While recently perusing topics that may interest me on the closest free market solution to peer review and peer accreditation that we currently have, I came across a question that asked Europeans whether they preferred the European/UK health care systems, or the United States’ system. Of course, the answer from the Europeans were varying degrees of snide and condescending, which I only note because my non-condescending answer was accused of such, in full disregard of how one of the Europeans’ answers began: “HAHAHAHAHAHAHAHA”.
Here is my answer. Enjoy the comments from Europeans who cannot freaking stand the suggestion that their health system isn’t perfect.
Expensive Now or Free Later?
The question about socialized medicine can easily be boiled down to one simple question: Would you rather have an expensive cancer cure now, or a free* cancer cure in eighty years? Despite fears that the United States is going to lose its technological and biotechnological edge, the numbers are in, and there’s actually been a 7% increase in the recent years. Beyond that, the United States alone is responsible for forty percent of all biomedical research papers. In fact, the United States produces more medical research papers than the next five countries combined.
One might be inclined to think that this is only possible if the United States is producing junk papers, yet this also is proven untrue by the numbers. American research papers are the most cited by an enormous margin, far outstripping even the 40% production line. While there isn’t a direct correlation between “medical research papers” and “medical advancement” there obviously will be some correlation, and it certainly serves as a valid metric for determining biotechnological research in the United States.
Take the Charile Gard case for example. This poor infant had a disease that was fatal. Doctors in the UK could do nothing but provide comfort for the child as he died. Doctors in the United States had a treatment–a long-shot treatment, but I will remind everyone that every new procedure initially begins as “a long-shot treatment.” Once upon a time, heart valve replacement surgeries were on the cutting edge of medicine and the last hope of the desperate. The first aortic valve replacement was done only 57 years ago, and I’ll give you one guess in what country this took place. If you said anything but “The United States,” then you might be out of touch with reality.
Even among the diehard European Socialists who jizz over their system, there is widespread admittance that medical care in the United States is top-notch. They simply add the caveat “if you can afford it.” Well, allow me to introduce you to a little device we call…. the television. Of course, the first television was demonstrated in San Francisco in the 1930s (yes, before Hitler attempted to show German might by making the first on-air broadcast). Adjusted for inflation, this television that cost $795 in 1948 with a 16 inch screen would cost $8,202.50 today.
That. For that. Can you imagine paying $8,202.50 for that? “Hell to the naw!” you might be saying. That’s what I said, so ridiculous is the idea. What sort of television will $8,000 get you today?
Holy crap, it’s a computer, designed for music and with a 65 inch screen. It’s a technological marvel.
But you and I don’t have one of those, and neither do we want one. No, instead, we buy televisions in the $200 to $500 range. So what does a $200 television get you today? A standard 32 inch 1080p HDMI television. If we were to assign “Degrees of Awesomeness” to each machine, where the 1948 television was a 1 and the behemoth I just posted is a 100, then the ordinary television you have in your home is going to be around a 35 or 40.
Innovation & Competition Drive Down Prices
Why is it that, in 1984, you bought a tiny screen television for $650, yet today you can get a multitudes better television for merely a third of that price, and why is this almost exactly the opposite of what we see in the health care industry? Because the government didn’t really get involved in television manufacturing to grant monopolies to this coalition or that coalition. Many companies rose that wanted to sell you a television, and how could they entice you to buy theirs? By making one with better quality, by making it cheaper, and by selling it at a lower price.
Let’s rip on the Affordable Care Act for a moment. Even if you happen to live in a state that presents you with multiple options (Mississippi only has the one option), they’re all effectively the same. It doesn’t matter which you go with, because they are all required by law to offer the same things as the same prices to everyone. It’s obvious that this is bad for business. If this had been imposed on the television industry in 1948, we’d all be watching television on 16 inch black-and-white screens with monaural sound. There’s no competition in the health care industry today, so there’s no need to try to offer an enticing package to customers.
The Affordable Care Act: A Boon to Insurance Companies
Insurance is a relatively simple thing, although its formulae are complicated. The idea is this: you insure people against unexpected disasters. If those disasters happen, you pay for them. If they don’t, then you keep their money. It’s immediately obvious that, for this to be a viable business model, you need 100 customers who routinely go one month without any accidents if they pay you $1 per month and if the average cost of an accident is $99. We’re using simple numbers just to make the point. If the cost of whatever you’re insuring will be $100, and you have 100 customers each paying $1 a month, then if two accidents happen in a single month, you lose money.
This is the entire premise of insurance, and it’s why many rightly refer to it as gambling–it is identical to the casino industries. You might be that one person to actually go to the casino and win $1500, but if everyone went in and won that amount of money, they’d go out of business. It only works because most people lose money in system. Like gambling, insurance only works because most people don’t have vehicular accidents regularly. Some math people crunch the numbers and figure out how many customers they need at what monthly rates against x% of likely accidents in order to stay profitable.
