Naming the cause of medicine's failures

Paul Jacob

4/27/2008 12:00:06 AM - Paul Jacob

The trouble with making government the solution for our medical system’s failures is that government is without a doubt the chief cause of those failures.

But I guess “government” isn’t a good enough name for the cause. Some government, after all, is good for us. So, how to name the problem?

Several months ago Greg Blankenship, founder and president of the Illinois Policy Institute, gave us a good name for one governmental cause of health care failure. In a fascinating column, Blankenship looked at the regulations that beset planning for medical care in his state, Illinois, and gave it a name: Protectionism.

What’s happening in Illinois isn’t hard to understand. It’s the same old protectionist racket. A hospital in Joliet hasn’t been allowed to add beds to its mental health and OB-GYN clinics for years now. Nearby hospitals in Aurora, Joliet, Bolingbrook and Morris oppose the project.

So people in Joliet suffer. Not enough options. Not enough health care.

And so many no doubt blame insufficiencies on doctors, or nurses’ unions, or markets in general.

Yet the real blame rests solely on the state of Illinois and its Health Facilities Planning Board. A sad case, yes; a sick system.

The Simplicity of the Idiocy
As Blankenship makes clear, protectionism isn’t just for busybody politicians in nation-states. State governments get in on the act, too.

And, like nationwide protectionism, special-interest influences come to play as a matter of course, with one or two businesses reaping most of the rewards. Blankenship likened the practice to a (fictional) fast food restaurant regulatory board getting captured by McDonald’s. Suddenly, Burger King outlets can’t get permission to expand.

Economists have been writing on this for 50 years or more. Regulatory capture, it’s called . . . but here applied to the business of medicine.

And medicine is a business. Calling it a “service” and pretending it’s like government doesn’t make it any less a business. It only helps run the business into the ground.

Further, medicine may be a “basic service,” yes — but remember: food is a basic product. And the farming, distribution, and marketing of our food supply works best with minimal government involvement. (Indeed, our biggest food-related problems are largely caused by government involvement.) And there’s little inherent in the services of medicine to require “sharing the burden” through government.

This critique is not an instance of being “anti-government.” I am no more “anti-government” than I am “anti-drugs.” I just believe that, if you have a headache, you only take two aspirin, not the whole bottle. If you have a social problem, you call upon government to do only what it can competently do.

Any more and you get poison.

Hormesis (look it up)
That’s it in a nutshell: A little government goes a long way. Adding more government is just increasing the dose. Then all you get are addicts and increasingly bad side effects.

As they say in pharmacology: The poison is in the dose (yes, that’s the principle of hormesis). Water is healthy, right? Drinking it is good for you. Well, last year several people died from drinking too much water. Their cells ruptured from overdose of H2O.

Same with government. It may be effective (sorta) in fighting back criminals and rogue foreign powers. But having it run a health care system is . . . socialism.

Yes, that’s another name for the problem affecting health care. Socialism. The S-word.

And here’s something we know for sure: socialism just doesn’t work. Why? Socialism is government at, or near, the highest dose.

If you don’t believe me, just read the British papers. I regularly come across news stories that show how bad socialism can be. In Britain. Today.

Take dentistry. Please. What a job, sticking fingers into opened mouths. Probing. Drilling. Filling. Ugh.

And, for those who take it upon themselves to do the job, it can’t be easy managing patients, or clients, or whatever they call the people who pay their bills.

It’s bad enough here in America; It is obviously much harder in Britain, where dentists were just told to . . . . go on vacation. By the government. Why? They had filled their work quotas. Even while millions — yes, millions — of English people can’t get in to see any dentist!

Dentistry is socialized in Britain. The government hires the dentists. Tax money — not patients directly — pay for the dental work.

So no wonder there aren’t enough dentists in Britain, and why British teeth, in general, are getting worse, even though the service is “free of charge.”

Just try to provide a free service using tax funds — you still can’t void the laws of scarcity and value by edict. If you want something, you still have to pay for it. You still have to invest. Scarce resources must go from some use and be put to another.

The trouble, as economists starting with the Austrian Ludwig von Mises have shown, is that when you try to run things by bureaucracy, forfeiting private means of production and capitalist investment and competitive markets, you give up some amazingly effective tools to organize scarce resources. And you are left with guesswork. And politics.

And, under socialized medicine, bad teeth.

Leave It to the Swedes
Sweden is often looked upon by the American left as socialism done right. I have not been there, nor have I devoted extensive study to the Swedes’ peculiar (and waning) love for high taxes and big government. But what I read in the papers leads me to regard Sweden as reducing socialism to absurdity.

Take a basic problem of medicine: dignity, or lack thereof. Going to the hospital requires a certain . . . humility, I guess. You get dressed up in flimsy gowns, and if your situation renders you immobile, you no longer remain in charge of what you might normally think of as your bathroom functions.

Dignity is not always easy to maintain.

Now, if I were in the hospital biz, I’d be trying to figure out ways of maintaining and catering to customer — I mean, patient — dignity.

But then, if I were in the hospital biz, it would be as an entrepreneur, not as the head of a government bureau.

Sweden, on the other hand, has what Hillary and Obama other Democrats say they want here: nationalized care.

Now, so does neighboring Norway, and their system is so far in the red, and so chaotic that we should be hearing about it in the news, nightly. But we don’t.

Still, the costs associated with socialized care do leak into the American consciousness. The latest? Sweden’s decision to buy unisex boxer shorts for patients. In just a few weeks Swedish patients will no longer get to wear underwear designed for their precise anatomy. It saves money, you see.

Even socialists must ration. So in Sweden they ration underwear! That, friends, is reducing socialism to absurdity.

More of the Current Disease?
Astoundingly, state-run medicine gains political ground. Against all logic. Against all evidence. How? Because politicians and bureaucrats have repeatedly crippled the system, and then successfully blamed the injuries on “the ‘free’ market” part of the system.

The only way to stop its onslaught is to prescribe two bitter pills and repeat daily:

  1. Government has caused most of our current mess.
  2. More government is no cure for too much government.

Only if those of us who understand how the world works keep explaining it to our friends and neighbors and relatives do we have any chance. The government schools don’t teach much of anything about this.

It’s up to us. Or we will lose the vibrancy of the current system, and any chance of making medicine better — and cheaper — in the future.

Please, America, don’t infect the health care system with yet more of its current disease: Too much government.