aneeshm
Deity
Two interesting articles about the inevitable effects socialised healthcare shall have on the US healthcare system:
The above was authored by:
A second article, on how the personal experience changes under state-controlled systems, and what citizens can expect a few years later:
To those who say that this cannot happen, I would point to the dismal state of half (or more) of the US' school system, and how it is divided into the "good" and "bad" tiers, exactly as expected.
Comments and opinions?
What Soviet Medicine Teaches Us
In 1918, the Soviet Union became the first country to promise universal "cradle-to-grave" healthcare coverage, to be accomplished through the complete socialization of medicine. The "right to health" became a "constitutional right" of Soviet citizens.
The proclaimed advantages of this system were that it would "reduce costs" and eliminate the "waste" that stemmed from "unnecessary duplication and parallelism" i.e., competition.
These goals were similar to the ones declared by Mr. Obama and Ms. Pelosi attractive and humane goals of universal coverage and low costs. What's not to like?
The system had many decades to work, but widespread apathy and low quality of work paralyzed the healthcare system. In the depths of the socialist experiment, healthcare institutions in Russia were at least a hundred years behind the average US level. Moreover, the filth, odors, cats roaming the halls, drunken medical personnel, and absence of soap and cleaning supplies added to an overall impression of hopelessness and frustration that paralyzed the system. According to official Russian estimates, 78 percent of all AIDS victims in Russia contracted the virus through dirty needles or HIV-tainted blood in the state-run hospitals.
Irresponsibility, expressed by the popular Russian saying "They pretend they are paying us and we pretend we are working," resulted in appalling quality of service, widespread corruption, and extensive loss of life. My friend, a famous neurosurgeon in today's Russia, received a monthly salary of 150 rubles one third of the average bus driver's salary.
In order to receive minimal attention by doctors and nursing personnel, patients had to pay bribes. I even witnessed a case of a "nonpaying" patient who died trying to reach a lavatory at the end of the long corridor after brain surgery. Anesthesia was usually "not available" for abortions or minor ear, nose, throat, and skin surgeries. This was used as a means of extortion by unscrupulous medical bureaucrats.
To improve the statistics concerning the numbers of people dying within the system, patients were routinely shoved out the door before taking their last breath.
Being a People's Deputy in the Moscow region from 1987 to 1989, I received many complaints about criminal negligence, bribes taken by medical apparatchiks, drunken ambulance crews, and food poisoning in hospitals and child-care facilities. I recall the case of a fourteen-year-old girl from my district who died of acute nephritis in a Moscow hospital. She died because a doctor decided that it was better to save "precious" X-ray film (imported by the Soviets for hard currency) instead of double-checking his diagnosis. These X-rays would have disproven his diagnosis of neuropathic pain.
Instead, the doctor treated the teenager with a heat compress, which killed her almost instantly. There was no legal remedy for the girl's parents and grandparents. By definition, a single-payer system cannot allow any such remedy. The girl's grandparents could not cope with this loss and they both died within six months. The doctor received no official reprimand.
Not surprisingly, government bureaucrats and Communist Party officials, as early as 1921 (three years after Lenin's socialization of medicine), realized that the egalitarian system of healthcare was good only for their personal interest as providers, managers, and rationers but not as private users of the system.
So, as in all countries with socialized medicine, a two-tier system was created: one for the "gray masses" and the other, with a completely different level of service, for the bureaucrats and their intellectual servants. In the USSR, it was often the case that while workers and peasants were dying in the state hospitals, the medicine and equipment that could save their lives was sitting unused in the nomenklatura system.
At the end of the socialist experiment, the official infant-mortality rate in Russia was more than 2.5 times as high as in the United States and more than five times that of Japan. The rate of 24.5 deaths per 1,000 live births was questioned recently by several deputies to the Russian Parliament, who claim that it is seven times higher than in the United States. This would make the Russian death rate 55 compared to the US rate of 8.1 per 1,000 live births.
Having said that, I should make it clear that the United States has one of the highest rates of the industrialized world only because it counts all dead infants, including premature babies, which is where most of the fatalities occur.
Most countries do not count premature-infant deaths. Some don't count any deaths that occur in the first 72 hours. Some countries don't even count any deaths from the first two weeks of life. In Cuba, which boasts a very low infant-mortality rate, infants are only registered when they are several months old, thereby leaving out of the official statistics all infant deaths that take place within the first several months of life.
In the rural regions of Karakalpakia, Sakha, Chechnya, Kalmykia, and Ingushetia, the infant mortality rate is close to 100 per 1,000 births, putting these regions in the same category as Angola, Chad, and Bangladesh. Tens of thousands of infants fall victim to influenza every year, and the proportion of children dying from pneumonia and tuberculosis is on the increase. Rickets, caused by a lack of vitamin D, and unknown in the rest of the modern world, is killing many young people.
Uterine damage is widespread, thanks to the 7.3 abortions the average Russian woman undergoes during childbearing years. Keeping in mind that many women avoid abortions altogether, the 7.3 average means that many women have a dozen or more abortions in their lifetime.
