The Brookings Institution’s Martha Derthick wrote more than twenty-five years ago about Social Security, and what she said applies to Medicare and Medicaid as well: “Economic analysts who exposed what they regarded as the myth of social security learned to expect a swift and vigorous response from program executives, especially if critics were liberals and could therefore be regarded…as ‘natural friends’ of the system. Then they would be charged with heresy and made to feel that they were endangering the system.” Jodie Allen, an economist who wrote a critical article for the Washington Post in 1976 (“Social Security: The Largest Welfare Program”), described the response:
I was deluged by calls and letters from the guardians of the social security system…saying, “Gee, Jodie, we always liked you, but how can you say this?” I acted very politely, and I said, “Well, what’s the matter with this; isn’t it true?” And they said, “Oh, yes, it’s true, but once you start saying this kind of thing, you don’t know where it’s going to end up.” Then I came to perceive that social security was not a program; it was a religion.30
A religion indeed. So much for the Statist’s supposed reliance on reason, empiricism, and knowledge.
In 2008, the Congressional Budget Office (CBO) projected that if Social Security, Medicare, and Medicaid go unchanged, by 2082 “the tax rate for the lowest tax bracket would increase from 10 percent to 25 percent; the tax rate on incomes in the current 25 percent bracket would have to be increased to 63 percent; and the tax rate of the highest bracket would have to be raised from 35 percent to 88 percent. The top corporate income tax rate would also increase from 35 percent to 88 percent. Such tax rates would significantly reduce economic activity and would create serious problems with tax avoidance and tax evasion. Revenues will fall significantly short of the amount needed to finance the growth of spending; therefore, tax rates at such levels would probably not be economically feasible.”31
Despite dire warnings from the CBO, from the former comptroller general of the United States, and from the various trustees that these programs are unsustainable and demand urgent attention, the pillaging of future generations not only continues, but the Statist proposes much more of it in the form of government-run “national health care” or “universal health care.” As with Roosevelt and Johnson before him, for today’s Statist this is about maximizing power.
It is said by the proponents of government-run health care that 47 million people go without health care in the United States. For example, during the so-called Cover the Uninsured Week event in 2008, Democratic Speaker of the House Nancy Pelosi issued a statement declaring that this is the “time to reaf-firm our commitment to access to quality, affordable health care for every American, including the 47 million who live in fear of even a minor illness because they lack health insurance…. In the wealthiest nation on earth, it is scandalous that a single working American or a young child must face life without the economic security of health care coverage.”32 This is more deceit.
In 2006, the Census Bureau reported that there were 46.6 million people without health insurance. About 9.5 million were not United States citizens. Another 17 million lived in households with incomes exceeding $50,000 a year and could, presumably, purchase their own health care coverage.33 Eighteen million of the 46.6 million uninsured were between the ages of eighteen and thirty-four, most of whom were in good health and not necessarily in need of health-care coverage or chose not to purchase it.34 Moreover, only 30 percent of the nonelderly population who became uninsured in a given year remained uninsured for more than twelve months. Almost 50 percent regained their health coverage within four months.35 The 47 million “uninsured” figure used by Pelosi and others is widely inaccurate.
And why is it accepted as fact when Pelosi and other Statists assert that the government can deliver health-care services more efficiently and to all who need them? The British example provides compelling evidence that government-run health care is disastrous, if not deadly, for too many.
In Great Britain, in order to limit waiting times in emergency rooms, the National Health Service has mandated that all patients admitted to a hospital be treated within four hours.36 However, the inefficiencies of a government-run system cannot be cured by the passage of a law. Consequently, instead of sitting for hours in the hospital waiting room, thousands of patients are forced to wait in ambulances parked outside emergency rooms.37 Having patients wait in ambulances allows hospitals to use a loophole in delaying care. If the patient is waiting in an ambulance, he cannot be admitted to the hospital and, therefore, does not need to be treated within the four-hour legal time period.
The waiting times for surgeries is a systemic disaster. Patients wait between one and two years to receive hip and knee replacement surgeries.38 Across specialties, one in seven patients waits more than a year for treatment.39 Children must travel to the United States to receive certain cancer treatments that are unavailable under Britain’s health system.40
Like physicians, dentists are employed by the government and required to meet annual treatment quotas. Once the quotas are filled, the dentists are not paid to perform additional work. Recently, dentists in parts of Britain turned away patients and went on vacation because they had met their annual quotas.41 There are too few public dentists for too many people—even though less than half of adults are registered with public dentists. Those who manage to see a dentist are often given cursory treatment. It is not uncommon for a dentist to spend five minutes on a cleaning. As a result, many Britons are forced to seek dental care abroad. A preferred destination is Hungary.42
A recent survey in Britain indicates that as many as one in three family and hospital doctors believes that elderly patients should not be given free treatment if it is unlikely to help them over the long term. Half of the physicians believe that smokers should be denied bypass surgery and a quarter believe the obese should not be eligible for hip replacement surgery.43
During her 2008 campaign for the Democratic nomination for president, then-senator Hillary Clinton repeatedly told a shocking tale of a pregnant woman who was about to give birth. Feeling sick, this woman went to her local hospital but was denied care because she lacked health insurance and could not pay a hundred dollars for treatment. Shortly thereafter, the woman was rushed by ambulance to the same hospital, where her baby was stillborn. Several weeks later, the woman died from complications.
