Health and Health Care Are Not the Same: Part 2

By | January 27, 2014 | 0 Comments

Five-year survival rates for common cancers

If the American health-care system is “broken,” why do we have the highest survival rates for most cancers? And if it isn’t “broken,” maybe what it needs is a tune-up, not a major overhaul. Maybe we should improve it, not scrap it. But at least we can say that we are doing fairly well in cancer care – better, in fact, than nations held up as models of “universal coverage.” If this is true for cancer, where health care is the primary determinant of survival, what can we say about other conditions, where health care may play a lesser role?
In the current debate about ObamaCare, we may tacitly assume that health and health care are synonymous. They aren’t. Health care is not the only factor influencing the health of Americans. Often it is not even the most important factor.
If you doubt this, check out the life expectancy and the rates of infant and maternal mortality in the various states. Compare the best figures with those from the District of Columbia, which is similar to other inner cities. For example, the maternal mortality rate for D.C. is 34.9 maternal deaths per 100,000 live births, compared with 2.7 in Massachusetts. The infant mortality rate in D.C. is 14.1 per 1,000 live births, compared with 4.5 in Utah. The life expectancy in D.C. is 72.0 years, compared with 80.0 years in Hawaii.
Then you might check out the rates of AIDS. The rate in D.C. is 148.1 cases per 100,000 inhabitants, while that in Vermont is 1.0. Why is a resident of D.C. 148 times more likely to get AIDS? Is there an AIDS clinic on every block in Vermont? Do they have medicines not available elsewhere? Do they hand out condoms in pre-school? Or does it have something to do with the way Vermonters live their lives?
And if any doubt remains, look at homicide rates. The rate for the District of Columbia is 29.1 per 100,000 inhabitants, compared with 1.0 in New Hampshire. These are not minor differences − these are gross disparities. The pathologies of the inner city are many, but government-run health care cannot be the answer. We already have it in the District of Columbia, and the figures are the worst.
But note that I did not say “results.” The terrible health figures from the inner city are not the result of the health-care system. They are the result of horribly unhealthful lifestyles and living conditions. They are the result of pervasive violent crime, rampant drug abuse, and promiscuous sex. They are the result of rotten schools run by the government, which leave young people unprepared for gainful employment.
They are the result of ignoring the proverb, “He who does not teach his son a trade teaches him to be a thief.” Of course, this assumes that there is a father present to teach anything at all. But look at the data for births to single women. Compared with Utah, where 19.6% of births are to unwed mothers, the rate in D.C. is 58.5%. Well over half of all births in the inner city are to single women. This fact is related to the number of children living in poverty. And that fact in turn is related to the poor health of many of the children, which may have lifelong consequences. These are moral and social problems, and they cannot be solved by health care.
One more factor to consider is unlimited immigration. Milton Friedman, recipient of the Nobel Prize in Economics, taught us that we can have either open borders or a welfare state, or we can have neither, but we can’t have both. And that is precisely where we are headed.
Advocates of ObamaCare smugly point out that it does not cover illegal immigrants. So what? They know that soon after ObamaCare takes effect, someone will file a lawsuit demanding coverage for everyone, regardless of immigration status. The outcome of that suit is totally predictable.
But we may not have to wait for a suit to wend its way through the courts. Officials are already urging that illegal immigrants be covered by ObamaCare. True, President Obama promised that illegals would not be covered. He also promised that we could keep our insurance and our doctors, and that he would get to the bottom of the IRS scandal and the Benghazi attack, so this promise will probably go the way of the others.
Of course, the problem will be “solved” when amnesty is declared – either by congressional statute, as the Constitution requires, or by presidential decree, as is becoming common.
And what will follow? A flood of immigrants, legal and illegal, will cross our borders to enjoy “free” health care. If you are worried about rationing of care now, think what will happen to the elderly, the disabled, and those with expensive diseases when millions of newcomers overflow waiting rooms.
In short, “reform” of health care may very well cause a deterioration of our health.
Ignoring these facts may be convenient for proponents of government control of health care. Many of these people also push for government control of almost everything – from light bulbs and toilets to dishwashing detergent and shower heads. But ignoring facts can be dangerous. Government-run health care has many problems in Canada, the United Kingdom, and other places it has been tried. But the biggest problem is that health care of whatever type is only one factor that affects health − and often not the most important factor.
Our object should be to improve our health, not merely to rearrange our health care. Our object should be to help Americans become healthier, not to control every aspect of their lives. And the longer the debate goes on, the clearer it becomes that the object of ObamaCare is control, not health.
No, health and health care are not the same. Confused terminology leads to confused thinking, which leads to confused action, which leads to where we are today.




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