmal knowledge of economics on display as she writes in favor of single-payer health care.

Universal health care is a benefit that a large majority of Americans say they want. It would grant Americans some semblance of the kind of peace-of-mind that Canadians and Western Europeans enjoy. We wouldn't have to worry that a job loss would also put our family's health coverage at risk. And on and on.

A large majority of Americans want universal health care? A pity that Blumner failed to name her source. Here is one, from 2003, that calls her claim into question.

In an extensive ABCNEWS/Washington Post poll, Americans by a 2-1 margin, 62-32 percent, prefer a universal health insurance program over the current employer-based system. That support, however, is conditional: It falls to fewer than four in 10 if it means a limited choice of doctors, or waiting lists for non-emergency treatments.
(ABCNews.com)

Focusing simply on the first sentence, one would think that universal health care appeals greatly to Americans. But the four in 10 mentioned subsequently is not a majority, and doctor shortages and waiting lists are quite likely with universal health care.

At least we can say that Americans like the idea of pie-in-the-sky health care. Who could be against that minus the problems?

But even Blumñata admits there are problems:

But expanding health coverage to everyone is going to mean higher taxes in some form as well as other sacrifices, such as enforceable cost controls on the medical establishment and some practical limits on patient medical services. Expensive medical procedures that don't demonstrably work or have about the same outcomes as cheaper methods are going to have to be eliminated from coverage. Drugs too will have to prove their efficacy. Welcome to the age of generics.

Higher taxes is a huge drawback to universal health coverage. This represents a core inconsistency with both President Obama's domestic policy and Blumñata's thinking.

Think about it. Mr. Obama is selling health care reform as an economic salve. But that is ridiculous. Sure, decreased spending on health care decreases the percentage of GDP spent on health care--but it also decreases the GDP, particularly where the expenses return workers to their jobs faster.

***
Interruption via update: To make myself clear, decreased spending on health care decreases the GDP generally, while the rapid return of workers to their jobs shrinks the percentage of GDP spent on health care as a percentage of GDP generally.

I apologize for the poor job I did expressing that idea.
***

But back to her list of admitted problems.

• cost controls
  
• limits on patient medical services
  

To be sure, Blumñata offers only one example in support of these euphemistic-sounding drawbacks. Expensive treatments that do not work well would be eliminated as options, she says, and where two treatments offer about the same benefit the more expensive of the two would be sidelined.

It is neither that simple nor that benign.

Cost controls will very probably include restrictions on your choice of doctors as well as limitations on seeing a specialist. They will probably include (perhaps only when the money starts to run out) assessments on the quality of life a patient expects following treatment. They will include rationing of services, which will grow gradually more pronounced as the wealth of medical resources produced by our past systems turns obsolete. As for Blumner's example of reduced availability of medications, doctors often have clinical reasons for choosing a more expensive medication. Patients do not always respond the same way to medicine, and some medicines do not work well in conjunction with other therapies.

The benign-sounding push toward efficiency is, by analogy, an initiative that removes tools from the doctor's toolbox, and, instead of your doctor, the government will decide which tools belong in there.

Knowing there will be costs and how much Americans hate the thought that lunch may not be free, opponents to health care reform have already launched a "Harry and Louise" style scare campaign. A group called Conservatives for Patients' Rights expects to spend up to $20 million on television ads that feature patients and doctors in Canada and Britain complaining about long waits for surgery or how they couldn't get needed medications under their national health care.

Sometimes the truth hurts, which is probably why single-payer proponents like Blumñata want to poo-poo the real problems with the idea by labeling it as a "scare campaign." The poll above shows how support for universal health care shrinks based on the existence of its traditional drawbacks. Conservatives who want to publicize those drawbacks are simply trying to scare people. Or something:

It is designed to make you want to desperately cling to the status quo.

I doubt it, for the admitted problems with the current system stem largely from government involvement, including the ramifications for malpractice within the framework of the U.S. legal system. Other problems stem from attaching health care to employment--a problem presidential candidate John McCain had hoped to address with his health care reform plan--and the third party payment system as represented by private insurance, Medicare and Medicaid.

As for the supposed desperation:

PRINCETON, NJ -- Despite ever-increasing healthcare costs and widespread dissatisfaction with the U.S. healthcare system, a majority of Americans remain satisfied with what they pay for their own healthcare, the quality of the healthcare they receive, and their healthcare coverage.
(gallup.com)

What, Blumñata never told you that? Most of you are supposed to be desperate! Now get with the socialist pogrom! Er, I mean program.

Of course, President Barack Obama isn't suggesting that we adopt a single-payer system like these other countries have — which is too bad in my view.

Obama has said that he prefers the single-payer plan. But he also clearly realizes that an immediate switch to a single-payer plan is a high political risk. His plan immerses the medical system frog in a pot of tepid water and starts heating it gradually from the bottom. Before you know it, you're cooked.