A tragic tale? Indeed. But the story was false. The woman was not turned away from the hospital. She had health insurance. She had received obstetrics care from doctors affiliated with the hospital.44
It appears that in her search for an example of the heartlessness of the private health-care system, Clinton came up short. But it is not all that difficult to find such examples respecting public health care.
Take Barbara Wagner, who was diagnosed with a recurrence of lung cancer. Her doctors recommended a specific drug to help prolong and improve the quality of her life. However, Barbara is a resident of Oregon and, therefore, part of the state-run Oregon Health Plan. The state refused Barbara’s request for the drug, since it does not cover drugs that are meant to prolong the life of individuals with advanced cancer. After all, when the Oregon Health Plan was established in 1994 it “was expressly intended to ration health care.” But Oregon also has legalized assisted suicide, and in an unsigned letter from the state, Barbara was informed that the health plan would pay to cover the costs of a doctor to help her kill herself.45
Barbara was not ready to have herself killed. However, it seemed she had reached a dead end—until the pharmaceutical company that invented the drug learned of her plight and stepped in to provide Barbara with the medicine free of charge.46
Unlike private care, where the difficult, mistaken, or even bad decisions or policies of a single insurance company, hospital, or doctor are usually limited in their societal impact, such governmental decisions and policies have a wide effect on the health-care industry, medical profession, and population of pa
tients. Moreover, the continued centralization of health care decision making ensures further rationing by government fiat with fewer avenues of escape by needy individuals who are denied critical health services. For example, because Medicare and Medicaid, along with other government-run health programs, make the federal government the biggest single purchaser of medicines and medical services, it has an enormous influence on the drugs, medical devices, therapies, and treatment modalities that are available to Americans. It achieves this through formularies: the lists of approved drugs that these programs will pay for. Therefore, those which the government will not approve for payment will generally either not make it to the market or not stay on the market for long, significantly influencing the direction of research and development. The government’s payment schemes also affect the nature and quality of doctor and hospital care throughout the marketplace.
The Statist argues that millions of people benefit from these government-run “insurance” programs. Trillions of dollars in government expenditures over the years should result in benefits, particularly for those who receive far more in return than they “contributed” to the system. However, tens of millions more people benefit from private health-care coverage and receive the best medical attention on the face of the earth. Even the government-run programs benefit from the medical advances the private sector is still able to produce; without those advances, the government would have little to ration. And the private sector does not forcibly impoverish future generations with a colossal debt incurred on behalf of current beneficiaries.
Moreover, millions of people might benefit more if they were not forced to participate in government-run “pension” and “insurance” programs. Perhaps they could find less expensive alternatives; invest the taxes deducted from their income to improve their overall financial situation; help pay for food and other necessities during economic setbacks; and hire more employees, who, in turn, can purchase private insurance; or reinvest the dollars into expanding the business. Most individuals know best how to use their own money, which they earned from their own labor. And most individuals are not self-destructive.
Edmund Burke said it well: “What is the use of discussing a man’s abstract right to food or to medicine? The question is upon the method of procuring and administering them. In that deliberation I shall always advise to call in the aid of the farmer and the physician, rather than the professor of metaphysics.”47
But it is the Statist’s purpose to make as many individuals as possible dependent on the government. Most Americans are, in fact, satisfied with what they pay for their own health care, the quality of the health care they receive, and their health-care coverage.48 However, the Statist continues to press for government control over the entire health-care system. He is not satisfied with constraining liberty today. He seeks to reach into posterity to constrain liberty tomorrow.
President Barack Obama’s first choice for “Health Care Czar” and Secretary of Health and Human Services was Tom Daschle, who was forced to withdraw his name from nomination due to failure to pay federal income taxes. Nonetheless, Daschle laid out the prototype for nationalizing America’s health-care system in his book, Critical: What We Can Do About the Health Care Crisis.49 He proposes the establishment of a Federal Health Board, which would make health-care recommendations binding on all federal health programs. However, as columnist Tony Blankley points out, Daschle writes that “Congress could opt to go further with the Board’s recommendations. It could, for example, link the tax exclusion for health insurance to insurance that complies with the Board’s recommendation.”50 That would effectively destroy private health care. Daschle proposes that the board be independent from “political pressure”—that is, from public input. Daschle also denigrates technological advances as a “technology arms race” rather than lauding their benefits to patients. And Daschle laments doctors’ using their best judgment in providing treatment.51 No more bothersome insurance regulations, doctor referrals, or co-pays. Daschle’s medical Politburo is truly a nightmare circa East Germany 1957: A few well-placed political appointees and their bureaucratic support staff ration health-care resources and decide who gets treatment and who does not and, ultimately, who lives and who dies.
