Anti Government Hippies, and Government Healthcare

If you read Reason's Hit and Run blog you will see the vast majority of what gets me hot and bothered. It's a libertarian think tank that has a similar distaste for statists (read: socialists) and paternalists (read staunch conservatives). They never fail to please, especially with this.





What is it with anti-war protester's and thinking that government as an entity can do nothing right. Hippies should not be saying this, because they're making me agree with them! That cannot be right. At the same time though, before dreadlocks come to rest from their epileptic description of genocide for oil, if asked about universal healthcare, you'll hear about a bunch of mindless drivel about how awesome the government could be if only it had the power to regulate everything healthcare related!


I say government, by the simple fact that they have to manage over 300 million people are incapable of developing, let alone maintaining, a system that is fair (by my standards) and doesn't cause more problems than already exist. The US government is not inherently evil; I would have the same reservations if this system were to be managed by the most benevolent and competent organization in the world.

What is great though, is that the one girl is willing to say that she doesn't fully understand how she hate's government because of war, but looks to the government for all the answers regarding healthcare. She's willing to say she isn't entirely informed. That's awesome! If we are reasonable creatures we have to be willing to acknowledge our lack of knowledge sometimes. I like to think I'd be willing to say I'm wrong (if it ever ends up happening).

Government Managed Healthcare: How Do You Decide What's Covered?

What kind of system needs to be in place to determine what is and what is not covered by Universal Health Care Dollars: British style.



Article by Maggie Mahar on the NICE system in Brittain. NICE is used to evaluate technologies and procedures based on the effectiveness per dollar. Basically if there is a technology out there which is A-OK but there is one that comes out which is twice as expensive, but a little better, the NICE system publishes this and basically decides that the new technology will not be covered by the national system's dollars. This is all well and good, but it brings forth a question of what people are allowed to pay for. This makes very reasonable sense if you have a large, over-arching system which is in charge of everyone's care (and the associated cost there-of).

Reason does a terrific job of bringing to light some problems with this type of system:
Reason:
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Debbie Hirst, a woman with metastasized breast cancer, wanted to take Avastin, a drug that, per The New York Times, is "widely used in the United States and Europe to keep such cancers at bay." The NHS refused to pay for it, saying it was too expensive. That much is par for the course in a system that holds down costs by rationing care according to standards set by a single central authority. But then Hirst, with the support of her oncologist, decided to raise the $120,000 she'd need to pay for the drug on her own, mainly by selling her house. The NHS said she was perfectly free to do that, but then she would have to pay for all of her care out of pocket, a financial burden that was far beyond her means.
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NY Times article on the woman will breast cancer in Brittain:
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Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones. Patients "cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs," the health secretary, Alan Johnson, told Parliament. "That way lies the end of the founding principles of the N.H.S.," Mr. Johnson said.
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There are many moral hurdles which must be crossed when we start down this path. Having an independent agency which reviews technologies for effectiveness for dollar is perfectly reasonable for a universal coverage system. There must, however, be the option of utilizing your own money for getting the best possible treatment at any cost. We must realize the following:

• There will (and should) be a two-tiered system
• People should be arguing for universal coverage, not equality in all things healthcare

• There will be points at which a bureaucrat says, "Nope, you've spent too much, you can't get that surgery" Or, "Well, it may extend your life, but there's only a 10% chance, we're not willing to spend $xxx,xxx of tax-payer dollars for this" Or, "Well, since you've smoked your life away, we will not pay for a lung transplant".

• We need to seriously look at the incentives currently in place for primary care doctors
• Right now, there is a bias towards specialization that very well may cause a shortage of primary care docs. Just generalizing here, but specialists (orthopaedics, cardiologists, and the like) get paid 3+ times more than a primary care doc. Since the baby-boomers will be needing more consistent care here soon, and if there is a flood of millions upon millions of newly insured individuals, there will be a massive shortage of primary care docs to understand and manage a patient's health situation.

So what's to be concluded from all of this? Well, I don't think there's any way of us not having universal health-care in the future. It just makes people feel better about themselves when we can say, "Everyone has a right to live healthy." By that logic, everyone deserves to have a job, everyone deserves to feel like they're treated justly (let's take more money away from the rich so the poorer feel less down-trodden comparatively). I don't like where we're going, but we have to be honest about the ramifications and what we can do to make the best of the situation. We need to poke and prod the ideas being put forward, as well as the ideas in practice in Brittain, France, Canada, etc. etc.