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The Left Explains Why We Must Ration Health Care

Via Jonah Goldberg at NRO The Corner: The NY Times Blames – Guess Who? – for the Death Panel “Rumors”

If you haven’t read the story, it’s the usual connect-the-dots to blame dishonest and crazy rightwingers piece gussied up as truth-squadding. My own question is why the Times couldn’t bother to at least quote Obama’s interview with … The New York Times:

LEONHARDT: And it’s going to be hard for people who don’t have the option of paying for it.

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

LEONHARDT: So how do you – how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

I don’t think Obama’s calling for a death panel here, if by death panel you mean something out of Logan’s Run. But, it sure sounds like something that even a non-conspiratorial person might worry about. If Obama said he wanted a “free speech panel” to offer guidance on what newspapers should or shouldn’t say, the Times would get its knickers in quite a twist (at least I hope they would).

Also, now that I think of it, The Times story could also have mentioned a huge piece by Peter Singer in this magazine called The New York Times magazine called “Why We Must Ration Health Care.” It drips with examples, illustrations and arguments about why oldsters should be offed to save money. Again, it can’t be held against Obama, but if you’re trying to figure out why conservatives think liberals want to do this sort of thing, the Times might ponder just a bit harder where conservatives got the idea in the first place. It’s all fine to point fingers at Rush Limbaugh and Glenn Beck, but both of those guys actually cite evidence that comes from the left’s own words and actions. A real truth-squadding piece would look at the actual evidence.

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August 14, 2009 , 12:25PM - Posted by | Barack Obama, Communism, Death Panels, Healthcare, Liberalism, Media Bias, New York Times, Socialism

4 Comments

  1. As Obama tries to reform the medical welfare system people protest because they don’t want to help others then them selves!!, let me elaborate… In a debate yesterday in Wheeling, West Virginia. A woman carefully asked if they please could hurry up with the reform so that her daughter could be helped with her rheumatism since at the moment there was no way of paying for it. The response came quick… A man in a shirt stood up and said loud and clear: why should I pay for your daughter? Well there you have it people, the actual American reason for protesting against the reform… The product of a Supercapitalistic society. As soon as ones tax money helps other people people shout out Communism and Socialism as if they knew the meaning of these words!… is equality for all wrong? I call it Welfare. In Sweden we have a higher tax which everyone is willing to pay because we care for the less fortunate in our nation… as a matter of fact we have the best welfare in the world because of this… are we Communists now suddenly.. No definitely not! Maybee Obama sees the countries with the best welfare in the world and believes America has something to learn… who knows!

    Comment by Bob van den Eijkhof | August 16, 2009 , 10:01AM

    • What does any of that have to do with the point of this post, which is… with socialized medicine, there will be rationing?

      Also, Sweden’s single-payer health care system is an example of what NOT to do: Sweden’s Single-Payer Health System Provides a Warning to Other Nations

      For much of the 20th century, Sweden had a single-payer system of health care in which the government paid almost all health care costs. Like other nations with a single-payer system, Sweden has had to deal with the problem of ever-growing health care expenses causing a strain on government budgets. It has dealt with this problem by rationing health care – instituting waiting lists for medical appointments and surgery.

      Sweden stands not merely as a warning about single-payer systems, but also as an example of what happens when market-based reform of such systems do not go far enough.

      In the 1990s, Sweden set about reforming its health care system by introducing aspects of privatization. These reforms were limited, however, and the old problems with waiting lists and rising costs had re-emerged by the beginning of this decade.

      [ … ]

      Görann Persson had to wait eight months during 2003 and 2004 for a hip replacement operation. Persson was not considered to be a very pleasant person to begin with, and he became even grumpier due to the pain he endured while waiting for his operation. As a result, Persson walked with a limp, reportedly used strong pain medication and had to reduce his workload.20

      What made Persson unique was not his wait for hip surgery. Despite the government promise that no one should have to wait more than three months for surgery, 60 percent of hip replacement patients waited longer than three months in 2003 (see Figure 2).21 Rather, Persson stood out because he was Prime Minister of Sweden at the time. Persson could surely have used his position in the government to gain access to private care, essentially jumping the waiting list. Yet Persson stated that he planned on waiting for his surgery like everyone else.

      Whether Prime Minister Persson did this out of benevolent motives is an open question. His party, the Social Democrats, have used the phrase “equal access to health care” to attack the center-right parties on the issue of health care for many years. Persson would have greatly undermined the effectiveness of that attack had he jumped the waiting list.

      In practice, the political notion of “equal access” actually means “restricted access.” Swedes who do not have private insurance must wait, often for months, for treatment. For all Swedes who needed an operation in 2003, slightly more than half waited more than three months (see Figure 2).22 The situation continues. Moreover, patients often wait in great pain and distress.

