The Inuit of the Arctic used to sacrifice their old people to save food for the rest of the clan during the long winters. The elders were expected to commit suicide. As they ran low on food and fuel, as sled dogs were slaughtered and eaten, the old ones walked into the long night and died. It made sense because there was a limited amount of food and warmth, and so many months of cold and darkness to go before the sun came back. If the elders resisted they might be publicly shamed. They would rather die. And so they walked into the snow.
It’s astonishing, but that’s the reasoning Barack Obama is using for the United States today. Obama’s command seizure of one-sixth of the American economy is based on the assumption that medicine is a zero-sum game. The trouble is that Obama’s assumption is false — and destructive. It has been falsified by every single advance in human health since the Industrial Revolution. It’s simply not true that there is a fixed supply of medical care, one that cannot grow, become more effective, cost less, and make our lives better and longer. It is not true that my gain must be your loss.
Obama thinks the way Thomas Malthus did in 1798. But Malthus was wrong then, just like Obama is now.
So here’s the question for every American. Under ObamaCare, when we really will have to divide up a Malthusian lockbox of federal money, how much will your life be worth? Your spouse’s? Your child’s? Your parents’? If you are an aging boomer, is your life worth as much as Sarah Palin’s baby, born with Down Syndrome? And whom do you trust with the God-like power to make those decisions?
If we have a limited budget for all medical care — no more and no less — who is entitled to that extra dollar of care? Is it Michelle Obama or you? Your grandchildren? Ted Kennedy? Or some family in Somalia? For socialists, all the people of the world deserve the same medical care that you get. There is a fixed amount of medical dollars in the world. Your gain is their loss.
Older people spend a lot more on doctors than younger people. Should they be stopped from spending their money on staying healthy? If you spend your money on health care, does that subtract from the medical care of a young Mexican immigrant?
The Obama belief is that it does. But that’s not the reality of medical science since the 1860s.
Take as an example clean water. It has saved more lives than any other advance in history. It was public sanitation that triggered the first great leap in life expectancy, starting in 1869, when Louis Pasteur figured out how typhoid fever spread.
Public sanitation has doubled the human life span since then. All it took was separating the food and water supply from our bodily wastes. Now, if you’re Obama, you believe all those miles of plumbing are a cost — everybody in the country has to pay for it. But if you’re in touch with economic reality you see it as a net benefit. Sure it takes money to lay all those pipes for fresh water and to dispose of sewage. But life expectancy has doubled. That’s not a net cost; it’s an unimaginable benefit for all those lucky people. (That would be us, our parents, and children.)
If you’re Obama you think, “Uh-Oh, more money to spend on bodies that live twice as long!” That’s Obama’s Malthusian lockbox thinking. What we find in reality is that those longer-living people are healthier, more vigorous, think more clearly, have more fun, are better educated, generate more wealth and productivity, and create a gigantic demand for goods and services that keep industrialized economies humming. (If you allow markets to work, that is.)
Spending money on public sanitation is a wealth-generator. If you don’t believe Western history, look at India and China since the end of communism. Or take a look at South Korea versus North Korea. Which one is the Malthusian society, with hundreds of thousands of people dying from starvation? Which is the wealth-generating society? Which one has healthier people? Yes, you guessed right.
I’ve been reading one of Obama’s central planners, Dr. Ezekiel Emanuel, brother of Rahm Emanuel — the Rahm-Bro — whose writings are all over the Journal of the American Medical Association. Dr. Emanuel is a “bioethicist” who runs studies of medical care for the National Institutes of Health. Somehow all his “studies” come to exactly the same conclusions: American medicine stinks. It’s too expensive. And we’re not getting value for all that money.
Dr. E doesn’t hide his outraged feelings in JAMA, in a commentary called “The Perfect Storm of Overutilization“:
The United States spends substantially more per person on health care than any other country, and yet U.S. health outcomes are the same as or worse than those in other countries. … It is more costly care … that accounts for higher expenditures in the United States.
Dr. E blames these factors.
- U.S. doctors are “too thorough” in examining patients. (No kidding!)
- Fee-for-service creates the wrong incentives — although “most physicians are not income maximizers.”
- Physicians are targeted by medical advertisers — and don’t have comparative studies of effectiveness.
(But a Google Scholar search for “medical effectiveness” brings up no less than three million nine hundred and ninety thousand scholarly articles on that topic.)
- Defensive medicine costs more.
- U.S. patients “prefer high technology over high touch.”
- Patients find out about new drugs from medical ads and news stories, and keep bugging their docs for the latest.
Well, I must say I’m not shocked — and not appalled. I’m willing to risk an extra three thousand dollars per year for medical care, on the chance that a doctor will diagnose breast cancer in a woman I love, quickly enough to save her life. Does Dr. E have different values? I pity his loved ones. But I certainly do not want him in charge of my medical choices — or yours.
Real scientists know science is unpredictable. Every issue of Science magazine brings more surprises. But Dr. E’s assumption is that he can judge medical advances — and therefore economic costs and benefits — for decades into the future. That is patently false and foolish.
For example, recent discoveries in biomedical science point to new ways to extend human life. Google Scholar cites 122,000 scientific articles on “extended lifespan.” Those discoveries will take time to become practical, but the scientific frontier is moving amazingly fast. Or take another example: simple aspirin, which was first synthesized in 1899, is now known to be an excellent anti-inflammatory drug — and systemic inflammation is now known to make us vulnerable to cardiovascular disease and some cancers. And guess what? If you’re taking statins for cholesterol, you’re getting all kinds of unanticipated health benefits. All that was discovered in the last ten years. Nobody could have anticipated those findings.
The thing is, to Obama’s Malthusian mind-set it would be bad for us to live longer. The older you are, the more you’ll cost the feds. Well, then, what’s the Malthusian answer? Don’t let people get older. Make sure they take end-of-life counseling. It’s mandatory every five years under the House bill, and more often than that if you get a bad cough. Don’t kill older people, but just keep asking them how they are willing to die. The real purpose of all that counseling is to make you sign that do-not-resuscitate order. Gotta move ‘em out, ya know.
How’s that for cheering up your golden years?
If you think all that’s wild speculation, consider Prime Minister Gordon Brown, the man who has run Britain’s National Health Service for the last dozen years (as chancellor of the exchequer and PM). Brown is obsessed by the Malthusian trade-offs required by socialized health care. So here is Gordon Brown’s solution to the Malthusian lockbox dilemma: mandatory organ donations by all citizens as soon as they die.
It makes perfectly good sense in a mad kind of way. You see, the government has invested public money in your body. So the taxpayers are entitled to use whatever mileage is left in your heart or lungs when you’re done with them. And rather than let your body go bad, the docs need to get at those organs while they’re nice and fresh, as soon as you flatline. So they can’t afford to wait to ask your nearest and dearest, right? And what if you didn’t sign that little organ donation card, as Gordon Brown told the world he did, like a good citizen?
I’m not kidding. In the British newspapers nobody even seemed to be surprised. It’s the brave new world of socialist cannibalism.
So we’re back to the Inuit elders in the long Arctic winter. Except that unlike the Inuit of old we are not living in a zero-sum world. We are not on the edge of starvation. We are not forced to choose between saving babies or driving old people into the Arctic night.
No — we are only dealing with a malignant fantasy land by the obsessional control freaks of this administration.
And yet — Obama’s Malthusian lockbox will become the law of the land if you don’t do anything about it.