Ijust finished reading Edwin Hus- tead’s article, “National Health
Insurance—Socialism or Realism?” in
the September/October issue of
Contingencies and would like to respond to
his contentions that a public option will
lead to lower costs and greater efficiency.
With respect to cost, can anybody
point out one instance where the federal government has ever actually
lowered the cost of anything? The very
notion defies common sense and centuries of experience, both here and all
over the world. The fact that Medicare
is vastly more expensive than the experts promised us it would be, and is
going broke already, is mentioned nowhere in this article.
In Canada, Britain, and other places where the state runs the health care
system, it’s not uncommon for people
to be forced to wait for months for
needed services, such as a mammogram or a colonoscopy. By the time
it’s your turn in line, it’s often too late.
It seems that these systems don’t so
much lower the cost, as simply refuse
to pay the cost.
With regard to efficiency, the author
seems to be unhappy with all the messy
confusion caused by “tens of thousands
of different plans offered through thousands of insurers and other entities.” In
the old Soviet Union, if you wanted to
buy a car, you didn’t have to be bothered
with lots of confusing choices about
make, model, features, or color. There
was only one car, it came with whatever
features the government bureaucrats decided it should have, and it came in only
one color. And it was a piece of junk. So
is the case with Canadian-style health
care all over the world, and so will be
the case with our health care system if
the feds ever get control of it.
I cannot help noting that socialism
is still socialism, however “realistic”
it may appear to be to its defenders.
Changing the language, or declaring
certain words to be out of bounds, may
be an effective debating tactic, but it
doesn’t require reality to follow suit.
were complicit in the fiscal child abuse
that is the predominant legacy of our
politicians. I hold out the hope that Ed
will supplement his article with an actual actuarial look at Medicare.
fiscal child abuse
Ed Hustead’s paean to Medicare (“Na- tional Health Insurance—Socialism
or Realism?”) is actuarially appalling.
He fails to mention the cost-shift-ing that imposes hidden taxation of
many billions of dollars annually on
those who use private means to obtain
medical services. So much for transparency in government. Far worse, he
completely ignores the $80 trillion of
actuarial debt that has been foisted
(so far!) on future generations, otherwise known as non-voters. So much for
fulfilling the actuarial profession’s responsibility to the public.
The reputation of the actuarial profession will be shredded over the next
decade or so if it can be shown that we
open markets Work Best
Edwin Hustead’s commentary (“Na- tional Health Insurance—Socialism
or Realism”) provides ample opportunity for counterarguments in a number
of areas. I will limit myself to just two.
First of all, he argues for Medicare as
a model single-payer system using that
old saw that the administrative cost of
Medicare is only 1. 5 percent of health
care costs, and then suggests that the
largest (and supposedly more efficient)
private plans require at least 5 percent.
This has always been a questionable
comparison. The 1. 5 percent figure reflects only direct costs to the Centers
for Medicare & Medicaid Services,
and doesn’t reflect the costs of other