Many advocates of “universal” health care tell us that the best way to fix American health care is to expand Medicare to cover everyone. They ignore the fact that the program is already fiscally unsustainable, even if its scope remains static. George Will explains why:

When Medicare was created in 1965, America’s median age was 28.4; now it is 36.6. The elderly are more numerous and medicine is more broadly competent than was then anticipated.

Meanwhile the number of people who pay the bills is shrinking in proportion to the number of people generating them:

In the 43 years since America decided that health care for the elderly would be paid for by people still working, the ratio of workers to seniors has steadily declined.

This has caused the geniuses who run the Medicare system to revert to price controls, the standard model that all government bureaucrats (everywhere) use for “cost containment”:

Medicare is a price-fixing system for upward of 12,000 procedures and drug codes — and for hundreds of categories of equipment.

This hasn’t worked, of course (price controls never work). Medicare is careening toward bankruptcy. Yet single-payer advocates claim government should have MORE control over the health system. And the apparatchiks are willing:

Governments with powerful political incentives to behave this way will play an increasingly large role in health care. As is said, if you think health care is expensive now, just wait until it is free.

Will stole that last line from P.J. O’Rourke, who coined it in a 1993 piece for Cato. But it still captures the magical thinking that surrounds the debate over government-run health care.

Many people think the government should provide free medical care because it is a “right.” The problem is that there is no such thing as “free” health care. Medicare demonstrates just how “not free” it is.

As I pointed out recently, the socialized medicine crowd has come up with a new pretext for imposing government-run health care on the country—-that it will somehow stimulate the economy. Michael Cannon asks an inconvenient question:

That seems to contradict their usual spiel … that America’s health care sector is wasteful and inefficient … How is pumping more money into such an inefficient economic sector supposed to stimulate growth?

The answer, of course, is that it won’t. Not that this really matters to the advocates of government-run health care. For them, this is just another bogus argument they can use to trick the public into giving them yet more power over our lives and money. 

The more government involvement we have in health care, the more politicized the system becomes. In addition to shenanigans such as those we have seen relating to SCHIP and Medicare Advantage, there will also be straightforward graft. Per the WSJ:

The $8 million in new state money that Illinois Gov. Rod Blagojevich allegedly tied to a $50,000 campaign contribution from a children’s-hospital executive would have provided medical treatment to the sickest and poorest children throughout Illinois.

That’s right. In addition the other skulduggery he was up to, Blago was planning to withhold additional funding for seriously sick kids unless hospitals coughed up campaign contributions:

After the governor decided to approve the new $8 million in funding, he told an aide on Oct. 8 that he was considering reversing course because [Children’s Memorial CEO] Magoon hadn’t contributed $50,000 to the governor’s campaign fund.

OK. Now read the following very slowly (then actually think about it): This kind of thing is NOT UNUSUAL when politicians and bureaucrats control health care. For these creeps, it isn’t about health care (universal or otherwise). It’s about money and power.

A favorite talking point of the “universal coverage” crowd is the claim that 18,000 Americans die annually because they have no health coverage. Greg Scandlen does a good job of debunking this canard:

Like other misleading claims, this one is also based on a report by the Institute of Medicine … The study conducts no original research, but is a “meta-analysis” of existing studies. There is little consistency between these studies in quality or methods, and all are “observational rather than experimental.”

Ironically, considering the amount of play this bogus stat gets in the media, the IOM report only mentions the18,000 number in passing:

The number shows up only once in the entire report, buried way back in Appendix D that explains the tortured methodology used to come up with that number.

And, as Scandlen explains, there are so many flaws in this tortured methodology that the oft-repreated datum simply can’t be taken seriously. The bottom line is as follows:

Of all the things that might be said about the uninsured, the one thing that is almost certainly not true is that 18,000 of them die each year simply because they do not have coverage.

Like most of the claims made about the fabled uninsured, the tragic fate of those 18,000 victims is pure fiction.

