Posted by: bkivey | 20 March 2010

Clothing the Emperor

In a column published on 19 March, NY Times columnist Nicholas Kristof attempts to make the case for ObamaCare by casting the argument in terms of access. Now, Mr. Kristof  was educated at Harvard, won a Rhodes scholarship, and earned a JD, all of which make his logical fallacies and inconsistencies the more surprising. But Mr. Kristof is not trying to make a rational argument, he is trying to rationalize his beliefs. This in and of itself is not especially notable, as it is a human trait unrestricted by ideology.

In the second paragraph he begins to make his argument by admitting that “While the data differ and the statistics aren’t fully reliable. . .” Does Mr. Kristof really expect someone to be persuaded by an argument that he admits is based on unreliable data? In the next paragraph he states that American life expectancy increased in each of the years 1942 – 1945 “. . .even as hundreds of thousands of young Americans were being killed in World War II. . .” In probability theory these are known as independent events. The occurrence of the one has no influence on the occurrence of the other. Sure, if you were a male between the ages of 18 and 45 and got drafted you probably weren’t too sanguine about your chances of seeing 60, but your personal circumstances did not affect one whit the probability that Thelma at the gun factory would see 60.

Mr. Kristof asserts that the passing of ObamaCare would increase access to health care, which I don’t think anyone denies, but then he states that not passing it would decrease access. Huh? So if ObamaCare isn’t passed doctors and hospitals will close their doors? Or does he mean to say that not as many people will be covered under a health care plan? Access to health care and being covered under a health care plan are not synonymous. I can illustrate this from personal experience.

In my post of 18 March I stated that I have had to seek medical care for traumatic injuries on several occasion, sometimes while insured, most of the time not. I was never denied care and I worked out payment plans with the providers when I was not covered by a health care plan. I have on occasion had to seek treatment for non-traumatic medical conditions. On those occasions I picked up the phone, made appointments with the appropriate people, and paid for the treatment. Accessing care was not a problem. I was also able to exercise options that would not be available to me under a government-run medical system: I could shop around for the lowest price, receive a substantial cash discount, and see a provider in a timely manner, usually within the week. It is unfortunate that people have become so conditioned to equating participation in a health care plan with accessing health care that they don’t think  in terms of what they can do for themselves. This is good for people who want to control others lives  and bad for the individual.

In a revealing bit of sophistry Mr. Kristof manages to refute his own premise. In one paragraph he notes the increasing ability of Americans to access health care and in the very next paragraph he blames recent reversals in this trend to “. . . politicians’ ignominious failure over the past half-century to provide universal health care. . .” It appears that he is claiming an increase in the ability of Americans to access health care during the very same period he decrys the lack of a universal health care plan. As an argument in favor of government-controlled health care this isn’t a very good one.

Mr. Kristof states that “. . . uninsured people are significantly more likely to die than insured people.” This statement is non-sensical, the human mortality rate is 100%. Period. He says that diseases are caught later in uninsured people, which is probably true, but that’s not a function of lack of access, it’s a function of individual choice. The widely held premise is that people with a health care plan are more likely to see a physician on a regular basis. I don’t know that this holds up under scrutiny. In fact, I think that there is a good case to be made that government-controlled health care actually reduces access to health care.

Consider that one of the selling points used by proponents of ObamaCare is that millions of people who are not covered by a health care plan would have a health care plan. Setting aside the fact that that’s not even true, as coverage wouldn’t begin until 2014 while the taxes start immediately, where are those people going to go? The question of where the thousands of health professionals and facilities that will be required to handle the sudden influx of patients has been completely ignored by the proponents of ObamaCare. I have not seen a single supporter of government-run health care address this. Do they really expect that people will happily pay a greatly increased tax bill and not demand to use the services for which they are paying? This breathtakingly shortsightedness is emblematic of an immature worldview in which people focus on the immediate “We want something now!” while incapable of thinking a situation through.

To Mr. Kristof’s credit he doesn’t try to sell ObamaCare as a cost-saving measure, something others have tried to do. There have been recent reports that the Congressional Budget Office (CBO) has said that ObamaCare will save billions of dollars in health care costs. This doesn’t even begin to make sense, yet I have heard President Obama make the point in speeches. How can you propose that something that we are not spending money on now, that by all estimates will cost hundreds of billions of dollars in new spending, is ‘saving’ money? This is typical political logic. If you buy a car that is marked down at the end of the year you may have ‘saved’ hundreds of dollars but you’ve still spent the money, money that you hadn’t spent before, to buy the car.

This is of a piece with the same assertions that there are billions of dollars to be ‘saved’ by eliminating waste and fraud. What,  this alleged waste and fraud can’t be eliminated now? Do the people who administer current government medical programs need expensive and expansive legislation before they can start doing their jobs? The one question I would ask of anyone who says that eliminating waste and fraud will help pay for ObamaCare is “Why aren’t we doing that now, and more to the point, why haven’t we done that in the past?”

Another major financial consideration is that enacting ObamaCare will very likely cause the downgrading of U.S. debt. There is already talk of having U.S. debt downgraded from AAa to a lower rating, even before ObamaCare is enacted. If this comes to pass, the U.S. government will have to increase the interest paid on bonds to fund the budget, thereby increasing the cost of government programs. I find it amazing that people who obsess over their credit scores don’t realize that credit ratings work the same way for nations, too.

As I have noted in previous posts, I don’t understand why Congress doesn’t try incremental changes in our health care system, give those changes time to see how they work, and go from there. Politically, it’s always more appealing to go for the grand gestures. Every politician want’s to go back to their constituents and say “Look what I did!” whether or not said gestures are useful or even helpful to society as a whole.

A couple of things that Congress could change, wouldn’t cost the taxpayers a dime, and would fundamentally alter the U.S. health care system would be to allow insurance companies to compete for business nationwide and allow portability of health care plans. Time and time again it has been demonstrated that competition leads to lower costs and better products and I can’t think of a single good reason why a person who has been paying into a plan in California should have to buy a new plan, and be treated as a new customer, if they move to Virginia.

At the end of his column Mr. Kristof asserts that “. . . those trying to kill this health care reform proposal are simply on the wrong side of history.” Well Mr. Kristof, considering that most of human history consists of small numbers of people  forcibly controlling the lives of large numbers of people, I’d say you’re right. If opposing the stripping away of individual freedom and responsibility and the bankrupting of a nation for an unsustainable ideology is on the wrong side of history, then that’s a side I’ll gladly be on.


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