For the Statist, this is the ultimate authority over the individual he has long craved. Once the individual is entrapped, the Statist controls his fate. The individual will be seduced by the notion that he is receiving a benefit from the state when in reality the government is merely rationing benefits. The individual is tethered to the state, literally and utterly reliant on it for his health and survival. Not only does the government have an ownership interest in private property, but it also has one in the physical individual. Rather than the individual making cost-benefit and cost-quality decisions about his own condition, the Statist will do it for him. And the Statist will do it very poorly, as he does most other things.
8
ON ENVIRO-STATISM
SCIENCE, BROADLY DEFINED, IS
a door to knowledge. Although the Statist is fond of accusing the Conservative of slamming the door shut, it is actually the Statist who abandons science—just as he abandons the laws of nature, reason, experience, economics, and modernity—when he promotes what can best be characterized as enviro-statism. His pursuit, after all, is power, not truth. With the assistance of a pliant or sympathetic media, the Statist uses junk science, misrepresentations, and fearmongering to promote public health and environmental scares, because he realizes that in a true, widespread health emergency, the public expects the government to act aggressively to address the crisis, despite traditional limitations on governmental authority. The more dire the threat, the more liberty people are usually willing to surrender. This scenario is tailor-made for the Statist. The government’s authority becomes part of the societal frame of reference, only to be built upon during the next “crisis.” The pathology of the statist health scare works like this: An event occurs—cases of food contamination are discovered or instances of a new disease arise. Or, as is increasingly the case, government agencies such as the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), or the Environmental Protection Agency (EPA), or nonprofit organizations such as the Center for Science in the Public Interest or Sierra Club release a new study identifying a “frightening” new health risk. Urgent predictions are made by cherry-picked “experts” that the media accept without skepticism or independent investigation and turn into a cacophony of fear. Public officials next clamor to demonstrate that they are taking steps to ameliorate the dangers. New laws are enacted or regulations promulgated that are said to limit the public’s exposure to the new “risk.”
The examples of this pathology are numerous and include such “scares” as alar, sweeteners, bird flu, swine flu, dioxins, E. coli, listeria, the Ebola virus, formaldehyde, MTBE (methyl tertiary butal ether), BSE (bovine spongiform encephalopathy), salmonella attached to tomatoes/jalapeño peppers, and CFCs (chlorofluorocarbons). All were blown into huge panics, far beyond the actual scope of any health threat.
Economist George Reisman relates how advances in science make it possible to detect minute levels of contaminants in substances, which are misused in too many cases to destroy products. “The presence of parts per billion of a toxic substance is routinely extrapolated into being regarded as a cause of human deaths. And whenever the number of projected deaths exceeds one in a million (or less), environmentalists demand that the government remove the offending pesticide, preservative, or other alleged bearer of toxic pollution from the market. They do so, even though a level of risk of one in a million is one-third as great as that of an airplane falling from the sky on one’s home.”1
Indeed, the modern environmental movement was founded on one of the most egregious frauds in human history: that dichloro-diphenyl-trichloroethane, or DDT, is a human-killing poison when, in fact, it is a human-saving wonder chemical—a chemical compound developed in 1939 for use as an insectic
ide. DDT was critical in protecting American soldiers from the typhus epidemic and malaria during World War II.2 In 1948, Paul Hermann Müller received the Nobel Prize “for his discovery of the high efficiency of DDT as a contact poison against several arthropods.”3
DDT’s usefulness in combating malaria and other insect-borne diseases was unprecedented. San Jose State University professor J. Gordon Edwards, who was a longtime opponent of banning DDT, wrote in 2004: “Hundreds of millions have died from malaria, yellow fever, typhus, dengue, plague, encephalitis, leishmaniasis, filariasis, and many other diseases. In the 14th century the bubonic plague (transmitted by fleas) killed a fourth of the people of Europe and two-thirds of those in the British Isles. Yellow fever killed millions before it was found to be transmitted by Aedes mosquitoes…. More than 100 epidemics of typhus ravaged civilizations in Europe and Asia, with mortality rates as high as 70 percent. But by far the greatest killer has been malaria, transmitted by Anopheles mosquitoes. In 1945, the goal of eradicating this scourge appeared to be achievable thanks to DDT. By 1959, the U.S., Europe, portions of the Soviet Union, Chile, and several Caribbean islands were nearly malaria free.”4
Journalist and bestselling author Malcolm Gladwell recounted the successful eradication campaigns waged in Italy, Taiwan, the Caribbean, the Balkans, parts of northern Africa, the South Pacific, Australia, and India: “In India, where malaria infected an estimated 75 million and killed 800,000 every year, fatalities had dropped to zero by the early sixties. Between 1945 and 1965, DDT saved millions—even tens of millions—of lives around the world, perhaps more than any other man-made drug or chemical before or since.”5
Liberty and Tyranny Page 10