Like MacBeth, the Obama administration and its accomplices in Congress know the danger of dawdling. They believe that Hillarycare was killed back in 1993 because the Clintons moved too slowly, allowing time for the opposition to mobilize. This time, as the WSJ points out, Obama’s “health care czar” isn’t about to let that happen:

According to Mr. Daschle, because of the Clintons’ hesitation, “reform opponents succeeded in confusing and even frightening Americans about what change might mean.”

He believes, in other words, that the opponents of government-run health care tricked the public into opposing it. Thus, the project of dramatically increasing the government’s role in health care will remain pretty much the same. Only the tactics will change:

[The Democrats] aren’t about to let history repeat itself. And since the lessons they learned from the HillaryCare fiasco are political, and not substantive, they are already moving full-speed ahead.

The Dems are planning to short-circuit the normal legislative process in order to ram this thing down our throats. And they have a plan that will allow them to do it without a filibuster-proof majority:

Democrats are talking up “budget reconciliation” to pass a health overhaul. This process was created in 1974 and allows legislation dealing with government finances to be whisked through Congress on a simple majority after 20 hours of debate.

They will declare victory against the “enemies of reform” and the “news” media will repeat this BS. Eventually, of course, their “reforms” will crash and burn, just as a very similar intiative has failed in Massachusetts.  Why? Because their plan fails to address the underlying diseases afflicting American health care.

With the grim inevitability of Greek tragedy, costs will skyrocket, access will contract, and quality will decline. The only question involves who they will blame it on. Bush will be gone and they control both houses of Congress. Maybe they’ll blame it on global climate change. Yea, that’s the ticket.

Last weekend, as I trudged through the airport, I saw a copy of Time on a magazine rack. When I noticed the title of the cover story, “The Sorry State of American Health Care,” I couldn’t resist the urge to buy a copy.

Predictably, the article was just a recitation of the same old tired arguments and phony statistics repeated over and over (and over) by the advocates of government-run health care.

The phony stats parroted in the piece include our old friend infant mortality. As I pointed out a few days ago, infant mortality rates tell us nothing about a nation’s health care system, but Time doesn’t care about that:

In 2005, the most recent year for which data are available, about 7 babies out of every 1,000 live births in the U.S. died before their first birthday.

The piece admits that this represents another incremental gain in a century of progress, but then adds a black cloud to the silver lining by repeating the following faux-stat from the OECD:

But globally, it still places us 29th in the world, behind Cuba and Singapore and on a par with Poland and Slovakia.

The piece repeats equally specious canards about life expectancy, the uninsured, preventable deaths, and preventive medicine. All of its assertions about these things have been long ago debunked. 

But this is not about information. The goal is to create a sense of crisis that will cause the public to accept government-run health care. And this “news” magazine has been engaged in this project for a long time.

Obvious and Urgent … Republicans and Democrats, liberals and conservatives, and even the American Medical Association, which fought Medicare for so long, are all agreed that a new federal role is necessary to help Americans pay their bills.

In other words, government intervention is urgently needed to avoid catastrophe. The only problem is that the above passage is from a piece that the magazine published in 1971.

That’s right. These people have been giving us the Chicken Little treatment for nearly 40 years. This is reminiscent of the hysterical nonsense they publish about “global climate change.”

But that’s another story.

I have already pointed out that Ted Kennedy has a health care agenda that he plans to begin pushing early next year. Yesterday, he reiterated his intentions:

Senator Edward M. Kennedy … told reporters yesterday that he would advance a bill early next year calling for universal health care.

Kennedy plans to reclaim his chairmanship of the Senate Health, Education, Labor and Pensions Committee from which he will launch his initiative.

And it isn’t likely that the President-elect will have much influence on what the final product will look like. I explain why at the American Thinker.

Louisiana governor Bobby Jindal, who is a Republican, wants to introduce market-based reforms to save his state’s Medicaid program:

Gov. Bobby Jindal on Friday proposed restructuring Louisiana’s health-care program for the poor into a private insurance model that relies on managed-care principles to control costs and improve health outcomes.

And why are these reforms needed?

The state’s Medicaid program … is on an unsustainable financial path. Whereas the program consumed about 8.5 percent of the general fund budget in 2006, it is projected to take up 21 percent by 2011, the governor said.

