Health Care Quality vs. Equality: Irreconcilable Differences

By | June 14, 2012 | 0 Comments

Most people on the left are not opposed to freedom. They are just in favor of all sorts of things that are incompatible with freedom.
Thomas Sowell

The ethical challenge of rationing care will have to be faced sooner or later, particularly when we confront the inequitable distribution of health care resources globally. [Emphasis added.]
New England Journal of Medicine, 2012

As we await the Supreme Court’s historic decision on ObamaCare, read the first quote, taken from one of the wisest people around today. Then read the second quote, taken from the leading medical journal in America. The ivory-tower leftists who yearn to control all of us are now planning to equalize health care not just across this country, but across the whole world.
It would be extremely difficult, expensive, and time-consuming to improve the level of health care throughout the world. It’s much easier to lower the level of American health care. And that’s what is intended.
For many years, what I did was called “medical care.” This seemed reasonable, since it was overseen by physicians. But some felt that this term undervalued the contributions of nurses, technicians, paramedics, and all the others who provide care. So the name was changed to “health care.”
Then the words were condensed to “healthcare.” This was part of a tendency to put combine words into compounds like “frontseat” and “backyard,” as if we were speaking German. But that makes me nervous. The modern welfare state was introduced by German Chancellor Bismarck, who was hardly my role model.
The term “healthcare” emphasizes the goal, health – but it also reduces the emphasis on those in charge of achieving that goal, doctors. Doctors were in charge of medical care. But who is in charge of “healthcare”? Government bureaucrats.
The World Health Organization rates U.S. “healthcare” as 37th in the world, and Cuba as 39th. But how can any sane person rate our health care as the virtual equal of Cuba’s, where common people can barely get an aspirin? On the contrary, America has the best survival rates in the world for most cancers.
As far as life expectancy is concerned, if you eliminate violent deaths − homicide, suicide, and accidents, for which medical care has the least effect − the U.S. has the longest life expectancy of all nations. I’ll bet you didn’t read that in pro-ObamaCare media.
If we are to believe the World Health Organization and the proponents of socialized medicine, the quality of a nation’s care is judged not by life expectancy, or by survival rates from cancer, or by other indices of quality of care, but by equality or care.
So how can we improve equality of care? We could improve the care of those now receiving the worst care, as has been our goal for many years. Or we could use the Marxist approach by decreasing the care of those receiving the best care. And this, regrettably, seems to be what the ObamaCare advocates have in mind.
Consider this: To improve the U.S. ranking on the World Health Organization scale without spending a penny, we could simply close the 100 top hospitals in the country. We could close Columbia-Presbyterian in New York and Cedars-Sinai in Los Angeles. Instead of making MRI scans more available in outlying areas, we could make them less available in urban areas. And instead of making expensive drugs and treatments more available to the needy, we could make them less available to the affluent.
But, you say, this is ridiculous, dangerous, even homicidal. Yes, but isn’t all Marxism? Isn’t this plan for “healthcare” the equivalent of what Occupy Wall Street wants to do to the economy?
Marxism is the outgrowth of the French Revolution. Despite the example of American Revolution, which led to greater freedom, the French proceeded with a series of decapitations of the nobility and the wealthy.
The guillotine removed the “top one percent” so hated by Occupy Wall Street. By the standards of the World Health Organization, this led to greater “equality.” True, there were just as many poor. Their condition was, if anything, even worse than it had been under the monarchy. But they were more “equal.”
Leftists talk endlessly about doing things for “the people.” But the people they actually want to do something for are themselves. They want to feel altruistic, but feeling altruistic and actually helping others are two different things entirely.
● Many (not all) leftists would prefer that all people get mediocre care rather than that some get mediocre care while others get excellent care.
● They would prefer that all people have the minimum to survive rather than that some have the minimum and others have an excess.
● They would prefer to lower the ceiling rather than to raise the floor.
● Their real objective is not health care but control of our lives.
ObamaCare covers 2700 pages of impenetrable bureaucratese. But it contains not one word about funding for more physicians, nurses, physician’s assistants, technicians, or paramedics. More care for more people, but no more medical personnel? There could be no clearer proof that what is intended is rationing, with long waits and “gatekeepers” to block access to specialists.
The Soviet Union collapsed after 74 years of “building socialism.” They did build socialism, but what else did they build? A huge military and police apparatus, yes, but not much else. How many new drugs did the Soviet Union develop in those 74 years? Not penicillin. Not polio vaccine. Not AZT. And how many new medical devices? Not the CAT scan. Not the MRI. Not fiber-optic diagnostic and therapeutic devices. In fact, aside from a few elite clinics where Communist Party bigwigs received Western-style care, health care in the Soviet Union was mediocre at best, and more often terrible or nonexistent.
Leftists do not intend to construct a Soviet-style economy and health-care system in America. But they did not intend to construct them in the Soviet Union, either. They dreamed of universal peace, brotherhood, plenty, and health. But their dream, like the dreams of all totalitarians, turned into a nightmare.
At least Russian communists had the excuse that their ideas had not yet been tried. At least they could hope that their dreams could be put into effect. But American leftists have the example of 74 years of Soviet failure and despotism. What’s their excuse? They have the example of 60 years of Western European socialism, with its overbearing bureaucracy, stifling regulations, mountainous debt, and collapsing social-security and health-care systems. But they ignore that example. They are narcissists. They imagine that they know how to do it better.
Our goal should be to assure that everyone has at least adequate health care − that is, to raise the floor. If at the same time the ceiling is raised less, then health-care equality will increase. That’s okay with me. But if at the same time the ceiling is raised more − that is, optimum care is raised to a still higher level − then health-care equality will decrease. And that’s also okay with me.
Leftists see economics – erroneously – as a zero-sum game. They believe the poor are poor because the rich are rich. So they aim to redistribute wealth, not to create more for everyone. But leftists were not satisfied with making a mess of the economy. In a colossal display of hubris, they transferred this discredited theory to health care. They believe some people receive poor health care because other people receive good health care. So they aim to redistribute health care, not to improve it for everyone. Marx was a lousy economist, but he would make an even worse physician.
A place already exists where there is equality of health care, equality of income, equality of housing, equality of food, equality of clothing, and equality of work. It is called prison.
Dr. Stolinsky writes on political and social issues. Contact: You are welcome to publish or post these articles, provided that you cite the author and website.

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