Reality: Obama Has Consistently Said That If We Were Starting From Scratch, He Would Support A Single Payer System, But Now We Need To Build On The System We Have
(barackobama.com)

No doubt that prospect makes Blumñata impatient.

People in the United States seem to like our own single-payer government-run program: Medicare.

Sure they do. So long as they aren't thinking about the incredible waste in the Medicare system along with the fact that it already consumes over 16 percent of federal spending (Social Security included). National defense takes up about 19 percent.

clipped from www.factcheck.org

The Medicare budget just keeps expanding, and the baby boomers will push its expenses to even more amazing heights. Sorry if that sounds scary, but it is reality. There is one way to avoid the problem: Cut and/or ration services. The only part of his plan for Medicare that Obama will currently admit, so far as I'm aware, is the part that expands the government's share of medical costs and raises taxes to pay for it. Is that fiscal responsibility? Seriously?

Back to Blumñata:

And as to the poor Canadians who can't get decent medical care? A 2008 Harris poll of how the citizens of 10 developed countries feel about their health care system found the United States dead last, with fully a third of Americans saying our system needs to be completely rebuilt. Meanwhile, Canada's system was third-highest in popularity.

Hmm. Blumñata left out the poll's conclusion to the effect that all the nations surveyed had majorities calling for health care reform.

Regardless of what system a country has it falls far short of satisfying public expectations. Most systems always seem to be in a crisis or near crisis.
(harrisinteractive.com)

It is true that the U.S. system ranks last among the nations surveyed in terms of native popularity. But there could be innumerable reasons for that other than quality of care, including the existence of a pervasive negative message from the national press.

Blumñata again:

But the folks coordinating the ads don't let the facts stand in their way.

They'll face a stiff challenge in ignoring more facts than our own Blumñata. Rather than start in on how those folks play with the facts, she engages in four paragraph's worth of personal attacks against Rick Scott of Conservatives for Patients' Rights. Supposedly it is relevant that the hospital group Scott once headed, HCA, was found guilty of various wrongs even if Scott himself was charged with nothing and convicted of nothing.

Too cute.

After apparently exhausting her supply of facts misrepresented by Scott (without ever starting on it), Blumñata runs off to attack the strategy she says Republicans will use to oppose Obamacare:

Republicans in Congress are positioning themselves in this camp too. They're working from a 28-page attack plan by GOP strategist Frank Luntz, an expert on phrasing political positions for maximum advantage. The plan lays out ways to defeat Obama's health care reforms by painting Democrats as wanting "to put Washington politicians in charge of your health care."

The charge is absurd since Obama's intention is to leave current health insurers in place while offering a government plan as an alternative. But there may be real trouble in holding congressional support together when the new costs and sacrifices necessitated by a $120 billion universal health care plan start coming clear.

Somehow, Blumñata has worked in an editorial position with a newspaper for over 15 years without apparently realizing that Congress controls the expenditures of the government. Along with not realizing that government insurance automatically carries a competitive advantage over private insurance. Know of any private insurance companies that can levy general taxes in order to support their bottom line?

How long did it take for Florida's state-sponsored homeowner's insurance entity to its current status as Florida's #1 homeowner's insurance company?

The Florida Legislature created Citizens Property Insurance Corp. in 2002 when it merged two existing state-backed insurance pools, the Florida Residential Property and Casualty Joint Underwriting Association and the Florida Windstorm Underwriting Association. Commonly called Citizens, it is now Florida's largest home insurer. As of November 2007, Citizens insured more than 1.4 million homes, condos and businesses in Florida.
(SunSentinel.com)

FYI, the Florida Residential Property and Casualty Joint Underwriting Association was established way back in 1992. The Florida Windstorm Underwriting Association is comparatively ancient, kicking off in 1970 to cover properties in the Florida Keys. In any event, they demonstrate the tendency of government entities to grow. A big part of that growth stems, in this case, from the state insurers exemption from leverage rules applied to private insurers.

So, yes, the plan set forth by Obama does increase the government's role in health care and that role is likely to incrementally increase, leading to exactly the types of problems characteristic of single-payer programs--unless the political pressure brought by groups such as Scott's prevent it.

And for Blumñata it isn't just the supposed misrepresentations by Scott, it is the method they supposedly intend to employ.

She quotes a portion of the Frank Luntz "attack plan," but where is the rest of the so-called "attack plan"? I have been unable to find a copy of it online. If it is so bad, then why not publicize the whole thing? Why quote tiny portions from the 28 pages without any surrounding context?

Maybe that's the only way to keep Luntz from misleading people? Keep the people from accessing the information?

Bottom line, Obama's health care reform as part of an economic stimulus is a dangerous fantasy. And the resulting health care system will surely deliver a lower quality of care even if it satisfies people who believe they would have to pay for their own care otherwise. Speaking of free lunch.