Jindal’s approach differs pretty dramatically from the Democrat strategy of doing nothing to avert the impending financial meltdown of Medicare.

Maybe we need this guy in Washington.

If the definition of insanity involves doing the same thing over and over again expecting different results, Democrat Senator Max Baucus is as crazy as a rat in a barrel. 

The health care plan he just announced has the same features that doomed every state-level universal coverage plan. John Goodman provides an example:

The Baucus plan includes many of the same elements implemented in the Massachusetts mandated health plan, which is now suffering from massive cost overruns for the state and escalating premium costs for consumers. 

This is exactly what has happened every time this economically illiterate strategy has been attempted. You can’t repeal the laws of economics by government fiat.

I guess the bright side of this idiocy is that Baucus and the people who now control our government will prove once and for all that they are unable to learn from experience.

Maybe that will cause the voters to give them the bum’s rush—-again.

The WSJ has a good op-ed on the effect a Democrat Congress will have on our new President. On health care, for example, Pete Stark will “encourage” him to abandon his “centrist” health care plan and go for single-payor.

The Chairman of a crucial House subcommittee dealing with health care doesn’t think Mr. Obama’s proposal to significantly federalize the insurance market goes far enough. He wants a single-payer system like Canada’s. Mr. Obama may want to strike a deal with Senate Republicans on health care, but Mr. Stark will be pulling him left at every turn.

Obama’s record is one of “going along to get along,” so I don’t see him putting up much of a fight on this.  In fact, he was for single-payer before he ran for President. So they probably won’t have to push him very hard.

Also, as I have pointed out before, Senator Kennedy is working hard on a Medicare-for-All bill, for which his impending demise will create considerable congressional momentum.

With Pete Stark and Kennedy pushing hard for single-payer, and Obama only recently against it for the sake of political expediency, is it not obvious what’s going to happen on health care next year?

While Barack Obama runs for President on an ostensibly ”moderate” health care reform proposal, his accomplice Ted Kennedy is busy putting together the actual program they plan to shove down our throats:

From his sickbed, Sen. Edward M. Kennedy has secretly been orchestrating meetings with lobbyists and lawmakers from both parties to craft legislation that would greet the new president with a plan to provide affordable medical coverage to all Americans, a measure he has called “the cause of my life.”

Obama claims he isn’t for a single-payer system, but he has made no attempt to discourage Kennedy from producing a piece of legislation calling for Medicare-for-all:

Mr. Kennedy is also moving with the knowledge of the presidential candidate who’s now leading in the polls, Sen. Barack Obama.

Here’s how this will come down if “the One” winds up in the White House. He will be presented with the Kennedy legislation in January. And he will sign it, throwing his own phony plan over the side. 

Obama will ask for a few changes just for CYA, but the plan we end up with will be just the sort of single-payer boondoggle he and his supporters claim he doesn’t want.

Then there will be the inevitable appeal an to public sympathy because Kennedy is going to kick the bucket soon, and this is likely to be his final hoorah in the Senate:

There will be a very strong impulse in the Congress to do things for him, especially things he really cares about, and health care would be at the top of that list.

There is no word, of course, on what Mary Jo Kopechne thinks of Kennedy’s plan.

I wonder how many state-level “universal coverage” plans have to crash and burn before the advocates of government-run health care figure out that they don’t work. The latest such plan to slam headlong into the laws of economics is The Keiki Care program in Hawaii:

Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

Why? Because, like all such programs, this one cost too much:

Gov. Linda Lingle’s administration cited budget shortfalls and other available health care options for eliminating funding for the program. 

And, while failing to solve the uninsurance problem, the program crowded out private insurance:

A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

And Hawaii’s ill-considered plan, as Michael Cannon of Cato points out, has much in common with Obamacare: 

[Obama] would waste taxpayer dollars on people who can already afford coverage on their own.  He would draw millions into government health programs that would threaten their access to care.

If the voters are foolish enough to put Obama in the White House, and he colludes with a Democrat-controlled Congress to implement his health care plan, we will see exactly the same result on a national scale.

The laws of economics are stubborn things.

