Debunking Health Care Myths

Once again, the health care debate is on. And once again, sophistry is in vogue. Everything about the entire debate is rife with misinformation, down to the very premise for the need for reform. Let's take them myth by myth:

1) Health care costs are out of control -

Health care costs, unlike almost any other good or service, are calculated on a per person basis. The cost on a per person basis goes up when on average people receive more health care, which is a good thing, not a bad thing. The standard of care increases as technology increases, and treatments for more conditions become available. People today receive treatments and tests that were not available ten years ago, and may never be available in countries that "control" costs by denying access to these new technologies. To argue that health care costs are out of control is like arguing the costs of electronics are out of control because people today have ipods, plasma tv's, and wireless telephone devices that did not exist ten years ago. Include all the service contracts for these devices, and divide by the number of people and society is experiencing an explosion of electronics costs. Make no mistake about it, when people in government talk about a health care cost problem, what they are really saying is that we have too many new ways to treat people, not that the price of anything is out of control. A question to ask is, "what better should society be investing in than treating the sick?"

2) Too many people don't have access to health care

Everybody in this country has access to health care. It is illegal to deny care based on an inability to pay. Show up in an emergency room, and you get care. There is charity care available, as well as medicaid for the indigent. It just isn't true that anyone is denied care because they cannot afford it. Yes, people worry about not being covered and how they will pay, but when push comes to shove, they get treatment.

3) A government system will be more beneficial because they will not be seeking profit

It may be unpleasant for some to think of profit as a motive for treating the sick, but the lack of a profit motive does not mean that the people providing treatment will have any better motive. It is nice to imagine that a government system would result in a flood of altruistic people rushing into the health care profession, but the idea is just silly.

4) Insurance companies abuse people and the government would be better at the job

Insurance companies deal in contracts that they enforce based on terms that are prospective in nature and based on rules that are subject to government anti-discrimination laws. For example, an insurance company would have a difficult time writing a policy that says that certain conditions will not be treated based on the age or disability of the patient because the government has laws designed to protect people from the insurance companies doing this. But once the government becomes the insurance company, and is faced with increasing "costs", which include inevitable increases in technology, who will stop the government from making such rules, "for the good of society?" An insurance company could never make such an argument. Whenever a government takes over health care, exactly this type of reasoning occurs and people who need care are denied care, often even if they can afford it on their own dime.

5) If we cover everybody costs will go down

This one is a statistical trick that can make it appear that the cost per person is going down because money is collected from more people who are not currently getting care. If you start charging them, they will start getting care, whether they need it or not. The overall costs in absolute dollars spent on health care will increase, if you cover everyone, even if the costs per person decrease slightly as money is collected from more healthy people with no need for health care.

6) Emergency room care is costly

Emergency rooms are indeed set up for emergencies and they are equipped to do a lot of expensive tests quickly. But if you go to an emergency room for a runny nose, it does not cost them any more to treat you than if you went to your primary care physician. Emergency room costs appear high mainly because they charge based on paying patient, not based on all patients. Since they are obligated to treat patients whether or not they can pay, the costs of those not paying are spread over those who do pay. If you consider the health care system as a whole, you would have to argue that the emergency room is providing more services per condition in order to suggest that the emergency room is more costly. Since the tests are all readily available, it might ironically be the case that those without insurance who are treated in the emergency room are receiving a higher standard of care than those who go to a primary care physician, who does not order the tests available in the emergency room. At least, this is the argument you have to make for emergency rooms to be more costly than going to a primary care physician. Which means, the uninsured may actually be better served in the emergency room, than if you provide them insurance.

7) Preventive care saves money

Screening thousands of people to discover a couple with a condition that might be discovered prior to symptoms presenting typically costs more than waiting for symptoms to present. These screenings may be an appropriate standard of care, but they don't save money. Nor does visiting your doctor once a year and hearing him tell you to lose weight, stop smoking and stop drinking. Certainly, if these behaviors can be curtailed, short term health savings can be achieved, but the best that can every be attained in a preventative care regime is delaying costs. Eventually, we all will develop a condition that needs treatment, no matter how healthy our lifestyles

8) Most health care costs occur in the last two weeks of life, so we should treat people less at these times to save money

Can anyone say with certainty when the last two weeks of life will be? Who makes this judgement? Most people are sickest and in most need of treatment when they are within the last two weeks of life, so it makes absolute sense that this would be when costs would generated. If we do not treat people when they may die without treatment, when will we treat them?

9) It is better to have a doctor decide when you should be denied treatment than the insurance company

Doctors currently are advocates for their patients, and they have no conflict of interest. Putting doctors in the position of making decisions to deny care corrupts the profession, and violates they Hippocratic Oath. I would rather have my doctor advocating for my care and confronting an insurance company on my behalf than have a government doctor deciding it is not worth it to society to treat me.

10) People should not go bankrupt paying for treatment

What better reason to go bankrupt than you are too sick to work to pay off your debts? What better incentive for buying insurance than to avoid this situation? Are we saying those who are prudent, and buy insurance, are just foolishly wasting their money to prevent a situation that the government should not allow to happen? Bankruptcy protects people from their creditors. It is good that people have bankruptcy laws to protect them from creditors when they cannot pay because they are too sick. Should we disparage the bankruptcy laws that are acting to the benefit of the sick?

The entire premise of the health care debate, that we as a society spend too much on health care, and too many people do not have access to care, are simply not true. There is nothing more important that a society could spend its resources on than on advancements in life-saving health care. We are in a time of unprecedented innovation in health care, and it is not time to stop. As technology progresses, we will likely have more treatments, for more conditions, while the costs of current treatments will likely decrease, just as costs of new electronic gadgets increase, while older gadgets decrease in price. Let's not make the mistake of saying we've had enough innovation because it costs too much; there is nothing more important to invest in.