American Elephants

How did we get into this dreadful health-care mess anyway? We were told that runaway spending on health care was having a terrible effect on the national budget, and if we didn’t fix it, disaster would occur.That seems to have been a convenient myth. The growth rate of national health expenditures has been declining for a decade  driven by better medical care and consumer choice.
This chart is from the Centers for Medicare and Medicaid Services, the agency in charge of that sort of data. From the Wall Street Journal:

“New data show that health spending over the past several years has been normalizing toward the rate of general inflation, rather than growing higher and higher, as had been the case almost continuously since the 1970s. This moderation in the growth rate of spending predates the national recession. And it puts the lie to the claim that we need government to put the brakes on an “out-of-control” health-care system.”

“The moderation has been driven by cumulative improvements in medical care and by insurers, and by marketplace disciplines on the demand for medical care. Consumers are finally getting more involved in managing and paying for their own care.”

We have new breakthrough drugs for chronic disease, mental illness, HIV and cancer. Many are generics. The market works. You will notice that the spending starts back up again in 2010.

It took a lot of lies and misstatements to get us into ObamaCare, and ObamaCare is full of illusions and pipedreams. Before ObamaCare, you had three parties—the patients, the medical establishment, and the health insurance companies. ObamaCare assumes that those three groups cannot manage to care for the sick and the well without direction and supervision by many assorted bureaucracies full of smart people who went to all the right schools telling them what to do and how to do it. And those many bureaucracies (over 100 agencies) filled with all those smart people will make ObamaCare cost less? They cannot deny care to the elderly and the frail fast enough to compensate for the added expense of all that bureaucracy.

The goal of the system shifts from improving care for those who need it, to getting paid. In Britain, doctors are on salary and work for the state. Rules and regulations descend from the state. You will cut costs here, you will cut wait times there. So some hospitals parked patients in ambulances, so they wouldn’t be registered as entering the system and messing up the wait-time records. In other hospitals, sheets were used over without washing to save money, and patients were left soiled in their beds. Do the jobs in the medical establishment depend on the excellent care they give to patients or do they depend on meeting budget limits?

But back to ObamaCare: A single committee — the United States Preventative Services Task Force — is empowered to evaluate all preventive health services and decide which will be covered by health-insurance plans. They rate services with grades of ‘A’ through ‘D’. Colon cancer screening for adults age 50-75 must be covered by health-care plans without co-pays. Screening for ovarian or testicular cancer that get ‘C’s and ‘D’s may get eliminated. In 2009, it decided that women age 40-49 shouldn’t get routine mammograms. More recently it cancelled routine prostate-cancer screening and the use of tests that detect the viruses that can cause cervical cancer. Doctors are inclined to look at family history, symptoms, that kind of thing. People are not all the same and can’t be divided up by age categories.

Its advice is often out of sync with conventional medical practice. For example, it recommended against wider screening for HIV long after such screening was accepted practice…Only in 2009 did it finally recommend aspirin for the prevention of stroke and heart attack among those at risk — decades after this practice was demonstrated to save lives and had become part of standard medical practice.

That’s a perfect example of the problem of liberal belief in the overwhelming superiority of the liberal mind. Whatever it is, they just know better.  They went to the right schools, you see. They know the right people. They’re friends of your friends. They don’t require any specialized knowledge of medicine, pharmacology or administration. They’ll just look at some statistics and make the hard decisions.

No problem, unless you don’t fit the statistical norm, then you’re out of luck.