Tuesday, November 10, 2009

A Better Way

Dr. Scott W. Atlas is a professor and chief of neuroradiology at Stanford University Medical Center and a senior fellow of the Hoover Institution at the university. He's an expert on health care and is very cool to the various health care reform proposals being bandied about by congressional Democrats. To read much of the reportage on the matter one might think health care in America ranks near the bottom of the Western world. In an op-ed piece in the Washington Times, however, Dr. Atlas points out that this simply isn't true:

Inexplicably, the facts published in the world's top medical journals about our system continue to be ignored:

  • Americans have the best survival rates from cancer and most serious diseases, and the most rapid decline in breast and prostate cancer deaths despite being hindered with severe obesity and the largest burden of smokers over 50 of any Western nation.
  • Americans have the most successful, most available treatment for chronic diseases like high blood pressure and high cholesterol.
  • Americans have the shortest wait times for life-changing surgeries, like cataract and hip replacements, that may not increase survival but greatly impact quality of life.
  • Americans have the best access to the newest, most effective drugs.
  • Americans have the quickest access to the safest, most advanced medical technologies.
  • Americans have the easiest access to specialty doctors, doctors of their choice, doctors who lead the world in health care innovation, regardless of what metrics are assessed.

Instead of solely considering costs, shouldn't we ask if Americans are willing to die sooner from cancer, to give up access to specialists, to be refused safer, more accurate diagnostic imaging, to lose the most accessible screening programs, and to lose their autonomy in pursuing treatments for their families? Shouldn't we ask if Americans want to replace the most advanced and successful medical care in history with the restricted care and lower cost social programs of Europe, and insure the less than 5 percent of people who don't buy insurance but receive care anyway?

What needs reformed is certainly not the quality of care. The problem is keeping the quality high while making it cheaper, and nothing the Democrats are proposing will accomplish that:

The Max Baucus plan is paid by massive taxes on existing insurance plans that exceed our government's arbitrary threshold and by significant cuts to Medicare. Its Federal Exchange overtly skews the playing field by subsidizing - directly or indirectly - insurance plans that meet government definitions, and by penalizing existing plans that don't, plans already held by millions of Americans. The House proposals force a government-run "public option" - an option that shifts huge numbers of privately insured Americans to become the burden of an already unsustainable, taxpayer-funded entitlement program that ultimately eliminates private insurance choices.

A public option would interpose bureaucrats between doctors and patients, restricting access to new drugs, to innovative new cures, and to choice of doctors. It is already proven a failure the world over, even by our own Medicaid program, where government-imposed, below-cost payments have created patients who cannot even find doctors to care for them. While Congress and the administration claim otherwise, costs to the taxpayer increase, and choice and access disappear with a public option.

Meanwhile, serious alternative solutions that reduce costs but do not harm the excellence already in our health system are totally ignored, including:

  • Allowing people to shop for insurance across state lines at competitive prices.
  • Stripping back on costly coverage mandates that most Americans may not value, like acupuncture, massage therapy, in vitro fertilization, and wigs.
  • Expanding the availability of high-deductible plans for catastrophic coverage with health savings accounts, making insurance a good value for the millions of Americans who can afford insurance but (perhaps wisely) don't buy it.
  • Bold tax reforms like refundable tax credits, cash even for those who pay no income tax, or vouchers instead of tax deductions, to foster personal ownership and control of insurance, creating millions of value-seeking shoppers.
  • Forcing doctors and hospitals to post prices, qualifications and outcomes - information that is essential to value-based purchasing and fundamental for stimulating competition.

Atlas could also point out the exorbitant cost of medical malpractice insurance and the expense of a medical school education. Both of these are costs that get passed on to the consumer, but the Democrats' are not inclined to do anything about either. Instead Democrats, if their plan is eventually passed, will make criminals out of those who don't want insurance and choose not to buy it. Under their plan, people who, for whatever reason, don't think they need health coverage will nevertheless be forced to buy it or pay a penalty. If they don't pay the penalty they will go to jail. This is an unprecedented abridgement of individual freedom in this country, but taking a way freedom is simply what progressives do whenever they have the power to do it.


Lots of <i>Assuming</i> Going On

There's an interesting article on human evolution at MSNBC. The piece starts out by claiming that Neanderthals were a separate species from modern Homo sapiens, but everything in the article suggests that Neanderthals and H. sapiens interbred and produced feertile offspring. Since the ability to produce fertile offspring is the distinguishing characteristic of a species the finding that Neanderthals and H. sapiens were interfertile would mean that they're really members of the same species.

Indeed, none of the alleged predecessors of modern humans are actually known to have been unable to breed successfully with H. sapiens. It's simply assumed that sexual unions between them would have been sterile because it's assumed that they were different species. And it's assumed that they were different species because it's assumed that H. sapiens is the culmination of a long evolutionary history with lots of ancestral species leading up to it. But, for all we really know, creatures like H. habilis and H. erectus could have been conspecific with H. sapiens. We simply don't know whether they were capable of producing fertile offspring or not.

Of course, if it were ever found that these members of genus Homo were all the same species it would throw modern human evolution models into a state of complete chaos, so I suppose we have to assume that they really were all distinct species.