Phillip Klein points out an interesting development in the health care debate:

When it comes to health care, it’s actually conservatives who are offering change, and liberals who are offering more of the same failed policies (only on a much grander scale).

McCain’s health care plan calls for the elimination of the horribly inequitable and inefficient employer-based health insurance system. Obama, the ostensible progressive, is for sticking with the status quo:

The Obama campaign has taken to calling John McCain’s health-care plan “radical” and Barack Obama himself declared during Tuesday night’s debate that it would “lead to the unraveling of the employer-based health care system.”

If ever a system needed “unraveling” this is it:

The current system discriminates against those who seek to purchase their own health insurance, because it only offers a tax exemption for those who get insurance through their employers. As a result, many self-employed Americans cannot afford health insurance, even though their taxes help subsidize others.

McCain’s plan would go a long way toward fixing this situation:

McCain’s plan would make the system fairer by ending the tax exemption for health-care purchased through one’s employer and replacing it with tax credits of $2,500 for each individual and $5,000 for every family.

Meanwhile, Obama wants to exacerbate the problem:

Obama would not only maintain the current system of regulation, but he would implement onerous regulations at the national level.

I thought “progressives” were for, like, progress. Did I miss something? Is their progressivism just a social pose?

A trademark lie that has been consistently promoted by the Obama-Biden campaign is that  John McCain will tax everyone’s health care benefits. Joe Biden said it during the recent VP debate, and Barack Obama repeated it in tonight’s Presidential debate:

Now, Sen. McCain has a different kind of approach. He says that he’s going to give you a $5,000 tax credit. What he doesn’t tell you is that he is going to tax your employer-based health care benefits for the first time ever. 

This charge, like so many of the talking points that emerge from the Obama campaign, is pure fiction. When Biden told that whopper, the Washington Post gave him two Pinnocchios:

According to the nonpartisan Tax Policy Center, the McCain proposals would result in a net benefit of $1,241 to the average taxpayer in 2009.

But the Obama campaign is apparently convinced that this “tax your benefits” whopper will scare some voters into his corner, so they keep repeating it.

Hugh Hewitt interviewed Sarah Palin, and she made a good case for electing a real person to the office of VP. She also made it clear that she’s the only candidate in recent memory to have experienced the day-to-day health care travails of the average working person:

Early on in our marriage, we didn’t have health insurance, and we had to either make the choice of paying out of pocket for catastrophic coverage or just crossing our fingers, hoping that nobody would get hurt, nobody would get sick.

But, unlike her opponent, she understands that more government meddling in the health care market is not the answer:

I support flexibility in government regulations that allow competition in health care that is needed, and is proven to be good for the consumer, which will drive down health care costs and reduce the need for government subsidies.

So, who are we to trust: someone who has actually been there or the hopelessly out-of-touch Joe Biden? In other words, do we need a real human being like Palin or a corrupt buffoon?

It will be interesting to see if Gwen Ifill, the moderator of tomorrow’s debate whose fawning book proves she’s in the tank for Obama, asks a question that gets anywhere near this basic issue.

As I have pointed out before, the one health care position John McCain and Barack Obama have in common is their wrong-headed support of prescription drug reimportation. It appears, however, that both candidates may be waking up:

Barack Obama and John McCain are reviewing their support for allowing individuals to import cheaper prescription drugs in light of tainted medicines and other goods made in other countries, their advisers said on Thursday.

Unfortunately, the myriad economic and safety issues that militate against reimportation have still not quite convinced them that they were just wrong on this issue:

Neither adviser said their candidate had abandoned reimportation, but had realized it would be more difficult.

One must, I suppose, make allowances for the fact that these guys are politicians. Presumably they will eventually decide to deep six this exceptionally dumb idea.

Although we can safely disregard the WSJ piece by David Cutler and Brad DeLong on Obama’s health care plan, there is an excellent article on the plan in Health Affairs, and its conclusion is not flattering:

It greatly increases the federal regulation of private insurance but does not address the core economic incentives that drive health care spending. This omission along with the very substantial short-term savings claimed raise serious questions about its fiscal sustainability.

