"Change" and "new direction" isn't always for the best, or even good.
Wannabe presidential candidates are peddling new and improved snake oil for our healthcare ills, as usual. Now, while snake oil may well be a cure for some conditions, it's going to aggravate rather than ameliorate most.
It's almost funny to hear some supposedly "pro-choice" candidates also describing their "anti-choice" goals in healthcare. For example, Democrat presidential candidates Hillary Clinton and John Edwards both advocate forcing no-choice government health-system management on everyone in the country.
Edwards' official campaign Web site calls for "requiring all American residents to get insurance." This actually means everybody would be forced to pay for insurance, whether a person wanted it or not.
And when asked by a reporter if people could opt out of his plan, Edwards flatly said, "You don't get that choice."
These aren't the only politicians who have promised a program for every problem. But each new program seems to generate at least several new problems. Plus, many such "problems" turn out to be bogus. The resultant boondoggles continue to plague the country.
As I've described before, implying that the government can guarantee or provide universal health insurance is a phony remedy for the phony problem of "the uninsured."
Another such "problem" was the widely touted claim that the Medicare system was rife with fraud and abuse, costing taxpayers an extra 10 percent. This "10 percent fraud" figure came from an article in a highly respected medical journal, which analyzed a number of other reports. The problem is that all the reports and analyses boiled down to estimates, as revealed by subsequent analyses.
In other words, the 10 percent figure itself could be fraudulent.
Over a decade ago, I asked Sen. Patty Murray's healthcare staff people why the proposed Kennedy-Kassebaum HIPAA law included up to five years jail time for health insurance fraud. They told me these new government powers were included because of all the talk about this 10 percent fraud figure. (Oh, yes, this insurance fraud couldn't be penny-ante; it had to cost the insurance company at least $100.)
Sen. Murray's people didn't look kindly on my suggestion that it would only be fair to call for the same penalty for any $100 fraud, not just health insurance fraud, even if a U.S. senator perpetrated the fraud. The staffers promptly ignored my request for equal justice under law.
The Kennedy-Kassebaum (HIPAA) bill became law in 1996 (Public Law No: 104-191). Today, to solve this fabricated 10 percent-abuse problem, the law requires spending more than $1, billion every year to make sure doctors and hospitals follow Medicare rules. The money has to be spent on education and enforcement of the law.
As a result of the law, government prosecution for purported fraud, including inflammatory news releases, has ruined the careers of many excellent doctors. Some doctors have been locked up in federal prison, for insurance fraud equalling less than $100.
Yet, at the same time, the government blithely allowed insurance companies administering the Medicare program a $200,000,000 "error threshold" before even considering the possibility of investigation or prosecution. None of the insurance company people involved in this particular fraud even lost their jobs, according to whistleblower Theresa Burr.
Political demand for "integrity" of the Medicare bureaucracy has trumped the basic human need for simple justice and equality under law. Although Medicare law applies to "any person," federal investigators and prosecutors apply these laws very selectively and very unequally to different persons.
As noted above, a physician has had his career ruined for a purported $100 infraction. Yet, insurance company employees have been promoted and the company has been awarded more contracts from Medicare, despite evidence of losing hundreds of millions of tax dollars needlessly.
In another example of a problematic problem, the "prestigious" Institute of Medicine's Committee on the Quality of Health Care, issued a report, "To Err Is Human: Building a Safer Health System" eight years ago. The Committee claimed that somewhere between 44,000 and 120,000 patients died each year because of human error.
Of course, the Committee quickly followed up with another report advocating more money and power for its own agenda as well as more government involvement. It had no doubt that something should be done.
And, sure enough, legislation showed up in the U.S. Congress the very next day.
Yet again, subsequent analyses showed that many of the errors included in the count had nothing at all to do with the patient's subsequent death. False counting produced the phony problem.
Now, a lot of time, money, and other resources are now spent on trying to prevent errors, instead of actually helping people.
If someone wants to be absolutely free of human medical error, all a person has to do is to avoid any and all contact with the medical system.
All the talk about these purported problems reminds me of the story attributed to the 19th century political leader Lord Thomas Macaulay. Over a century ago, in response to parliament members shouting "Reform! Reform! Reform!" Macaulay responded "Reform? Reform? Don't talk to me about reform. Things are bad enough as they are!"
Another common feature of these solutions is a greater focus on increasing government power over American's lives. Naturally, many of the people presenting the problems are just the same ones who have the solutions and who make big bucks when the government enforces the "magic bullet" solution.
Although I certainly don't believe we currently live in the best of all possible worlds, the question "How could we tell if we actually lived in the best of all real, possible worlds?" chastens me. In such a best world, human conditions overall would be better than at any other time; accidents, human error, sickness, poverty, death and evil would continue to exist, but would be minimal and produce less suffering than at any other time, in the past or in the future.
I don't remember the philosophers who have asked the question, but the answer is profoundly simple: Any change made in this best possible world would result in the world becoming a worse place. Think about it for a moment.
Given the demonstrable worsening of our lives at the hands of innumerable government programs and bureaucrats, change for the sake of change becomes much less compelling.
Instead of telling 100 Americans how to run their lives so as to indirectly help one American, I recommend presidential candidates promote helping that one person directly.
For example, I recommend presidential candidates not try to force all Americans to buy health insurance, in an attempt to force we uninsured to have health insurance.
I recommend presidential candidates help persons who want health coverage by promoting attractive alternatives to many of the current, expensive and overly regulated plans, such as by expanding the choices available under current Health Savings Account (HSA) rules.
I agree with Milton Friedman's common sense suggestion to restoring freedom in the medical system by reversing past actions, as published in the Winter 2001 issue of the "Public Interest" journal: "repeal the tax exemption of employer-provided medical care; terminate Medicare and Medicaid; deregulate most insurance; and restrict the role of the government, preferably state and local rather than federal, to financing care for the hard cases."
Editor's Note: Robert J. Cihak wrote this week's column.
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Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., comments on medical-legal issues and is a visiting fellow in economics and citizenship at the International Trade Education Foundation of the Washington International Trade Council.
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