• Tag Archives health care

  • America’s Hyper-Regulated Health Care Industry Has Been Exposed by COVID-19

    Posted on by Azrael Comment

    It doesn’t take much searching to come up with dozens of examples of private companies stepping up to help provide our beleaguered medical professionals with desperately needed protective equipment and tools to save lives. Textile companies churning out face masks and protective clothing for doctors. Manufacturers switching their assembly lines to produce ventilators. Distilleries making hand sanitizer. Lots of companies are stepping up in other ways too, figuring out ways to serve their communities and protect their workforces as best they can, or diverting production to replenish items that panicked buyers have stripped store shelves of.

    Some people, though, can’t seem to see past their general disdain for big companies, which they see as merely exploiting people for wealth. Take the reaction to President Trump inviting a number of major corporate CEOs to the White House briefing to talk about how their companies are working to help fight the pandemic. This Vox reporter’s tweet is pretty representative of a widespread reaction by left-leaning talking heads on social media:

     

    I suppose a cynic can question these companies’ motives, whether they’re truly being altruistic or merely using this opportunity to boost their brand. But the fact is, their motivations don’t matter. None of this private effort to step up and combat the pandemic should surprise anyone who understands what free markets are and how they work—where there’s demand, entrepreneurs will figure out how to fill it, if they’re allowed to. It doesn’t matter if these companies are motivated by charity or merely the opportunity to increase their market share if the end result is people getting what they desperately need as fast as possible.

    That is the beauty of free people being allowed to associate and transact freely—capitalism helps connect people who have what others want or need, without judgment. As Walter Williams bluntly stated, “Capitalism made it possible to become wealthy by serving one’s fellow man.” Not that all these companies are making bank helping ease this crisis; many aren’t. Value is subjective, after all, and plenty of CEOs value the lives of their fellow man over money.

    Naturally, Marxists like New York Mayor Bill DeBlasio see this, and any crisis, as an opportunity not to be wasted to command and control the economy in proper, Soviet fashion. DeBlasio and others have called on Trump to use the government’s sweeping powers to effectively nationalize companies and their output under the Defense Production Act (DPA). Although the president has been fairly reluctant to use it so far, his recent appointment of the astonishingly economically retrograde trade hawk Peter Navarro to head the use of the DPA is alarming, as is his use of the DPA to attempt to block 3M from shipping any respirators overseas.

    Trump’s DPA saber rattling and threats to commandeer an empty GM plant to produce more ventilators made for good press but bad policy, especially when, as previously mentioned, companies like Ford are already stepping in to fill that exact need. How much do you want to bet that the several companies already producing ventilators voluntarily are likely to outperform those who are conscripted?

    Moving forward, there will be a focus on trying to ensure that our health care system has everything it lacked to combat this disease, and probably more besides. Very likely there will be a push to build more health care infrastructure with federal dollars. In the minds of many, government investment will be needed to fill in where the “market” failed.

    That notion rests on the pretense that there was a free market to fail in the first place. Even a cursory glance at regulations and laws surrounding health care reveals a tremendously complicated web of layered restrictions on the practice of medicine that Dr. Robert Graboyes has rightly dubbed “Fortress Health Care,” so named because the legal walls erected around it prevent all manner of newcomers from accessing the field without due permission.

    Why do so many hospitals lack the necessary number of beds? Why do they not have enough ventilators, CT scanners, and other essential equipment? Why is there a shortage of medical professionals, and why are doctors retiring at rates that cannot be replaced?

    A goodly chunk of the answer falls upon this fortress, erected at the federal, state, and local levels. Certificate of Need laws let existing providers deny competitors the ability to purchase health care infrastructure in their area. Scope of Practice laws lock highly trained physicians’ assistants and nurses into tightly defined roles that leave patients waiting for scarce doctors. Tax advantages for employer-sponsored health plans and restrictions on the individual market tie health care benefits to people’s jobs and obscure price incentives as people become dependent on third-party payment systems.

    The anti-competitive regulatory pressures on health care are profound. Everything from the licensing of medical professionals to the building of new facilities is regulated; prices are manipulated and fixed by subsidies and entitlements and middleman payers. The best thing the government could possibly do to provide health care is to unshackle it.

    Set it free, and the market will provide—if we let it.


    Josh Withrow

    Josh Withrow is a Senior Policy Analyst at FreedomWorks.

    This article was originally published on FEE.org. Read the original article.


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  • Declaring Health Care “Universal” Doesn’t Make It So

    Posted on by Azrael Comment

    “Universal health coverage is defined as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation, and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship.”

    – World Health Organization

    WHO’s definition describes the ideal outcome for a healthcare system. In other words, it is a goal, not a means. Often, however, universal healthcare refers to a government action or policy, or a specific way of producing health care. Much of the healthcare debate equivocates between using “universal” to describe an outcome, or alternatively, a government action.