Even today, according to the State Statistics Committee, the average life expectancy for Russian men is less than 59 years 58 years and 11 months while that for Russian women is 72 years. The combined figure is 65 years and three months.[1] By comparison, the average life span for men in the United States is 73 years and for women 79 years. In the United States, life expectancy at birth for the total population has reached an all-time American high of 77.5 years, up from 49.2 years just a century ago. The Russian life expectancy at birth is 12 years lower.[2]
After seventy years of socialism, 57 percent of all Russian hospitals did not have running hot water, and 36 percent of hospitals located in rural areas of Russia did not have water or sewage at all. Isn't it amazing that socialist government, while developing space exploration and sophisticated weapons, would completely ignore the basic human needs of its citizens?
The appalling quality of service is not simply characteristic of "barbarous" Russia and other Eastern European nations: it is a direct result of the government monopoly on healthcare and it can happen in any country. In "civilized" England, for example, the waiting list for surgeries is nearly 800,000 out of a population of 55 million. State-of-the-art equipment is nonexistent in most British hospitals. In England, only 10 percent of the healthcare spending is derived from private sources.
Britain pioneered in developing kidney-dialysis technology, and yet the country has one of the lowest dialysis rates in the world. The Brookings Institution (hardly a supporter of free markets) found that every year 7,000 Britons in need of hip replacements, between 4,000 and 20,000 in need of coronary bypass surgery, and some 10,000 to 15,000 in need of cancer chemotherapy are denied medical attention in Britain.
Age discrimination is particularly apparent in all government-run or heavily regulated systems of healthcare. In Russia, patients over 60 are considered worthless parasites and those over 70 are often denied even elementary forms of healthcare.
In the United Kingdom, in the treatment of chronic kidney failure, those who are 55 years old are refused treatment at 35 percent of dialysis centers. Forty-five percent of 65-year-old patients at the centers are denied treatment, while patients 75 or older rarely receive any medical attention at these centers.
In Canada, the population is divided into three age groups in terms of their access to healthcare: those below 45, those 4565, and those over 65. Needless to say, the first group, who could be called the "active taxpayers," enjoys priority treatment.
Advocates of socialized medicine in the United States use Soviet propaganda tactics to achieve their goals. Michael Moore is one of the most prominent and effective socialist propagandists in America. In his movie, Sicko, he unfairly and unfavorably compares health care for older patients in the United States with complex and incurable diseases to healthcare in France and Canada for young women having routine babies. Had he done the reverse i.e., compared healthcare for young women in the United States having babies to older patients with complex and incurable diseases in socialized healthcare systems the movie would have been the same, except that the US healthcare system would look ideal, and the UK, Canada, and France would look barbaric.
Now we in the United States are being prepared for discrimination in treatment of the elderly when it comes to healthcare. Ezekiel Emanuel is director of the Clinical Bioethics Department at the US National Institutes of Health and an architect of Obama's healthcare-reform plan. He is also the brother of Rahm Emanuel, Obama's White House chief of staff. Foster Friess reports that Ezekiel Emanuel has written that health services should not be guaranteed to
individuals who are irreversibly prevented from being or becoming participating citizens. An obvious example is not guaranteeing health services to patients with dementia.[3]
An equally troubling article, coauthored by Emanuel, appeared in the medical journal The Lancet in January 2009. The authors write that
unlike allocation [of healthcare] by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.[4]
Socialized medicine will create massive government bureaucracies similar to our unified school districts impose costly job-destroying mandates on employers to provide the coverage, and impose price controls that will inevitably lead to shortages and poor quality of service. It will also lead to nonprice rationing (i.e., rationing based on political considerations, corruption, and nepotism) of healthcare by government bureaucrats.
Real "savings" in a socialized healthcare system could be achieved only by squeezing providers and denying care there is no other way to save. The same arguments were used to defend the cotton farming in the South prior to the Civil War. Slavery certainly "reduced costs" of labor, "eliminated the waste" of bargaining for wages, and avoided "unnecessary duplication and parallelism."
In supporting the call for socialized medicine, American healthcare professionals are like sheep demanding the wolf: they do not understand that the high cost of medical care in the United States is partially based on the fact that American healthcare professionals have the highest level of remuneration in the world. Another source of the high cost of our healthcare is existing government regulations on the industry, regulations that prevent competition from lowering the cost. Existing rules such as "certificates of need," licensing, and other restrictions on the availability of healthcare services prevent competition and, therefore, result in higher prices and fewer services.
Socialized medical systems have not served to raise general health or living standards anywhere. In fact, both analytical reasoning and empirical evidence point to the opposite conclusion. But the dismal failure of socialized medicine to raise people's health and longevity has not affected its appeal for politicians, administrators, and their intellectual servants in search of absolute power and total control.
Most countries enslaved by the Soviet empire moved out of a fully socialized system through privatization and insuring competition in the healthcare system. Others, including many European social democracies, intend to privatize the healthcare system in the long run and decentralize medical control. The private ownership of hospitals and other units is seen as a critical determining factor of the new, more efficient, and humane system.
