Debating Health Care (Poorly)

I've been hearing a lot about the state of health care in the United States. Since I have some strong opinions in this area, I present you with my own rant on the topic.

Before digging in, I wish to start with a little bit of Chinese history. Fifty years ago, Mao Zedong started introducing a series of agricultural reforms to the new agricultural communes in China. These reforms were unscientific and had not been tested; grain production dropped by nearly a quarter over the next three years. To avoid government anger, officials would exaggerate their productivity in their official reports, which in turn led the government to requisition too much grain for state projects. This cycle of deception led to the deaths of tens of millions of people by starvation--comparable to the entire body count of World War 2.

Much of the grain taken by the state was being routed to work crews building massive infrastructure--dams, canals, and so forth. Unfortunately, many of these were so poorly designed and constructed that they turned out worthless. Many trained engineers had been disqualified from the work because Mao Zedong had ideological problems with them.

Mao's successor in the communist party was named Deng Xiaoping. Deng Xiaoping abandoned many of the communist economic theories and moved China toward a comparatively capitalist system. Defending this, he said "I don't care if it's a white cat or a black cat. It's a good cat so long as it catches mice." He had been forced out of power during Mao's lifetime due to his willingness to apply market economics to China's problems. After Mao's death, he returned to prominence, and is the architect of much of modern China's prosperity. Deng Xiaoping advocated seeking truth from facts. And this is what I feel is often missing from health care debates: People make emotional or ideological arguments, with no reference to actual facts about health care.

A handful have claimed there is no need for reform. Sen. Shelby (R-Ala) claimed that Obama would destroy "the best health care system the world has ever known." Of course, he is already on government health care, so I'm not sure how to interpret that. Still, what does he mean that it's the best health care in the world? How do you even measure that? The two most obvious measures that come to mind are:

1. What is our life expectancy?
2. What is our infant mortality rate?

The problem is that the United States does badly on both of these measures. And it's not just a problem of having a large population: Japan, Canada, the United Kingdom, and France are crushing us soundly, and all have 50+ million populations.

While some of the difference is probably the poor American diet and activity levels, how do you explain the infant mortality rate? Infants all weigh pretty nearly the same amount. Besides, the problems with our health care can be measured in a host of other ways (error rate, amount of preventive care, etc.), and we fare poorly on these measures as well. There's an article linked at the end if you want some actual numbers.

There's been a lot of ideological name-calling. Claiming that health care reform is evil because it is "socialist" is an attempt to evoke the ideological red scare of yesteryear. The fact is, most of the health care systems that are destroying us on efficiency, outcomes, and access to care are socialized systems. Is it okay for more of us to die or get sick so that politicians can score points? Or do you believe that America will implement socialized health care more poorly than other countries which have done it? Why do you believe we are less competent than they are?

Some believe that government always performs poorly compared to the private market. What is this argument based on? Do you believe private mercenaries would do better than our army? Do you believe a network of private toll roads would be preferable to the Interstate system? Do you believe that the heavy government price regulation of our water, sewage, and electrical systems has resulted in poor delivery of these services? The truth is that government does certain things better than private industry, and this is a well studied issue in economics. Further, health care run fully by the government has been tried and tested dozens of times in dozens of places, and many of them are healthier than we are. It's not an automatic failure.

I think there's a hidden issue behind this hatred of government programs. American social programs are usually directed at the poor. The middle class gets taxed to pay for these things, but we don't see the benefit. I agree that this is genuinely unfair. We don't resent roads because we all see the benefit from roads. We don't resent national parks because we can all visit them. We don't resent the military because the military defends everybody. I think that a basic level of health care should also be available to everybody, however that is accomplished. I think that there'll be a fair amount of bellyaching tell it gets passed, but as long as the benefits hit everyone, we'll shortly be wondering how we lived without it.

Finally, I refer you to someone who's done a lot more research than I have. This article is much longer than this post, but is backed by a great deal more research. You may not like its conclusions, but if you wish to contradict them, do so with actual facts. Please don't fight back using pure ideology. Because if there's one point I hope I made at the beginning of this post, it's that the cost of clinging to ideology in spite of reality is measured in human lives.