    Map of countries with so-called universal healthcare

    Many (if not all) countries which are typically said to have universal healthcare, do not meet WHO’s criteria. Take Canada as an example. A paper put out by the Fraser Institute estimated around 44,000 people died over a 16 year period due to wait times. Obviously, if a person dies while waiting for treatment, then they did not have access to the care they needed.

    Canada is not an exception. Researchers concluded that delayed access to a hospital bed led to approximately 5,500 deaths in the UK over the course of 3 years. In a hospital in Sweden last year, only 20% of cancer patients received treatment within the recommended time period. It seems likely that even if a system is doing quite well, there will still be at least a few people who fall through the cracks. Even in the top-tier Swiss system which mandates purchasing health insurance and provides subsidies for those who can’t afford it, there still remains 0.5% of the population who have no health insurance. This does not meet WHO’s criteria for “all people” if we are to interpret it in a strict manner.

    Yet curiously, these countries are well-known to have “universal healthcare”. So what’s going on? Well, the definition of universal healthcare is constantly in flux. On one hand, a country’s healthcare system is called universal if the government enacts certain policies. See Wikipedia’s definition for instance:

    The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards.

    Then, after it has been established these countries have universal coverage, a proponent can switch to WHO’s definition, which is based on the outcome of the system. The implicit assumption then, is that government actions aimed at a goal automatically produce that goal. But as we have seen in the aforementioned countries, intentions are quite different than outcomes.

    Moreover, this equivocation causes most people to overlook the possibility of a non-government system that could achieve or come close to the noble goal spelled out in WHO’s definition. Affordable access to medical care can be made possible through a freed market that drives down prices, supplemented with charitable activity and mutual aid. Before the advent of significant government intervention in the US healthcare industry, mutual aid organizations had already made inexpensive medical care available to the poor and working class.

    If universal healthcare means affordable access to all, then there is no reason to oppose it. It is in fact, an honorable goal. If, however, it refers to a specific government policy, then it is up for debate whether good outcomes are likely, and not at all a given. At the very least, the equivocation between the two definitions must end if there is to be any honest discussion.

    This article is republished from the Principled Libertarian.


    Andrew Kern

    Andrew Kern is the author of The Myth of the Social Contract: Refuting Common Arguments for Government Authority, and he has written on libertarianism, anarchism, and private alternatives to state authority. He founded The Principled Libertarian website in 2017 with the goal of spreading the ideas of liberty and helping to define what it means to be free. His work has been published by Antiwar.com, the Ludwig von Mises Institute, the Foundation for Economic Education, Being Libertarian, and others. You can follow him here.

    This article was originally published on FEE.org. Read the original article.


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  • No, Fidel Castro Didn’t Improve Health Care or Education in Cuba

    Posted on by Azrael Comment

    On CBS’s 60 Minutes, Senator Bernie Sanders recently praised the achievements of communist Cuba. An interviewer asked him about his 1985 comments that Cubans supported communist dictator Fidel Castro because he “educated their kids, gave their kids health care, totally transformed society.” In response, Sanders defended those comments, by stating that when “Fidel Castro came into office, you know what he did? He had a massive literacy program.”

    But Castro did not give Cubans literacy. Cuba already had one of the highest literacy rates in Latin America by 1950, nearly a decade before Castro took power, according to United Nations data (statistics from UNESCO). In 2016, the Washington Post fact-checker Glenn Kessler debunked a politician’s claim that Castro’s rule significantly improved Cuban healthcare and education.

    In today’s Cuba, children are taught by poorly paid teachers in dilapidated schools. Cuba has made less educational progress than most Latin American countries over the last 60 years.

    According to UNESCO, Cuba had about the same literacy rate as Costa Rica and Chile in 1950 (close to 80 percent). And it has almost the same literacy rate as they do today (close to 100 percent).

    Meanwhile, Latin American countries that were largely illiterate in 1950—such as Peru, Brazil, El Salvador, and the Dominican Republic—are largely literate today, closing much of the gap with Cuba. El Salvador had a less than 40 percent literacy rate in 1950, but has an 88 percent literacy rate today. Brazil and Peru had a less than 50 percent literacy rate in 1950, but today, Peru has a 94.5 percent literacy rate, and Brazil a 92.6 percent literacy rate. The Dominican Republic’s rate rose from a little over 40 percent to 91.8 percent. While Cuba made substantial progress in reducing illiteracy in Castro’s first years in power, its educational system has stagnated since, even as much of Latin America improved.

    Contrary to Sanders’ claim that Castro “gave” Cubans healthcare, they already had access to healthcare before he seized power. Doctors frequently provided free healthcare to those who couldn’t afford it. As the Washington Post’s Glenn Kessler noted:

    As for health care and education, Cuba was already near the top of the heap before the revolution. Cuba’s low infant mortality rate is often lauded, but it already led the region on this key measure in 1953-1958, according to data collected by Carmelo Mesa-Lago, a Cuba specialist and professor emeritus at the University of Pittsburgh.

