"Change" for "new direction" isn't always for the best, or even good.
Wannabe presidential candidates are peddling new and improved snake oil for
our healthcare ills, as usual. Now, while snake oil may well be a cure for
some conditions, it's going to aggravate rather than ameliorate most.
It's almost funny to hear some supposedly "pro-choice" candidates also
describing their "anti-choice" goals in healthcare. For example, Democrat
presidential candidates Hillary Clinton and John Edwards both advocate
forcing no-choice government health-system management on everyone in the
country.
Edwards' official campaign Web site calls for "requiring all American
residents to get insurance." This actually means everybody would be forced
to pay for insurance, whether a person wanted it or not and whether the
insurance would be worth the price or not.
And when asked by a reporter if people could opt out of his plan, Edwards
flatly said, "You don't get that choice."
These aren't the only politicians who have promised a program for every
problem. But each new program seems to generate at least several new
problems. Plus, many such "problems" turn out to be false myths. The
resultant boondoggles continue to plague the country.
As I've described before, implying that the government can guarantee or
provide universal health insurance is a phony remedy for the phony problem
of "the uninsured."
Another such supposed problem was the widely touted claim that the Medicare
system was rife with fraud and abuse, costing taxpayers an extra 10 percent.
This "10 percent fraud" figure came from an article in a highly respected
medical journal, which analyzed a number of other reports. The problem is
that all the reports and analyses boiled down to estimates, as revealed by
subsequent analyses.
In other words, the 10 percent figure itself could be fraudulent.
Over a decade ago, I asked Sen. Patty Murray's healthcare staff people why
the proposed Kennedy-Kassebaum HIPAA law included up to five years jail time
for health insurance fraud. They told me these new government powers were
included because of all the talk about this 10 percent fraud figure. (Oh,
yes, this insurance fraud couldn't be penny-ante; it had to cost the
insurance company at least $100.)
Sen. Murray's people didn't look kindly on my suggestion that it would only
be fair to call for the same penalty for any $100 fraud, not just health
insurance fraud, even if a U.S. senator perpetrated the fraud. The staffers
promptly ignored my request for equal justice under law.
The Kennedy-Kassebaum (HIPAA) bill became law in 1996 (Public Law No:
104-191). Today, to solve this fabricated 10 percent-abuse problem, the law
requires spending more than a billion dollars every year to make sure
doctors and hospitals follow Medicare rules. The money has to be spent on
education and enforcement of the law.
If there are 600,000 practicing physicians in the USA, this much money would
allow the government to spend $10,000 to investigate and educate every
physician in the country every six years. I'd guess than any competent
investigator should be able to come up with enough to prosecute most
doctors.
As a result of the HIPAA law, government prosecution for purported fraud,
including inflammatory news releases, has ruined the careers of many
excellent doctors. Some doctors have been convicted of insurance fraud
totaling less than $100 and locked up in federal prison.
Yet, at the same time, the government has blithely allowed insurance
companies administering the Medicare program a $200,000,000 "error
threshold" before even considering the possibility of prosecution. According
to whistleblower Theresa Burr, none of the insurance company people involved
in the fraud she proved even lost their jobs.
Political demand for "integrity" of the Medicare bureaucracy has trumped
simple justice and equality under law. Although Medicare law applies to "any
person," federal investigators and prosecutors apply these laws very
selectively and very unequally to different persons.
As noted above, a physician has had his career ruined for a purported $100
infraction. Yet, insurance company employees have been promoted and the
company has been awarded more contracts from Medicare, despite evidence of
losing hundreds of millions of tax dollars needlessly.
In another example of a problematic problem, the "prestigious" Institute of
Medicine's Committee on the Quality of Health Care, issued a report, "To Err
Is Human: Building a Safer Health System" eight years ago. The Committee
claimed that somewhere between 44,000 and 120,000 patients died each year
because of human error.
Of course, the Committee quickly followed up with another report advocating
more money and power for its own agenda as well as more government
involvement. It had no doubt that something should be done.
And, sure enough, legislation showed up in the U.S. Congress the very next
day.
Yet again, subsequent analyses showed that many of the errors included in
the count had nothing at all to do with the patient's subsequent death.
False counting produced the phony problem.
Now, a lot of time, money, and other resources are now spent on trying to
prevent errors, instead of actually helping people.
If someone wants to be absolutely free of human medical error, all a person
has to do is to avoid any and all contact with the medical system.
All the talk about these purported problems reminds me of the story
attributed to the 19th century political leader Lord Thomas Macaulay. Over a
century ago, in response to parliament members shouting "Reform! Reform!
Reform!" Macaulay responded "Reform? Reform? Don't talk to me about reform.
Things are bad enough as they are!"
Another common feature of these solutions is a greater focus on increasing
government power over American's lives. Naturally, many of the people
presenting the problems are just the same ones who have the solutions and
who make big bucks when the government enforces the "magic bullet" solution.
Although I certainly don't believe we currently live in the best of all
possible worlds, the question "How could we tell if we actually lived in the
best of all real, possible worlds?" chastens me. In such a best world, human
conditions overall would be better than at any other time; accidents, human
error, sickness, poverty, death and evil would continue to exist, but would
be minimal and produce less suffering than at any other time, in the past or
in the future.
I don't remember the philosophers who have asked the question, but the
answer is profoundly simple: Any change made in this best possible world
would result in the world becoming a worse place. Think about it for a
moment.
Given the demonstrable worsening of our lives at the hands of innumerable
government programs and bureaucrats, change for the sake of change becomes
much less compelling.
Instead of telling 100 Americans how to run their lives so as to indirectly
help one American get health insurance, for example, I recommend
presidential candidates promote helping that one person directly.
I recommend presidential candidates help persons who want health coverage by
promoting attractive alternatives to many of the current, expensive and
overly regulated plans, such as by expanding the choices available under
current Health Savings Account (HSA) rules.
I agree with Milton Friedman's common sense suggestion to restoring freedom
in the medical system by reversing past actions, as published in the Winter
2001 issue of the "Public Interest" journal: "repeal the tax exemption of
employer-provided medical care; terminate Medicare and Medicaid; deregulate
most insurance; and restrict the role of the government, preferably state
and local rather than federal, to financing care for the hard cases."
Editor's Note: Robert J. Cihak wrote this week's column.
