Wednesday, July 29, 2009

Why Not Socialized Medicine?

Anonymous said...

Dear Dr. Langbert:

Why should we be afraid of "socialized medicine"? The government runs health care for our service men and service women. The health care for our military is first rate. You get health care from CUNY. Under their plan you are covered even for dental care. The Senators and Congressmen get their health care from the government. They, too, have excellent coverage.

So the military, the Congress, and you are part of the "socialized" medicine system in this country. I have not heard you complain about the quality of care that you receive.

Mitchell Langbert said...

We should not be afraid of socialized medicine. We should recognize it as another potentially mismanaged government program that will reduce standards and intensify the 30-year decline in the real hourly wage. Take a trip on the New York City subway. The service irregularities, filth, often rats scurrying around. Now, project the same incompetence to health care. A few years ago there was a major scandal about the Veterans Administration hospitals, where the veterans were being kept in filth. Do you wish to treated in a hospital run by the same people? Have you visited a DMV office lately?

Now, you mention CUNY. CUNY does not provide me with care. They pay for the care I receive. The care is provided by an independent hospital that makes its own decisions and has to compete with other hospitals. That is not what is being proposed now. That is to be eliminated.

As far as the CUNY dental insurance, the benefits were repeatedly reduced between 2000 and now to virtually nothing. We no longer have meaningful dental insurance. What is to stop Washington from similarly reducing health benefits?

That is their plan. I do not deny that the current system has resulted in waste. The reasons are complex and many of them would be resolved by a single payer system. But that system would result in government controlled rationing and an elimination of medical innovation.

The problem with socialized health care (which is NOT the current proposal) is that it causes stagnation. There is one country that has been responsible for the majority of pharmaceutical and health care advance: the United States. There is also one country with a non-state-dominated financing system: the United States. Proponents of national health insurance aim to manage the cost of health care by REDUCING TREATMENT (and eliminating innovation). The reason that national health insurance is cheaper in Canada is that the Canadians limit treatment. Much of this is for unnecessary care, which is an advantage. But also, they will reduce innovative or new treatment.

Thus, a national system will enjoy economies of scale and possibly better management in some ways, but it would eliminate innovation. It would enable government officials to pull the plug on treatments that they deem inappropriate. Obama proposes this by requiring counseling to the elderly not to receive treatment but to die on narcotics. That is the crux of the reason why costs are lower in Canada and in Europe. Is that what you want, to be told to die when you are old?

Since the bureaucratic approach to government management has been an abject failure elsewhere in our society, why do you believe it to be an effective method when applied to health care? Veterans DO NOT receive "first rate" care. The standards at the veterans hospitals have been an ongoing scandal. Like everything else government touches, the veterans hospitals have been turned into sh*tholes.

The potential for break through cures that significantly extend life will be staunched by national health insurance. A decentralized system can support innovation much better and will facilitate the application of new and different treatments.

National health insurance is failure of the American dream. The Declaration of Independence states that all of us are entitled to "life, liberty and the pursuit of happiness". Socialized medicine attacks liberty; it circumscribes and attacks the right to life; and it limits the pursuit of happiness.


Anonymous said...


You are correct here. I have dealt with the VA hospitals in my city, and there is no way for anyone with a brain to say that the care is "first rate". Maybe in NY they are great, but I think this anonymous poster has to get out a bit more. In fact, I have been to a few, and frankly they are dumps.

You are also correct that this would stifle innovation- why? There is not a sound reason to invest the $800M in successfully launching a new drug if you are not going to recover a sound profit.

Now, more than ever, be well.


Mitchell Langbert said...

One of my friends from summer camp, Gary Nordine, became a career Army guy. He suffered an illness in his late 40s and died at age fifty in a VA hospital in NYC. His wife (whom I also knew from the same camp) contacted me to tell me of his death. I had last seen them about ten years earlier. She was quite clear about the dismal quality of the VA hospital in NYC. It is not improbable that had Gary had the level of care that Michael Moore and Barack Obama would receive under a state controlled system, he would have lived.