The above was authored by:
Yuri N. Maltsev, senior fellow of the Mises Institute, worked as an economist on Mikhail Gorbachev's economic reform team before defecting to the United States. He is the editor of Requiem for Marx. He teaches economics at Carthage College.
A second article, on how the personal experience changes under state-controlled systems, and what citizens can expect a few years later:
The New Bureaucratic Man
There is something to Trotsky's vision of man under communism. From all historical appearances, man under a totalitarian state functions differently than a man under liberty. And degrees of man exist as society slowly turns from liberty to slavery.
The prevailing view is that man under socialized healthcare will remain the same as man today a man living under a pseudo-free market. In fact, some even believe that man may progress. In this view, the doctor we see today will, at the very least, remain the same under socialized health care. Don't bet on it.
Unlucky Ducks
I once worked as a software contractor for a state agency (forgive me). The building where I worked was not your typical government building. It had a modern feel, with a decorative moat detailing the front entrance. The front door guarded, of course was accessible via a walkway bridge of sorts.
It's not what you may be thinking; it was all very subtle and nice. However, the drop from the bridge to the mulch-covered, bush-laden moat was a good three feet.
One year, at the beginning of spring, a duck built a nest in the moat, under one of the many bushes. As her ducklings hatched and grew, it came time for them to search for water. However, despite their repeated attempts, the ducklings could not jump from the moat to the walkway bridge.
One of the employees in the building asked the building manager if he (the employee) could place a wooden ramp to allow the ducklings to waddle out of the moat. Being a good state employee himself, the building manager called the state department of natural resources for guidance. The answer: since ducks are migratory birds, no one could do anything.
The next morning, someone plastered official signs around the entrance, stating that any attempt to help the ducks was a violation of law. No ramp, no water, no food. And violators you know this already would be prosecuted to the fullest extent.
Soon we had a real scene. The mother duck would leave the moat and encourage her ducklings to follow. They couldn't, of course. She would march back and forth on the walkway bridge and quack in desperation. All the while, the guard at the entrance stood watch, stopping any attempt to help.
Repeated calls to the bureaucrats at the department of natural resources were answered by a repetition of laws and fines. And not one of the department employees was going to go against the rules, or even ask for an exemption, for any reason.
The ducklings died days later.
There you have it: upon joining the state, the department of resource folks folks who likely dreamed of careers helping wildlife became staunch bureaucrats enforcing rules over reason.
Healthcare
I have had many good experiences with doctors, nurses, and such. Our pre-Obamacare system was not perfect, but it suffered from nothing that the free market couldn't cure. Nevertheless, our elected officials believe otherwise. And they have a lot of support from the masses, who, I believe, are deluded.
Many proponents of socialized healthcare envision a system where their current providers remain, and society, hidden behind the state, pays the bills. But man changes by degree as liberty is lost. So the smiling doctor and caring nurse you trust will become the faces of the nomenklatura and apparatchiks. They can become nothing else.
Yuri Maltsev, former economist under Gorbachev, detailed the truths of Soviet medicine in a recent Mises.org article. He wrote of drunken medical professionals roaming the halls of filthy hospitals hospitals devoid of necessary equipment and supplies. And he wrote of a system where adherence to the rules of the bureaucracy trumped reason and sanity.
Meeting quotas was the mission, not serving the patients. So people died due to the rules of the bureaucracy, and no one could or would do otherwise.
Do we really believe the conduct of Russians under socialist rule was due to genetics or geography? Do we really believe there is something unique about Russians or Russia and all the other groups who lived under socialist rule? And do we really believe Americans under that very same system would comport themselves in a different manner as if altruism were genetic in the 50 states? Does anyone really believe any of that?
We have a tough case to make. We have the supporters of socialized healthcare dreaming that everything will remain the same, except someone else will pay the bill. It's a nice fantasy. But a fantasy, nonetheless. And fantasies can be hard to defeat at times.
On our side, we have the science of economics that says the system will collapse in the end. It will collapse under its own weight due to the state's inability to allocate resources efficiently. And just as important, we have history that shows how man behaves when under socialism how man will behave until the system finally collapses. And let me tell you, that behavior ain't pretty.
Your doctor and nurse, no matter how nice today, will become the bureaucracy. They will see you in terms of state rules and regulations. They will push you out into the cold rather than risk having you die on site and them having to suffer the consequences of a bad report to the central authorities.
Of course, your beloved healthcare professionals will not change overnight from Dr. Jekyll to Mr. Hyde. No, they will slowly change as the cloud of socialized medicine and accompanying bureaucracy incessantly rots their souls (as it rots our souls as well). It will happen it has to.
To think otherwise is to be that mother duck, expecting officials of the state to rescue her ducklings because that is what employees of the department of natural resources are supposed to do: rescue wildlife.
To those who say that this cannot happen, I would point to the dismal state of half (or more) of the US' school system, and how it is divided into the "good" and "bad" tiers, exactly as expected.
Comments and opinions?
and what about those 30 odd developed nations where the evil "socialized medicine" is better than what the US has and nothing like that happens? Why don't we emulate them instead of the Soviets?