      Researchers studying Swedes waiting for hip or knee replacement concluded that “almost every aspect of daily life is affected by the indeterminate wait for surgery and the related experiences of pain and disability. The respondents express a deep sense of lost dignity, powerlessness and frustration.”23 One patient complained that the pain had gotten so bad that she “had no quality of life.” “I can’t participate in anything,” she said. “I can’t go for a walk, I can’t do anything, so why on earth do I need to wake up in the morning!”24 Depression and hopelessness were other common symptoms. Another patient complained, “I feel as though I’ve lost my human dignity. You get depressed and fed up with the pain. Still I try to be patient. But you lose the desire (to live).” She further complained of her treatment by the clinic where her surgery was to take place. “I felt so neglected, you get treated, yes, worse than an animal because you can take an animal to the veterinary… I feel so powerless.”25

      Pain and anxiety are also common problems for Swedish heart patients waiting for surgery. One study found that more than half of patients waiting for heart surgery experience chest pain daily, and longer wait times were associated with increased nervousness.26 Another study found that 88 percent of patients waiting for heart surgery reported chest pains that limited their daily activities. It also found symptoms of anxiety and depression to be strongly associated with the pain.27

      While rationing may permit the government to save on costs and thereby restrain health care budgets, putting patients on waiting lists is not cost-free. One study that examined over 1,400 Swedes on a waiting list for cataract surgery found that 5.2 million kronas were spent on hospital stays and home health care for patients waiting for surgery.28 That was the equivalent of what it would have cost to give 800 patients cataract surgery.

      A recent study that examined over 5,800 Swedish patients on a wait list for heart surgery found that the long wait has consequences far worse than pain, anxiety or monetary cost.29 In this study, the median wait time was found to be 55 days. While on the waiting list, 77 patients died. The authors’ statistical analysis led them to conclude that the “risk of death increases significantly with waiting time.”30 Another study found a mean wait time of 55 days for heart surgery in Sweden and a similar rate of mortality for those on the waiting list.31 Finally, a study in the Swedish medical journal Lakartidningen found that reducing waiting times reduced the heart surgery mortality rate from seven percent to just under three percent.32

      Sweden is one of several nations whose practices offer proof that single-payer health care systems lead to the proliferation of waiting lists. It also shows that waiting lists have adverse and sometimes tragic consequences for patients.

      Comment by michaelinmi | August 16, 2009 , 11:58AM

    • Here is yet another example of how Sweden’s single-payer system has failed: A Look at Sweden’s Way

      “OK, Williams,” you say, “Sweden is the world’s socialist wonder.” Sven R. Larson tells about some of Sweden’s problems in “Lesson from Sweden’s Universal Health System: Tales from the Health-care Crypt,” published in the Journal of American Physicians and Surgeons (spring 2008). Mr. D., a Gothenburg multiple sclerosis patient, was prescribed a new drug. His doctor’s request was denied because the drug was 33 percent more expensive than the older medicine. Mr. D. offered to pay for the medicine himself but was prevented from doing so. The bureaucrats said it would set a bad precedent and lead to unequal access to medicine.

      Malmo, with its 280,000 residents, is Sweden’s third-largest city. To see a physician, a patient must go to one of two local clinics before they can see a specialist. The clinics have security guards to keep patients from getting unruly as they wait hours to see a doctor. The guards also prevent new patients from entering the clinic when the waiting room is considered full. Uppsala, a city of 200,000 people, has only one mammography specialist. Sweden’s National Cancer Foundation reports that in a few years most Swedish women will have no access to mammography.

      Dr. Olle Stendahl, a professor of medicine at Linkoping University, pointed out a side effect of government-run medicine: its impact on innovation. He said, “In our budget-government health care there is no room for curious, young physicians and other professionals to challenge established views. New knowledge is not attractive but typically considered a problem [that brings] increased costs and disturbances in today’s slimmed-down health care.”

      These are just a few of the problems of Sweden’s single-payer government-run health care system. I wonder how many Americans would like a system that would, as in the case of Mr. D. of Gothenburg, prohibit private purchase of your own medicine if the government refused paying.

      Comment by michaelinmi | August 16, 2009 , 12:07PM

    • And here is yet a little more for you about Sweden’s failed single-payer system:

      What can other countries learn from the Swedish health care system?

      1. Choices for the middle class in the towns have diminished since the 1950s. One cannot get into a private clinic except in Stockholm and Gothenburg, and it is only the very well-to-do patients who can afford private hospital care. Patients have little consumer choice.

      2. Productivity in hospitals has fallen sharply since the 1970s, when doctors began receiving fixed salaries and not a fee per patient.

      3. Productivity in hospitals has increased recently only as a result of diminishing financial resources. The productivity of district doctors can be extremely low — it is not unusual for a doctor to treat an average of only six to 12 patients a day.

      4. Long-term care reform has increased the number of available beds, but the quality of care for elderly patients is not satisfactory.

      5. A worker with a wage of US$20,000 pays about US$3,000 a year in taxes for health care. A scientist at Astra with a salary of US$50,000 has to pay more than US$7,000 in taxes for health care, plus a fee of at least US$22 for prescription medicine or consultation with a doctor.

      6. When Sweden was a rich country in the 1970s, there were few restrictions on the introduction of new medical methods, new pharmaceuticals, etc. Now the environment is different, and there is a tendency to block or restrict the availability of specialized care in order to save money. Some new medical procedures are introduced as standard later than they are in other countries. For example, while bypass operations were standard (with overcapacity) in Switzerland in 1983, patients in Sweden had to wait more than a year for bypass operations.

      7. Waiting lists have become a big problem. “Care guarantees” have reduced the waiting list problem temporarily in the past, but these problems began reappearing during the last few months of 1995.

      Comment by michaelinmi | August 16, 2009 , 12:22PM


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