• Passing the baton of irony

    Back during the whole health care reform fight, Investors Business Daily wrote an editorial in which they tried to claim that if government were more involved in health care, it would (of course) result in rationing. People would be evaluated by bureaucrats, and if found wanting, they would let them die. As an example of this, they chose world-reknown physicist Stephen Hawking, who has a severe motor neuron disease:

    People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

    You see their point? A government system would have just looked at a man like Stephen Hawking, said he was uncurable, and let him die. Then, the world would have been deprived of his genius. There was just one problem. Stephen Hawking was born in Great Britian, and has lived in, and been cared for by, the NHS his entire life. In his own words:

    “I wouldn’t be here today if it were not for the NHS,” he told us. “I have received a large amount of high-quality treatment without which I would not have survived.”

    In case the irony is lost on you, the NHS is a completely socialized health care system. The government doesn’t just pay for it; the government runs the entire show. Stephen Hawking is a perfect example of just the opposite of what IBD was trying to say. They have since edited the editorial to remove the incredible irony that destroyed their whole argument, but left the rest of the piece up.

    I was thinking of this when I watched the following part of the debate last night:

    [I had to remove the embedded video due to an RSS error. I believe this is where to find it: http://www.youtube.com/v/1TnP1xnx6d8. — Austin]

    Herman Cain is trying to say that under the ACA, he would not have been able to survive his colon cancer. Under the ACA, bureaucrats have sat around and debated whether he’d get his care, and that would have resulted in delays that might have killed him.

    Where to start?

    First of all, there is no part of the ACA which sets up a “death panel” which debates whether individuals should get the care their doctor says they need. That’s a lie. In fact it was “lie of the year“. So please stop saying that.

    Secondly, Mr. Cain attributes his excellent outcome to the fact that once his cancer was detected, there were no delays in getting subsequent CT scans, tests, second opinions, and therapy. I’m not sure that Mr. Cain is aware that he was only able to get those things in a speedy fashion either because he had health insurance or because he is very wealthy. If you’re uninsured, you will experience enormous delays in getting tests, second opinions, and therapy, as you figure out how to get them paid for. In many cases, you may not get them at all. In other words, if you’re uninsured, you are more likely to die.

    Say what you will, but the ACA gets more people insurance. In fact, if gets more people private insurance. So the idea that this somehow will lead to less care for people diagnosed with colon cancer is exactly backwards.*

    Moreover, if you’re uninsured and can’t afford to pay for it out of pocket, your wait time for your screening colonoscopy is effectively forever. To fix this, the ACA specifically makes it easier for people to get screened. It literally says that there can no longer be any co-payments, co-insurance, or out-of-pocket payments for getting a screening colonoscopy.

    So let’s recap. The ACA does not include death panels, it gives more people insurance, and it makes colon cancer screening free. You may not like the ACA, but it doesn’t make it more likely that you will die from colon cancer. It does just the opposite. I hope this is a line that Mr. Cain will stop using during his candidacy.

    *If your argument is that getting more people care will result in wait times just because there are more people in the system, and not enough capacity, there could be a theoretical bit of truth to that. I don’t think there is, as I think we can increase capacity. But if that’s your argument, then you need to be explicit and say you would see a significant number of people be denied care just so that you can get it faster. I don’t think this is an argument any of the candidates will be endorsing.

    • So Herman Cain is a liar? I’m shocked, shocked I tell you, to learn that GOP candidates are lying at a Fox News sponsored debate.

    • I agree with everything you write, except one thing: in ANY system there will be rationing. We can’t treat everyone for everything all the time, even if we do increase capacity. Currently, rationing is done by excluding a large number of people from non-emergency “insurance” altogether. In a universal or single payer system, it would be done by having waiting lists (such as we already do for many of the less mundane procedures) for a lot of things that currently are treated expediently.

      I see the waiting list system as preferable to the current system of rationing, but it’s disingenuous to exclude this aspect from the debate.

    • I cannot believe the lies some people will tell in order to farther the liberal socialist democrat agenda. Obamacare is a govermnent take over of health care in this country. PERIOD. You can lie all you want about Herman Cain or twist his words to say what ever you want. Any time there is a socialistic government take over of health care (like Obamacare, hint hint), it IS a death panel.

      • American Flag said: “Obamacare is a govermnent take over of health care in this country. PERIOD.”

        Let me get this straight: Requiring that people buy PRIVATE health insurance is a government takeover of health care? How so? Wouldn’t a government takeover involve putting the government in control, instead of private insurance companies?

