Alice in Medical Care
Thomas
Sowell Tuesday,
June 30, 2009
Most political
and media discussions of medical care have an air of unreality reminiscent of
Alice in Wonderland. There is an abundance of catch-phrases but remarkably few
coherent arguments.
Let's start at
square one. Why is there alarm about American medical care? The most usual
reason given is because its cost is high and rising.
That is certainly
true. We were not spending nearly as much on high-tech medical procedures in
the past because there were not nearly as many of them, and we were not
spending anything at all on some of the new pharmaceutical drugs because they
didn't exist.
This general
pattern is not peculiar to medical care. Cars didn't cost nearly as much in the
past, when they didn't have air-conditioning, power steering and high-tech
safety features. Homes were cheaper when they were smaller, had fewer bathrooms
and lacked such conveniences as built-in microwave ovens.
We would like to
have all these things without the rising costs that come with them. But only
with medical care is such wishful thinking taken seriously, with government
regarded as a sort of fairy godmother who will give us the benefits without the
costs.
A cynic is said
to be someone who knows the price of everything and the value of nothing. If
so, then it is political cynicism to point to other countries that spend less
on medical care, including some countries where there is "universal health
care" provided "free" by their governments.
Just as medical
care, houses and cars were all cheaper when they lacked things that they have
today, so medical care in other countries is cheaper when they lack many things
that are more readily available in the United States.
There are more
than four times as many Magnetic Resonance Imaging units (MRIs) per capita in
the United States as in Britain or Canada, where there are government-run
medical systems. There are more than twice as many CT scanners per capita in
the United States as in Canada and more than four times as many per capita as
in Britain.
Is it surprising
that such things cost money?
The cost of
developing a new pharmaceutical drug is now about a billion dollars. Neither
political rhetoric nor government bureaucracies will make those costs go away.
We can, of
course, refuse to pay these and other medical costs, just as we can refuse to
buy air-conditioned homes with built-in microwave ovens. But that just means we
pay attention only to prices and not to the value of what we get for those
prices.
We can even
refuse to pay for so many doctors. But that just means that we will have to wait
longer to see a doctor-- as people do in countries with government-run medical
systems.
In Canada, 27
percent of the people who have surgery wait four months or more. In Britain, 38
percent wait that long. But only 5 percent of Americans wait that long for
surgery.
Surgery may well
cost less in countries with government-run medical systems-- if you count only
the money cost, and not the time the patients have to endure the ailments that
require surgery, or the fact that some conditions become worse, or even fatal,
while waiting.
A recent report
from the Fraser Institute in Canada shows that patients there wait an average
of ten weeks to get an MRI, just to find out what is wrong with them. A lot of
bad things can happen in 10 weeks, ranging from suffering to death.
Politicians may
talk about "bringing down the cost of medical care," but they seldom
even attempt to bring down the costs. What they bring down is the price-- which
is to say, they refuse to pay the costs.
Anybody can
refuse to pay any cost. But don't be surprised if you get less when you pay
less. None of this is rocket science. But it does require us to stop and think
before jumping on a bandwagon.
The great haste
with which the latest government expansion into medical care is being rushed
through Congress suggests that the politicians don't want us to stop and think.
That makes sense, from their point of view, but not from ours.
URL: http://townhall.com/columnists/ThomasSowell/2009/06/30/alice_in_medical_care?page=full