In his State of the Union message, Barack Obama used the phrase “healthcare” 15 times, calling healthcare reform a “necessary move to help salvage the sagging economy.”
He blamed the “crushing” cost of medical care for contributing to bankruptcies and foreclosures, and said it had all but stymied growth among small businesses.
He proposes basing “wholesale change” on modernizing how care is delivered and pushing Americans to lead healthier lives. This means investing in “electronic health records that will reduce errors, bring down costs, ensure privacy and save lives” (Matthew DoBias, HITS 2/25/08).
The “stimulus bill” provisions for health information technology and comparative effectiveness research (CER) appear to dovetail with these stated objectives. Obviously, entering data into a computer does not prevent or cure any illnesses, nor will spending $1.1 billion on CER lead to any new treatments—it is not designed to do so.
So what do they do? AMA denials notwithstanding, they set up the mechanism for monitoring the rationing of care through enforcement of “evidence-based” medicine.
“Variations from these best practices should be defined as medical errors and their causes and corrections should be pursued,” stated Robert F Meenan, dean of the Boston University School of Public Health.
Problems with the “evidence” include: researcher bias, discordant results, insufficient reporting, and fraud, writes Twila Brase, R.N., P.H.N. (“Evidence-based Medicine Is Rationing Care, Hurting Patients,” The State Factor, December 2008). Half the guidelines are out of date within 6 years, yet only half of the 18 prominent guideline organizations worldwide have a formal procedure for updating them. Practitioners are expected to comply in blind faith, Brase observes. Only 7.5% of 279 guidelines describe how the developers combined evidence and opinion.
Would universal health care (and its rationing mechanisms), like that in other developed countries, save the economy? The financial crisis is worldwide. Britain and Ireland have already nationalized banks, and the German cabinet passed a law permitting it to do so.
Germany has agonized over Enteignung (expropriation) of shareholders, a term linked to the Nazi seizure of Jews’ property in the 1930s (Myra MacDonald, Reuters 2/18/09).
Europe is even further along the way to national bankruptcy than the U.S., owing to its even more extensive social welfare programs. The total burden of EU countries under current policies is approaching 40% of GDP, and will exceed 60% of GDP by 2050 if current policies continue, with rapid aging of the population and below-replacement fertility (Jagadeesh Gokhale, “Measuring the Unfunded Obligations of European Countries,” NCPA Policy Report 3319, January 2007).
The average financial shortfall of EU nations is more than 8% of the present value of all future GDP. This means that, in addition to all projected tax and other revenues, the average country would have to have more than four times its current GDP in the bank, drawing interest, to fund current policies indefinitely. Of course, no nation has that much money in hand, so the gap will have to be closed by changing taxes and/or benefits.
For 2004, the fiscal imbalance for the UK was 6.5%, for Germany, 9.2%, and for France, 9.8%. For the U.S., it was 8.2%. The fiscal imbalance increases for each year that action is not taken; the U.S. shortfall grows by more than $1.5 trillion/yr.
The correct approach, Gokhale writes, is gradual but significant reduction in dependence on government-provided social insurance in favor of private saving.
What does the current regime mean to do? The predictable results of stated plans: Enteignung (expropriation) of private resources; stringent rationing of medical services; government-dictated treatments; ever heavier mortgages on our posterity.
Can we rebuild the economy by wrecking American medicine?
- “Voluntary Health Insurance—the American Way,” AMA pamphlet c. 1945 (Truman was president, and the fourth or fifth effort to enact the Wagner/Murray/Dingell bill was defeated.)
- “The Morning After,” AAPS News, December 2008.
- “Economic Fascism” by Thomas DiLorenzo, AAPS pamphlet, February 1995