There's been no shortage of nonsense and misinformation regarding opposition to President Barack Obama's plans to overhaul America's health care system. Unfortunately, the recent contribution on these pages by Pinchas Landau only makes matters worse.
In his column "Better dead than red" (September 4), Landau posits that only American selfishness and paranoia of anything labeled "socialized medicine" can account for what he deems unthinking, irrational opposition to governmental takeover of one-sixth of the US economy. He summarizes all American opposition to nationalization thusly: "Better that they (the poor, elderly, etc.) die than that we use part of our massive wealth to provide them with health services commensurate with our country's capabilities."
Well. That's an interesting perspective regarding a country that already provides substantially free medical care to 30 percent of its population - some 87 million poor people and seniors (heavily subsidized) through Medicare and Medicaid at a cost of approximately $900 billion, or more than $10,000 per recipient per year.
Landau compounds his spurious assessment with "amazing facts" (i.e., one easily refuted statistical canard after another). To begin with, he contends that "at least 25%-30%" of Americans (75 to 90 million people!) have no health insurance. Please. Not even the shrillest advocates of nationalization use such exaggerated figures. According to Census Bureau data, the actual number is 15%.
And even that doesn't tell the story. About half of those are not poor, but voluntarily choose to be self-insured. The actual number of "involuntary uninsured" is around 20 million, about 7% of the population - not surprising with an unemployment rate at 10%. And about half of those are illegal immigrants.
Landau claims that "hordes of obese Americans" - his kind words - and their doctors waste "mind-boggling" amounts of money on care that could have been addressed far more cheaply by preventive measures. Notwithstanding his medical expertise on what screening and prevention is appropriate for each individual American, even the Congressional Budget Office refutes his assumptions of cost-savings.
Preventive care may be invaluable where appropriate on an individual level, but it certainly isn't free, especially when used indiscriminately. CBO Director Doug Elmendorf notes that the definitive assessment in the New England Journal of Medicine reviewing hundreds of studies on preventive care found that more than 80% of preventive measures added to medical costs.
HE IGNORES the one area where mind-boggling money actually is wasted: doctors practicing "defensive" medicine; ordering needless tests with an eye on preventing malpractice suits. Yet Republican-supported tort reform has been squelched by Democrats protecting their generous constituency of trial lawyers.
Perhaps Landau's most outlandish claim is that "20,000 [Americans] die every year because they have no medical services accessible to them." Such a figure should make our nonsense-detectors set off alarms. Inaccessible? Federal law requires hospitals to treat emergency-room patients regardless of insurance or ability to pay, and there are thousands of clinics offering free care. More importantly, Landau's figure comes from a "study" debunked about 10 minutes after release: The researchers asked people if they had health insurance; if they did not, and then died at any time in the next 10 years (whether or not they later got insurance), their death was attributed to lack of insurance, regardless of actual circumstances of death. By that standard, having insurance kills about 3 million per year.
America has good reasons to be wary of further socialization of its medical system. Current government medical spending is spiraling out of control, and - even according to Obama - is racked with fraud (currently $90 billion per year) and corruption. The current Obama-supported plans anticipate $1 trillion in new federal spending, add layers of bureaucracy (imagine the Post Office in charge of medical care) and a battery of new taxes that will drive up medical costs (confirmed by Obama's own HHS Office of the Actuary) - and will still leave millions uninsured. Yet, Landau suggests, opposing these plans is "McCarthyite"?
Americans have watched Canada's socialized system degenerate over the years - now "imploding," according to the new president of the Canadian Medical Association. Canadians, with only a 10th of the US population, wait weeks for everything - an average of nine months for orthopedic surgery and seven months for neurosurgery. Of course, Canadians frequently employ another option: Over the past 10 years, more than a million Canadians have declined their "free" care and crossed the border to pay for needed services in American hospitals.
American survival rates for diseases, perhaps the single-best measure of health care quality, are still unsurpassed. For example, for cancer - a disease where socialized medical wait-times can be lethal - American men have a 40% greater five-year survival rate than Europeans. American women have a 24% advantage. Why ruin that?
There are legitimate arguments for and against increased socialization of American health care. Landau's misinformed diatribe, however, does not advance the discussion.
The writer is an American attorney and political commentator currently living in Jerusalem. He serves as Counsel to Republicans Abroad Israel.