American Elephants


Pay Attention to The Bitter Truths About NHS — And Our Future? by The Elephant's Child

I refer frequently to Britain’s National Health Service, which is the oldest of the “single payer” health care plans, initiated right after World War II, when Labour returned to power. When Obama’s health care advisers began talking about health care, they all expressed their admiration for NHS. In devising a health care plan, they talked a lot about how the big costs all came from old people in their final years. And they talked about things like life years and useful life, and did a lot of comparing a vigorous young person with many life years ahead — contrasting it with useless old people.

Well, I had this strange idea that that’s what the practice of medicine was all about, caring for people and their health problems throughout their lives, from every kid’s broken arm to the failing health of someone who has lived a long and valuable life. The Inuit supposedly left their old people to die out on the ice when they were no longer useful, and there have been tribes who eat their enemies as well. Are we still struggling to find an ethical way to deal with life?

Britain still has private health care for those who can afford it. The NHS provides care that is free at the point of service, and just what every liberal wants as their most cherished goal. But it doesn’t work. The incentive for the people immediately becomes to use as much as they want because it has no (visible) cost. This inevitably drives costs up sharply. The incentive for the government immediately becomes to control costs. The government who hires, fires and pays for the medical establishment, cannot do much about the people whom they urged to use all the medical care they want, but they can put a lot of pressure on the medical establishment to cut costs.

Escalating problems and the inevitable results should be obvious to the dimmest intelligence, but  politics and ideology get in the way. Not everyone believes in incentives, in spite of  overwhelming evidence that they are what moves events.

Can’t have people piling up waiting to get into the emergency room, ordered to fix that, hospitals took to holding people in ambulances so admissions would be spread out more equally. Cut costs more, and pretty soon hospitals were saving money by keeping the same sheets on the bed. When all the incentives become to cut costs, the old folks don’t get clean sheets or fresh water, and start dying of dehydration and starvation in the hospital.

ObamaCare incentives are just the same. We are just taking our first stumbling steps down the same long road to perdition. Nobody has even experienced actual ObamaCare yet. So far it’s all just the incredible fiasco of the rollout. The exposure of Obama’s lies about the law is just the surface. Everybody’s insurance is getting cancelled, if not this year — just wait until next year. Premiums are drastically higher, deductibles reach levels that almost make insurance useless. People don’t know if they are actually enrolled. They don’t know if their doctor will still be available to them, or who will be in their physician network. They don’t know if the drugs they need will be in the formulary. All is uncertainty. Much of the details of enrollment and payment have not yet been written.

A panicky HHS is just making up new ObamaCare ‘laws’ on the spot. They’re extending deadlines for making payment for coverage, requiring insurers to accept premium payments, changing due dates, ‘strongly encouraging”  insurance companies, HHS won’t release real numbers, and those numbers include those who haven’t paid anyway. Glenn Reynolds asks: “Where, exactly, do they get the authority for all these exemptions, waivers, and extensions?” Good question.

Please read this article from yesterday’s Telegraph, and do read the whole thing. This is the state to which the NHS has fallen, and it is our future if we don’t fight to stop it. See the related articles listed in the column. They are not just talking about dirty sheets, they are talking about lives lost unnecessarily.  Unnecessarily!




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