Its ”play or pay” feature and potential for private insurance crowd-out also trouble the authors:

Heavy regulation coupled with a fallback National Health Plan and a play-or-pay financing choice also raise questions about the future of the employer insurance market.

This is a detailed, intelligent though somewhat dry piece. But if you want an honest, realistic assessment of Barack Obama’s health care plan,  it’s well worth a read.

Last year, I took issue with a “study” which claimed to show that 50% of bankruptcies were caused by medical bills. At that time, I pointed out that a couple of researchers checked the data and discovered that only 17% of bankruptcies could be plausibly attributed to medical bills.

Well,  it turns out that the actual number is only 5%. Researchers at UC Davis have found that reckless  overspending has driven most personal bankruptcies, and that medical problems are not even the second most prevalent cause:

Zhu [the study’s author] concluded that debt accounted for more than 50 percent of recent bankruptcies, while medical problems caused just 5 percent and unemployment led to only 13 percent.

So, how did the authors of that original study reach conclusions so much at odds with those of other researchers? Well, its authors run PNHP, an advocacy group committed to foisting single-payer health care on the American public.

In other words, doctors Woolhandler and Himmelstein fudged the data in their widely publicized “study” to support their political agenda. Happily, there are still a few honest researchers out there whose work can actually be trusted.

That’s right. Progressive tut-tutting about “health care disparities” notwithstanding, it turns out that we spend almost exactly the same amount of money on health care for the poor as we do for the rich. Robert Samuelson reports the following in Newsweek: 

On average, annual health spending per person—from all private and government sources—is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest.

This information comes from a study conducted by economist Gary Burtless of the Brookings Institution, who was evidently not expecting such results:

Burtless was understandably astonished when he assembled these data … Probably in no other area, notes Burtless, is spending so equal—not in housing, clothes, transportation or anything.

Samuelson quotes the Burtless study to show that the health care debate often revolves around phony issues. To that end, he also points out that medical outcomes for the uninsured don’t differ significantly from those of the insured:

Outcomes differed little … After about six months, 20.4 percent of the insured and 20.9 percent of the uninsured judged themselves “better”; 32.2 percent of the insured and 35.2 percent of the uninsured rated themselves “worse.” The rest saw no change.

These data about spending and outcomes will surprise many and be denied by many others. But if we are ever going to fix health care, we will have to stop allowing everyone to bring his own “facts” to the debate.

Last week I did a brief post on Governor Palin’s effort to repeal Alaska’s burdensome and counterproductive Certificate of Need statute.  I’ve done a more detailed piece on that initiative and the CON issue for the American Spectator. Here’s an excerpt:

State CON laws originated, like so many bad health care ideas, with a mandate from the federal government. In 1974, states were effectively told by Washington that no new medical facilities could be built unless a “public need” had been demonstrated. The idea was to reduce costs, but the only measurable effect of this federal decree was a morass of bureaucratic red tape that stifled competition in the health care market.

And, like so many bad government ideas, the CON monster has been difficult to kill even after Washington tried to drive a stake through its heart:

In 1987, the federal statute was finally repealed, but many states inexplicably kept their CON processes in place. Alaska was one of them and, as Governor Palin put it in an editorial for the Anchorage Daily News, “Under our present Certificate of Need process, costs and needs don’t drive health-care choices — bureaucracy does. Our system is broken and expensive.”

The rest of the article can be read here.

As I have noted before, I have a rule of thumb that has served me well in assessing public figures and policy ideas: Anyone or anything Paul Krugman dislikes can’t be all bad.

So, when I saw that Krugman had trashed John Goodman about a (somewhat) tongue-in-cheek post he had written about abolishing the term “uninsured,” I knew Goodman must have made some worthy point. 

Goodman correctly points out that, like so many other terms used in today’s political and policy debates, “uninsured” has been rendered meaningless by misuse. Thus, he suggests dropping the misnomer:

Here is the idea: only people who are denied care are truly uninsured.  Everyone who gets care is effectively insured by some mechanism.  So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care.