Now imagine the absurdity of contacting your insurance company for the routine checkup on your vehicle. Imagine how broken the system would become if you invoked your insurance every time you had your tires rotated, or your spark plugs replaced. If the insurance company allowed these claims (they certainly wouldn’t), they would increase your monthly rates considerably. But imagine that the government has laws in place explicitly preventing them from increasing your monthly rates if you invoke your insurance too often, and other laws in place that will prevent insurance companies from denying your claims, no matter how mundane and predictable they are.
Within a few years, we’d have a completely broken auto insurance industry, with people clamoring for more government to fix it, when it was government that broke it in the first place. This is what has happened in the United States. People use their health insurance for every little thing: routine doctor visits, checkups, physicals, flu shots, penicillin prescriptions, you name it. And we do have laws on the books that prevent them from dropping people entirely for this, and from increasing their rates for such ludicrous behavior.
Moreover, you have people like me who exercise regularly and take pretty good care of themselves, are young and in good shape, and who simply have no need of health insurance. What can the health insurance company do to entice me to buy insurance from me? They could offer me lower rates and better benefits, right? Similar to how life insurance companies offer you things like “Pay us $12 per month for this $300,000 life insurance policy, and your monthly rate will never increase!” because they have calculated the odds, and they know that a person who does this every month, based on average life expectancy, will give them a profit. They’re not in this to lose money. Life insurance companies want you when you’re young, and so they offer you very low rates and offer to lock them in, no matter what.
Yet laws prevent them from offering me health insurance below certain thresholds. And even if they could do so, the system they have set up with doctors and hospitals ensures that, if I go in for a broken arm, I’ll be hit with 47 tests that I don’t need and be slapped with a $19,000 bill. Young and healthy though I am, they can’t profit from that. They created that bed, though. The horrific cycle began when insurance became common enough that doctors began running tests on everyone who had it, whether they needed it or not, producing huge markups for them and enormous profits. And the insurance companies didn’t really care, because they weren’t the ones paying for it–the healthy, young people who didn’t ever use their insurance were the ones paying for the $900 bag of saline. What did the doctors care? They could instead pocket the $870 profit. What did the insurance company care? The doctors were literally helping them by inspiring more people to get insurance in order to pay for these exorbitant costs. Hospital visits went from $200 a night to $4,000 a night, so many people sighed and said, “Well, I have no choice… I need to get health insurance, or I’m not going to be able to afford to go to the hospital.”
Bam! The insurance company got a new customer, thanks to the doctor, and the doctor got to run more tests, because now someone else had insurance. Everyone got to make more money.
What happened next was predictable. Tons of people like me–ordinary, healthy young people–saw this ridiculous state of affairs and decided that we had no reason to take part in it, because we were the ones being exploited to pay for this bullshit. If we refused to play, then they couldn’t be paid. And, again, what happened next was predictable:
The Affordable Care Act. A law forcing us to buy health insurance that the doctor/insurance company circle jerk could continue.
Europe & America
The American system has problems primarily because of government intervention. Contrary to what they believe, though, the European system has problems, too. If the two existed in bubbles, then by the year 2117, the United States would be, on average, eighty years ahead when it came to medicine. The only reason the European System has not stagnated entirely, as its research steadily slows, is that it is literally benefiting from research being done in the United States. We’re not selfish assholes, contrary to what the rest of the world thinks. When we finally cure AIDS, who is going to benefit? Everyone. We’re not going to refuse to teach the Europeans, Africans, and Asians how we did it. We don’t keep our ground-breaking research to ourselves. We share it with everyone, even those who demonize us and are too uninformed and too stupid to realize that the entire reason we have this ground-breaking research is that we allow our pharmaceutical companies to become very, very wealthy.
It’s true that if a cancer cure was developed tomorrow it would be extremely expensive, just as the television was in 1948. Almost no one would be able to afford it. But look around today! Most people have at least two televisions in their homes, and some people have a television in every single room except the bathroom. The microwave oven, the refrigerator, the cellular phone, the home computer… All technology follows that same arc where it begins very expensive, as a reward to the innovators who created it, and steadily gets cheaper as time goes on. Yet that reward, that possibility of hitting this tremendous breakthrough and the next Must Have item or medicine is precisely what motivates people to do these things in the first place! If you take that away, then… Well, you’ve taken that away, and the tech development stagnates. We’ve seen it time and time and time again.
Venezuela’s president recently put forward, no joke, the idea that the people of Venezuela should breed rabbits for food.
That’s the end result of eliminating competition and the profit motive. You get this Looney Tunes suggestion that even Trump would be embarrassed to admit he came up with as a legitimate and serious plan for addressing the starvation. This always happens. It has happened every single time the state has a monopoly over something. Monopolies are stagnation, and socialism is social stagnation, because it gives one group a monopoly on the whole of society. Medical stagnation is the predictable and obvious result of socialized medicine. Rationing is the first symptom, as too little supply is stretched over too much demand, like we see in the UK with its grave doctor shortage.
Even with our assistance, the European system will stagnate. It is already beginning to do so. The end result is inevitable: a drastic decline in the quality and quantity of health care. Who will they blame next? Ah, we know what they’ll say.
“It wasn’t real socialism.”
* Obviously, it isn’t free–it’s socialized. If everyone pays 10% of their wealth for the next 40 years for that cancer cure, then it was most certainly not free.