http://townhall.com/columnists/ThomasSowell/2009/07/21/medical_care_confusion



*Medical Care Confusion*
Thomas Sowell
Tuesday, July 21, 2009

Is there a coherent argument for government-controlled medical care or are
slogans and hysteria considered sufficient?

We hear endlessly about how many Americans don't have health insurance. But,
if we stop and think-- which politicians hope we never do-- that raises the
question as to why that calls for government-controlled medical care.

A bigger question is whether medical care will be better or worse after the
government takes it over. There are many available facts relevant to those
crucial questions but remarkably little interest in those facts.



There are facts about the massive government-run medical programs already in
existence in the United States-- Medicare, Medicaid and veterans'
hospitals-- as well as government-run medical systems in other countries.

None of the people who are trying to rush government-run medical care
through Congress before we have time to think about it are pointing to
Medicare, Medicaid or veterans' hospitals as shining examples of how
wonderful we can expect government medical care to be when it becomes
"universal."

As for those uninsured Americans we keep hearing about, there is remarkably
little interest in why they don't have insurance. It cannot be poverty, for
the poor can automatically get Medicaid.

In fact, we already know that there are people with substantial incomes who
choose to spend those incomes on other things, especially if they are young
and in good health. If necessary, they can always go to a hospital emergency
room and receive treatment there, whether or not they have insurance.

Here, the advocates of government-run medical care say that we all end up
paying, one way or another, for the free medical care that hospitals are
forced by law to provide in their emergency rooms. But unless you think that
any situation you don't like is a reason to give politicians a blank check
for "change," the relevant question becomes whether the alternative is
either less expensive or of better quality. Nothing is cheaper just because
part of the price is paid in higher taxes.

Such questions seldom get asked, much less answered. We are like someone
being rushed by a used car dealer to sign on the dotted line. But getting
stuck with a car that is a lemon is nothing compared to signing away your
right to decide what medical care you or your loved ones will get in life
and death situations.

Politicians can throw rhetoric around about "bringing down the cost of
health care" or they can even throw numbers around. But the numbers that
politicians are throwing around don't match the numbers that the
Congressional Budget Office finds when it analyzes the hard data.

An old advertising slogan said, "Progress is our most important product."
With politicians, confusion is their most important product. They confuse
bringing down the price of medical care with bringing down the cost. And
they confuse medical care with health care.

Nothing is easier than for governments to impose price controls. They have
been doing this, off an on, for thousands of years-- repeatedly resulting in
(1) shortages, (2) quality deterioration and (3) black markets. Why would
anyone want any of those things when it comes to medical care?

Refusing to pay the costs is not the same as bringing down the cost. That is
why price controls create these problems. When developing a new
pharmaceutical drug costs roughly a billion dollars, you are either going to
pay the billion dollars or cause people to stop spending a billion dollars
to develop new drugs.

The confusion of "health care" with medical care is the crucial confusion.
Years ago, a study showed that Mormons live a decade longer than other
Americans. Are doctors who treat Mormons so much better than the doctors who
treat the rest of us? Or do Mormons avoid doing a lot of things that shorten
people's lives?

The point is that health care is largely in your hands. Medical care is in
the hands of doctors. Things that depend on what doctors do-- cancer
survival rates, for example-- are already better here than in countries with
government-run medical systems. But, if political rhetoric prevails, we may
yet sell our birthright and not even get the mess of pottage.



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