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Home > Free-Market Toolkit > Fifty Fallacies About Health Care
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Fifty Fallacies About Health Care

By Richard E. Ralston

Continued from Page 1

12. "Huge jury awards in medical malpractice suits do not increase health care or insurance costs."

When you hear this, ask where the money comes from to pay the hundreds of millions of dollars in contingency fees that go to some trial lawyers every year. Ask whether these lawyers really care only about the "little guy." Ask why so many physicians and surgeons now have to pay liability insurance premiums of far more than $100,000 a year. (No, the insurance companies do not keep it all or lose it in the stock market.) Ask how the government legal framework and court management for our tort system is set up to encourage lawyers to convince so many juries that all patients live forever in perfect health unless a physician or hospital makes a mistake. Ask how much is paid in political contributions every year by trial lawyers to buy protection for this legalized extortion. Ask how some law firms were able to hire one radiologist to review more than 600,000 x-rays and diagnose most of them with the same disease. Ask how many billions of dollars are wasted on unnecessary tests and procedures that physicians have to order to protect themselves from frivolous lawsuits.

13. "When the Association of Trial Lawyers of America changed its name in 2006 to the American Association for Justice, did that not prove the true purpose of the organization?"

That only proved that they thought the name "American Association for Sincerity" was already taken. Their market research indicated most Americans had a low opinion of trial lawyers. That low opinion was unfortunate, because it was based on the action of only some trial lawyers—most of whom provide needed services to their clients. But who did they think there were fooling? It was an act of transparent hypocrisy. Their new name absurdly assumes that judgments favoring plaintiffs always reflect justice, and judgment favoring defendants always reflect injustice. If that were the case, juries could be dispensed with so judges could always find for the plaintiff. Although they claim their only interest is protecting "the little guy," a more accurate name would have been the "American Association for Huge Contingency Fees."

14. "The best way to reduce the debt and federal spending is health care reform."

Ask how the largest entitlement program in history, administered through more than one hundred new boards, agencies and commissions, will reduce spending and government debt. Ask how Medicare and Medicaid have reduced spending and debt.

15. "Members of Congress resist government control of medicine because of political contributions of drug and insurance companies and their lobbyists."

Some may be motivated by such financial considerations. But other politicians eagerly threaten those corporations with legislation that would do great harm or put them out of business completely. In the face of such threats they have the right to protect themselves. Those who are offended by these contributions are strangely unconcerned by $1 billion in campaign contributions from trial lawyers since 1990, massive political contributions paid for by the dues of members of public employee unions or by politicians who extort contributions from the American Medical Association through annual threats to lower Medicare reimbursements to physicians. Fastidiousness about political contributions is unconvincing when it is so highly selective.

16. "Congress will pay for whatever is required by health care reform in a way that is budget-neutral."

It never has—certainly not for Medicare, Medicaid or the Prescription Drug Program. Health care reform proposals pretend to do that, which is why they rely on creative accounting gimmick—such as combining ten years of new taxes with only six years of new spending. As a rule, politicians who seek more power do not spend a lot of time worrying about how to pay for that power. That is a detail. The important principle for them is an ancient one, "bread and circuses." They will promise anything to those citizens who surrender their choices and rights in return for a promise to take care of them. Dependence on government and politicians is the goal, and end in itself.

17. "Government-owned insurance companies must be created to provide competition in the marketplace."

It is a clear principle of the philosophy of law that government, or the "Sovereign," cannot compete—it can only compel. Competition does not exist because by law and regulation the government does not permit it. Advocates of such government insurance have clearly stated that they support it only because it is the best path to a single-payer system or complete government takeover of insurance. As Congressman Barney Frank said, government insurance would soon "demonstrate the strength of its power" and wipe out all private insurance. A public option would be created by Congress for that purpose and would then be administered by the government with that goal. An optional trigger to create a public option would be administered by those looking for any excuse to pull it. That would be the inevitable result of a game in which the government is the dealer, the cashier, the banker, the rule maker, the policeman and the judge.

18. "Support of a vast expansion of government control of medicine by drug companies means reform must be good for business."

When drug companies abandon a moral and economic defense of their business in favor of buying influence or making a deal within the spoils system, they have started down a road to their own destruction. As has the American Medical Association, which long ago gave up any defense of the rights of physicians to practice medicine as they think best, in favor of transforming themselves into a public employee union going checks-in-hand to Congress every year to prop up the size of Medicare reimbursements. When businessmen and professionals flee from their principles to play the political game, they will discover that politicians can play it far more effectively. The bribes will progressively buy less and less, and politicians will forget their new friends and move on to more lucrative conquests. Then Big Pharma will find itself without principles, without friends and without the resources to continue what has been the most productive drug research in human history.

19. "Health care reform would be supported by the public if politicians would just give straight answers about legislation."

Members of Congress cannot give straight answers about thousands of pages of legislation they cannot read or understand themselves. They may have a vague idea of whether special provisions to serve the special interests they support have been slipped into the bill. They may know that it authorizes additional taxes for ten years but additional spending for only the last six years so the result will be "balanced" on a ten-year basis. The last thing that advocates of such a shell game want to bring to the discussion is the clarity of straight answers.

20. "The government should require all senior citizens to receive end-of-life counseling."

End-of-life counseling is important, although receiving it many years in advance of death will not always provide sufficient guidance when it is most needed. But the government has no business forcing seniors to submit to such counseling. Americans are correctly concerned that a government that pays for such counseling and the cost of care will seek to set the terms of the counseling, or to place emphasis on the financial advantages of dying sooner rather that later. Government must never make or force end-of-life decisions.

21. "Old age is not a disease."

That idea is the reason that the Food and Drug Administration has no interest in research on drugs and supplements that would extend healthy life spans. Death from old age is not officially a disease. The FDA does not care if and when you die, as long as you are not sick when it happens. Admittedly the rigidity of the FDA's methods does not lend itself to such research. If a supplement demonstrates promise for extending life spans, the FDA would probably require a thirty-year clinical trial to approve it. If approved they would then require another thirty years of "comparative effectiveness" studies to make sure it works better than everything else. By then we would be dead, but the FDA will have kept us safe. If that seems ridiculous, remember all of the terminally ill patients who have died in recent decades while being denied access to existing drugs approved years later by the FDA.

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