Fifty Fallacies About Health Care
By Richard E. Ralston
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22. "Government insurance mandates will decrease the cost of insurance premiums."
Forcing everyone to buy insurance (or anything) will drive up the price. Forcing coverage for treatments or conditions for which everyone does not want coverage will drive up the price. Forcing young people to buy insurance will cost them a lot more if it used to cover insurance for older Americans. Requiring men to pay as much as women will increase premiums for men, even though they die younger. (It is not fair that men stop paying for women's insurance just because they are dead.)
23. "Too many medications are wasteful and unnecessary. The government must decide which are the most effective and forbid the use of any others."
When you hear this, first ask how much it will cost the government to do this and how long it will take. Do you want to pay that additional cost? How many years are you willing to wait for a drug you need while the government decides this? Do you want to decide, for example, if Excedrin or Advil relieves your headache most effectively? Or do you want the U.S. government to tell you? Do you want your doctor to decide if a drug will save your life, or do you want to wait for the government to decide? Should a drug be forbidden for a woman because it does not work as well for men? Or forbidden for a member of one race because it does not work as well for all races? Or do you want your doctor to treat you as a unique individual with your own needs? One of the most promising areas of medical research is personalized medicine, developing treatments based on each patient's genetic information. Will a huge government "comparative effectiveness" bureaucracy eliminate that research? Should the use of drugs that work best for you become a crime?
24. "Insurance companies can afford huge malpractice settlements, and doctors can afford large liability insurance premiums."
Ask who we really think ends up paying those premiums. Ask how much the fear of second-guessing and litigation has increased the use of unnecessary and expensive testing and treatments, and how much other "defensive medicine" has driven up the cost of health care and health insurance for everyone.
25. "Governments provide their citizens with free health care."
Point out that government cannot create anything, but rather it can only take things. Health care, like everything else, is ultimately made possible by business activity. What a government means when it says it is giving you something for "free" is that it is forcing you to pay for something whether you use it or not, or taking something from you to give to someone else.
26. "Countries with nationalized health care systems provide their citizens with all the health care that they need."
When you hear this, ask why Canadians travel to the United States every year and spend $1 billion on American health care. Ask why Americans have more access to MRI and CT scan equipment and more of the new breakthrough drugs. Ask why Americans have better survival rates for cancer and heart attacks. Ask why more than one third of physicians employed by the National Health Service in Britain buy private insurance, and why six million of their potential patients in Britain also buy private insurance, when government health care is free. Ask why so many British citizens waiting for free surgery and cancer treatment fly to India to pay for it, and ask why no one, other than Michael Moore, is jumping on a boat to get free health care in Cuba.
27. "Physicians must provide any services that the government requires because they are indebted to society for their medical education."
The first answer to this is that "society" did not spend many years of intense, dedicated effort to complete a medical education. Individual physicians did that, most of them accumulating a lot of personal debt in the process. But the most important answer is that, while many of us experienced public education (of inconsistent quality), we do not owe anyone anything. You might be grateful to some but not all of your teachers. You might be grateful to your parents for their taxes that paid for your education. But that does not mean that you must accept an undefined, unlimited and eternal moral obligation to everyone that ever has been or will be alive because you received a public education. Of course, this argument indicates that, for some people, imposing such an obligation might be the purpose of public education: if the government provides a part of your education, it owns you for life.
28. "Health care is very important, so the government should control all medical practices and health providers, to give everyone all the health care they lay claim to."
When you hear this, say, "Not in America. Our own health must never be handed over to government because it is so important.
29. "The government must take over health care to control increasing costs."
Ask when the government has been able to control the cost of anything, let alone something as technological, complex, personal and dynamic as health care. Ask why the cost of health care managed by the government has been increasing so rapidly. Ask, "What is the cost of cost control? How much do current cost-control efforts add to the amount of paperwork and expense of billing? How much would ever more controls add to the cost of health care?"
30. "The Food and Drug Administration must be given more powers and funding to control the development of drugs."
When you hear this, ask, "How many terminally ill patients have died while waiting for drugs later approved by the FDA? What does the FDA approval process add to the cost of new drugs? Why does the FDA spend years trying to determine how drugs might work in every possible instance, while losing track of safety issues? Why do clinical trials using terminally ill patients require that half of the dying patients be given a placebo instead of the new drug? How has the enormous power of the FDA become a magnet drawing those with a political agenda to manipulate and manufacture clinical research to serve their objectives?
31. "The Food and Drug Administration must create a new agency to evaluate new drugs for comparative effectiveness with other drugs, after they have spent years being evaluated and tested before being approved for safety and effectiveness."
Ask how much longer that will add to the time needed for new drugs. Ask what that will add to the cost of each new drug. Ask how new clinical trials will be able to compare the effectiveness of drugs that meet the unique needs of each gender and of different ethnic and age groups. Will your gender or ethnic group be denied medications that work better for them but not for all groups? Ask how all drugs can be compared in this way when some individuals respond differently to many drugs, and what will happen when a drug that is the only thing that helps some people is prohibited because something else works for others. (Ask whether the government should decide that, if ibuprofen works better than aspirin for most people, aspirin should be prohibited even if it works better for you.) Ask what will happen to the development of new "personalized medicine" that targets only a few individuals if the government requires that everything work the same way for everybody.
32. "The government should spend billions more on medical research to cure more diseases."
When you hear this, point out the most distinguishing factor of government medical research: it never has to actually get results. Private research is always more efficient and gets results because it has to in order to pay for itself. Also point out that government research funds are often allocated to "politically correct" diseases based on the political pull of the constituents for those diseases, rather than to areas that are more auspicious for research. Invested funds are always more productive than dollars taken from taxpayers.
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