Krugman, with his trademark dishonesty, pretends not to understand what Goodman is getting at. Instead, he reduces the entire argument into one of his tired faux-progressive talking points:

Last week John Goodman, an influential figure in Republican health care circles, explained that we shouldn’t worry about the growing number of Americans without health insurance, because there’s no such thing as being uninsured. After all, you can always get treatment at an emergency room.

You would think that a guy like Krugman, who was once actually respected as an economist, could come up with some new material. But, alas, it is not to be. Instead we get “After all, you can …… zzzzzzzzzzzzz

In reality, Goodman’s post provides a pretty good blueprint for classifying “the uninsured” in a way that might actually be useful in clarifying the health care reform debate.

Not that Krugman and his fellow travelers are interested in clarity. 

I think John McCain has hit the ball out of the park with his VP choice.

Among the many assets the Alaska governor brings to the Republican ticket is a bias in favor of free market health care reform. Here’s a quote that captures her general position:

I support flexibility in government regulations that allow competition in health care that is needed, and is proven to be good for the consumer, which will drive down health care costs and reduce the need for government subsidies. I also support patients in their rightful demands to have access to full medical billing information.

And she puts her money where her mouth is. Earlier this year she proposed legislation that puts the above into actual practice in Alaska:

Palin last week introduced the Alaska Health Care Transparency Act to provide consumers with factual information on quality, cost and similar matters … At the same time, Palin is proposing elimination of the Alaska’s Certificate of Need process, likely to be much more controversial in health care circles.

Regular HCBS readers (Hi, Mom!) will remember that eliminating the Certificate of Need process is part of the Catron cure for health care, so it goes without saying that Governor Palin is right on this issue.

With Governor Palin on the Republican ticket, we can be pretty sure of having a free market advocate in the White House, even if McCain succombs to his age or war injuries while in office.

I’ve written before about Hillary’s penchant for prevarication. During her speech to the Democratic convention, Hillary told another of her trademark whoppers:

I will always remember the single mom who had adopted two kids with autism. She didn’t have any health insurance, and she discovered she had cancer. But she greeted me with her bald head painted with my name on it and asked me to fight for health care for her and her children.

James Taranto explains why one should doubt the veracity of this tale:

The trouble with this story is that cancer does not cause baldness. Cancer patients often lose their hair as a side effect of chemotherapy or radiation treatment. Unless this woman had alopecia unrelated to her cancer or was just making a fashion statement, she had health care.

God, I’m going to miss that woman.

According to the Census Bureau, the number of uninsured Americans declined significantly in 2007. As David Hogberg reports in Investor’s Business Daily:

The number of uninsured fell to 45.7 million last year from 47 million in 2006, largely due to expanded government coverage. That’s 15.3% of the population, down from 15.8%.

But the advocates of government-run health care are determined to see bad news in the report. They claim that the remaining 45.7 million need a government program:

That’s proof, liberals say, of a health care crisis. There is a case for growth in the safety net,” said Kathleen Stoll, deputy executive director of Families USA.

The problem with this reasoning becomes obvious when one looks at the makeup of the uninsured population. The following chart provides an eye-opening breakdown:

As the chart shows, nearly 10 million of the fabled uninsured are not actual Americans, and a large percentage make more than $50,000 a year. It’s not obvious that the voters want their taxes raised to cover such people.

But that’s exactly what advocates of government-run health care, including most of the people meeting in Denver this week, want to do. They believe universal coverage is a “moral imperative.”

And they ain’t talking about private coverage.

The other day I did a brief post about Michelle Obama and the contract that was awarded by her employer, the University of Chicago Medical Center, to one of her husband’s political cronies. I thought I was done with it, but the Blackwell deal gave off such a stench that I decided to do a longer piece. Here’s a taste:

The people who run the University of Chicago Medical Center may live to rue the day they hired Mrs. Obama. The Post story quotes a UCMC spokeswoman who says that the Senator’s wife “was not involved in the selection process,” and it may well be true that she didn’t put her hands on her hips, smite the floor with her expensive heel, and order cowering underlings to give the intranet project to her husband’s patron. Nonetheless, the Blackwell deal hardly passes the smell test, and CMS has a very sensitive nose.

Read the entire piece in the American Spectator.