    Cuba led virtually all countries in Latin America in life expectancy in 1959, before Castro’s communists seized power. But by 2012, right after Castro stepped down as Communist Party leader, Chileans and Costa Ricans lived slightly longer than Cubans. Back in 1960, Chileans had a life span seven years shorter than Cubans, and Costa Ricans lived more than two years less than Cubans on average. In 1960, Mexicans lived seven years shorter than Cubans; by 2012, the gap had shrunk to just two years.

    (Today, life spans are virtually the same in Cuba as more prosperous Chile and Costa Rica—if you accept the rosy official statistics put out by Cuba’s communist government, which many people do not. Cuba has been credibly accused of hiding infant deaths, and exaggerating the life spans of its citizens. If these accusations are true, Cubans die sooner than Chileans or Costa Ricans).

    Cuba has made less progress in health care and life expectancy than most of Latin America in recent years, due to its decrepit health care system. “Hospitals in the island’s capital are literally falling apart.” Sometimes, patients ”have to bring everything with them, because the hospital provides nothing. Pillows, sheets, medicine: everything.”

    As The Washington Post’s Kessler noted:

    Reporters have also documented that Cuban hospitals are ill-equipped. A 2004 series on Cuba’s health-care system in Canada’s National Post said pharmacies stock very little and antibiotics are available only on the black market. “One of the myths Canadians harbor about Cuba is that its people may be poor and living under a repressive government, but they have access to quality health and education facilities,” the Post said. “It’s a portrait encouraged by the government, but the reality is sharply different.”

    Under communism, Cuba has also fallen behind on more general measures of human development. As the progressive economist Brad DeLong pointed out:

    Cuba in 1957—was a developed country. Cuba in 1957 had lower infant mortality than France, Belgium, West Germany, Israel, Japan, Austria, Italy, Spain, and Portugal. Cuba in 1957 had doctors and nurses: as many doctors and nurses per capita as the Netherlands, and more than Britain or Finland. Cuba in 1957 had as many vehicles per capita as Uruguay, Italy, or Portugal. Cuba in 1957 had 45 TVs per 1000 people—fifth highest in the world …Today? Today the UN puts Cuba’s HDI [Human Development indicators] in the range of … Mexico. (And Carmelo Mesa-Lago thinks the UN’s calculations are seriously flawed: that Cuba’s right HDI peers today are places like China, Tunisia, Iran, and South Africa.) Thus I don’t understand lefties who talk about the achievements of the Cuban Revolution: ‘…to have better health care, housing, education.’

    As Michael Giere notes, Cuba was prosperous before Castro’s communists seized power:

    A United Nations (UNESCO) report in 1957 noted that the Cuban economy included proportionally more workers who were unionized than in the U.S. The report also stated that average wages for an eight hour day were higher in Cuba than in “Belgium, Denmark, France, and Germany.”…PBS explained in a 2004 retrospective, that

    “Havana [prior to Castro] was a glittering and dynamic city. Cuba ranked fifth in the hemisphere in per capita income, third in life expectancy, second in per capita ownership of automobiles and telephones, first in the number of television sets per inhabitant. The literacy rate, 76%, was the fourth highest in Latin America. Cuba ranked 11th in the world in the number of doctors per capita. Many private clinics and hospitals provided services for the poor. Cuba’s income distribution compared favorably with that of other Latin American societies. A thriving middle class held the promise of prosperity and social mobility.”

    But after Castro took over, the prosperity came to an end:

    Castro’s destruction of Cuba cannot be over dramatized. He looted, murdered, and destroyed the nation from the ground up. Just one factoid explains it all; Cubans once enjoyed one of the highest consumption of proteins in the Americas, yet in 1962 Castro had to introduce ration cards (meat, 2 ounces daily), as food consumption per person crashed to levels not seen since the 1800s.

    Hunger became so widespread that a visiting Swedish doctor, Hans Rosling, had to warn Cuba’s dictator in 1992 about widespread protein deficiency among Cubans. Roughly 40,000 Cubans had been reported to have been experiencing “visual blurring and severe numbness in their legs.” Rosling investigated at the invitation of the Cuban embassy in Sweden, and with the approval of Castro himself. Rosling travelled to the heart of the outbreak, in the western province of Pinar del Río. It turned out that those stricken with the disorder all suffered from protein deficiency. The government was rationing meat, and adults had sacrificed their portion to nourish children, pregnant women and the elderly. Dr. Rosling told Fidel Castro about this.

    During this period of widespread hunger, Bernie Sanders was peddling the myth that hunger was non-existent in Cuba. In 1989, he published a newspaper column claiming that Fidel Castro’s Cuba had “no hunger, is educating all of its children and is providing high quality, free health care.”

    This article was reprinted with permission from Liberty Unyielding.


    Hans Bader

    Hans Bader practices law in Washington, D.C. After studying economics and history at the University of Virginia and law at Harvard, he practiced civil-rights, international-trade, and constitutional law.

    This article was originally published on FEE.org. Read the original article.


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