        Sending people for care at PRIVATE hospitals, at the hands of PRIVATE doctors, is a government takeover of health care? How so? Would a government takeover use markets as a means of expanding coverage?

        Flag again: “You can lie all you want about Herman Cain or twist his words to say what ever you want. Any time there is a socialistic government take over of health care (like Obamacare, hint hint), it IS a death panel.”

        Please specify the “lie” told about Herman Cain. That he got care most people without health insurance couldn’t/wouldn’t get? You don’t honestly believe that an uninsured person can just walk into a hospital ER and, without paying any money, get a colonoscopy, do you?

        They can’t — not out here in the real world, anyway. Don’t take my word for it. By all means, go on down to your local hospital ER and try it. Be sure to let us know how it turns out.

        • You are wrong. Every day indigents get free care in this country, including colonoscopies. The govt should nopt be allowed to force someone to have health insurance. Herman Cain is right, check out Canada, where the wait time is ridiculous.

          • You have no knowledge whatsoever about comparing wait times in Canada with those in the U.S. You’ve heard that from right-wing radio, TV or some blog, and so you repeat it.

      • How exactly were his words twisted and what exactly about Obamacare is socialist, encourages more rationing, or creates so-called death panels?

      • Repeat after me: I am an idiot. I am an idiot. I am an idiot. I am an idiot…

        Just because you say something many times does not make it so. If you had read anything about the ACA, you would know it is not socialized medicine. Repeating that it is does not make it so, regardless of how many times you repeat it.

      • What a beautiful example of Poe’s Law. I applaud your contribution. I honestly have no idea whether you’re a right wing idiot, or a liberal trying to do an absurd parody of a right wing idiot. There’s no way to distinguish. Well done.

    • That’s right, Flag. So unfair to repeat Cain’s words verbatim. then interpret them in the most obvious way. What do you think he was trying to say?

    • “and it makes colon cancer screening FREE.”

      This statement is utter idiotic nonsense.

    • Must be lights-out on FlagBoy’s ward. The orderlies are gathering up the laptops. Time for meds and drug-induced sleep. Tomorrow is another day.

    • As a physician, I regard the ACA as a great step towards making health care affordable for everyone in this country. I only regret that it was compromised too heavily by negotiating with the repubs in the senate. And I came to this conclusion after being involved through the AMA with input in the debate, and reading EVERY page of the bill.

      Now anyone who calls it “socialized” medicine, or “govt takeover” obviously have been misinformed or uninformed. It is so sad to see the debates where they lie to their audience about repealing a federal law, when they know they cannot. Or see Cain make up his own reality that others in this forum have adequately addressed.

    • 1) I’m quite sure Herman Cain is indeed relatively clueless about health care policy

      2) Making something free does not necessarily improve access, as was implied

      3) More preventive care tends to increase health care costs, not decrease them

      4) This blog is at its best when discussing the more technical/wonkier parts of health care policy. The “oh my god a fringe presidential candidate said something stupid about health care” beat is kind of beneath you. But that’s just my opinion.

      • “More preventive care increases cost”

        I know there are studies that say this, but I would be highly skeptical of them. They smell of having been constructed deliberately to undermine a strong pro-ACA talking point. It may take time for the full effect to be seen, and I don’t believe any of these studies had that kind of time. Of course, the cost will increase initially when more peole are getting preventive care; the question is simply whether that will in the long run reduce the cost of people needing critical care because they didn’t get simple preventive care.

        Think, e.g., being prescribed blood pressure medicine after blood pressure has been taken by a primary care nurse (total cost of visit plus medicine perhaps $1000 over a couple of years) vs. showing up in the emergency room with a massive heart attack ($50,000 and up?).

        • Do the studies take into account that preventative medicine keeps people functioning in the economy? In other words, you keep someone from becoming disabled or keep them from dying, they are able to continue an economic function in society. They continue working (we know that many uninsured people have jobs that don’t offer insurance). They continue consuming. They take care of kids, or even, grandkids, that society would have to spend money to care for otherwise. I would assume that all the studies on preventative healthcare are just purely that, an analysis on the cost of providing the care only. But I don’t know that. Just an assumption.

          • I guess I would even pose that as a question to Aaron or his colleagues as they have a better handle on the preventative medicine research that is out there.

    • The “socialized medicine” meme is a GOP talking point. Several prominent Republicans have admitted as much.

    • When people have a strong incentive to perpetuate a false narrative, it is perpetuated at almost any cost. From that standpoint advocates of meaningful change must always take several steps back before (and indeed in some cases IF) any steps forward can be taken.