Topic: Liberal Fascism
The drive for nationalized healthcare—of which Bernie Sanders’ Medicare for All plan is the latest manifestation—relies ultimately on the following arguments. (1) Compared with all other developed nations, the United States pays more for healthcare and gets less of it. (2) The principal reason for (1) is the greed of Big Insurance, which sucks up vast sums of money in wasteful administrative costs, profits and executive compensation while leaving millions uninsured. (3) The solution to (1) and (2) is the suppression of the healthcare market by making the federal government the nation’s sole healthcare insurance provider.
The specious comparison has long been a staple of the healthcare debate in this country. Comrades Sanders, for instance, runs around claiming that the United States spends twice as much per capita on healthcare than his beloved European welfare states. Chris Pope, writing in National Review, subjected this claim to something that it rarely gets: critical scrutiny. The latest statistics from the World Bank peg US per capita healthcare spending at $9,403. The three wealthiest European countries are Luxembourg, Norway and Switzerland. Their per capita healthcare spending comes to $8,137, $9,522 and $9,674 respectively. Sanders also claims that our supposedly dysfunctional healthcare system produces worse outcomes, e.g. lower life expectancy and higher infant mortality rates, than do those of the European welfare states. But this assertion is based on a fact not in evidence: that the healthcare system, tout court, is responsible for those poorer outcomes.
The truth is (1) that the US spends a lot of money on healthcare because it can, being a very wealthy nation and (2) that differences among developed nations in such areas as life expectancy and infant mortality owe more to social factors and lifestyle choices than they do to quality of care. Compared with European countries, the US has higher rates of obesity, diabetes, heart disease and cancer. It also has a higher murder rate and a higher rate of death due to traffic accidents. And the average life expectancy, infant mortality rate, etc. for a country as large and diverse as the US is somewhat deceptive: West Virginia is not Massachusetts is not Utah. Indeed, when you look into the numbers you’ll find that states and regions with lower per-capita healthcare spending often exhibit better health outcomes than those that spend more, this thanks to demographic and social factors that have nothing to do with the quality or availability of healthcare.
All right, then, how about the deprivations of those greedy insurance companies? Here again the actual numbers refute Sanders’ wild claims. The difference between what healthcare insurance companies take in via premiums and what they pay out in claims constitutes, supposedly, their unjust, excessive profits: 10% of total US healthcare spending. But only a fraction of this 10% goes to shareholders and executives. The rest goes for administrative costs: advertising, contracting, claims administration, fraud prevention, etc. Though Sanders pretends otherwise, much the same administrative costs would have to be borne by Medicare for All. Even now, Medicare fraud sucks about $40 billion per hear from the program; if Medicare for All were ever adopted it would have to be rigidly policed to prevent much higher losses due to fraud. And, yes, Medicare for All would also have an advertising budget, necessary to keep the public informed about the program. In short, Sanders’ promises of vast savings on the administrative front are pure wind.
Medicare for All, by increasing the demand for healthcare while limiting its availability via price controls, would yield significantly worse results than the present system. Progressives pretend that because it’s a “right,” healthcare is somehow exempted from the laws of economics. But this is twaddle. First, there’s no way around the economic law that states: Arbitrarily imposed price controls diminish supply, i.e. you can’t get more by offering less. Second, suppressing private health insurance companies will not eliminate the profit motive from the healthcare sector of the economy.
Right now, Medicare relies on an array of private contractors for various vital services—and these companies are for-profit entities. So are hundreds of clinics, medical practices, medical laboratories, medical device manufacturers, drug companies, etc., etc. It is to be foreseen that the price controls imposed by a single-payer system like Medicare for All would drive a significant percentage of these companies out of business. Only the largest, able to benefit from economies of scale, could survive in such an environment. It seems ironic that so dauntless a foe of Wall Street as Bernie Sanders is pushing a healthcare reform proposal that would benefit large corporations over small businesses, but there it is.
The conclusion is clear and inescapable: Bernie Sanders and his claque simply don’t know what they’re talking about. The promises accompanying his Medicare for All proposal are based on nothing more substantial than oversimplification, misinformation and wishful thinking. Comrade Sanders knows nothing about anything, and he wants to take control of the nation’s healthcare system. So be afraid, America. Be very afraid.
