Minor Thoughts from me to you

It's great that Great Britain has high quality health care available to everyone, courtesy of the British government. Expectant mothers are especially appreciative. After all, without the NHS, some of them would have never known that it's possible to give birth outside of a delivery room.

Thousands of women are having to give birth outside maternity wards because of a lack of midwives and hospital beds.

The lives of mothers and babies are being put at risk as births in locations ranging from lifts to toilets - even a caravan - went up 15 per cent last year to almost 4,000.

Health chiefs admit a lack of maternity beds is partly to blame for the crisis, with hundreds of women in labour being turned away from hospitals because they are full.

Latest figures show that over the past two years there were at least:

• 63 births in ambulances and 608 in transit to hospitals;
• 117 births in A&E; departments, four in minor injury units and two in medical assessment areas;
• 115 births on other hospital wards and 36 in other unspecified areas including corridors;
• 399 in parts of maternity units other than labour beds, including postnatal and antenatal wards and reception areas.

Additionally, overstretched maternity units shut their doors to any more women in labour on 553 occasions last year.

I'm so glad that the British don't leave their health care up to a greedy, heartless private sector motivated only by profits. Imagine what might happen if they did!

There Ain't No Such Thing as Market-Based Universal Coverage (Cato @ Liberty)

Over at The Corner, Harvard Business School professor and Manhattan Institute scholar Regina Herzlinger urges conservatives to support universal coverage -- but in a market-oriented way. That is an absurdity. Once the government adopts a policy of universal health insurance coverage, a free market is impossible and the casualties begin to mount.

Australia has socialized its medical services. Australian friends tell me that providing basic medical care for free is the only fair and just thing to do. Well, how fair and just is this?

A German doctor hoping to gain permanent residency in Australia said Friday he will fight a decision by the immigration department to deny his application because his son has Down syndrome.

Bernhard Moeller came to Australia with his family two years ago to help fill a doctor shortage in a rural area of Victoria state.

His temporary work visa is valid until 2010, but his application for permanent residency was rejected this week. The immigration department said Moeller's 13-year-old son, Lukas, "did not meet the health requirement."

"A medical officer of the Commonwealth assessed that his son's existing medical condition was likely to result in a significant and ongoing cost to the Australian community," a departmental spokesman said in a statement issued Thursday by the Department of Immigration and Citizenship.

"This is not discrimination. A disability in itself is not grounds for failing the health requirement -- it is a question of the cost implications to the community," the statement said.

This is the end result of socialized medicine. Everyone will be judged based on how much they cost the community. Do you cost too much? Goodbye, nice knowing you. It's impossible to preserve individual human dignity and worth as long as the community has to pay for that individuals. Communities will quickly find ways to exclude the costliest people and include the cheapest people. A system that was supposed to remove the "indignity" of making people pay their own quickly degrades to a system that values people solely on the basis of a cost / benefit analysis.

Ironic, no?

Yesterday, I read a very interesting op-ed about universal coverage: Bad Medicine For Health Care.

Individual mandate supporters typically justify the policy by citing the problem of uncompensated care. When uninsured patients receive health services but don't pay for them, the rest of us end up footing the bill one way or another. So advocates of insurance mandates contend, plausibly enough, that we should make the free riders pay.

But how big is the free-rider problem, really? According to an Urban Institute study released in 2003, uncompensated care for the uninsured constitutes less than 3% of all health expenditures. Even if the individual mandate works exactly as planned, that's the effective upper boundary on the mandate's impact.

Savings of less than 3%? That doesn't sound so good.

What about the states that mandate minimum coverage levels? Surely that does some good?

Some proposals couple mandates with subsidies for the purchase of private insurance. As far as policies to encourage more private coverage go, you could do worse. But as long as the public has to subsidize the formerly uninsured, the problem with free riders has not been solved. We're just paying for them in a different way.

Even now, every state has a list of benefits that any health-insurance policy must cover--from contraception to psychotherapy to chiropractic to hair transplants. All states together have created nearly 1,900 mandated benefits. Of course, more generous benefits make insurance more expensive. A 2007 study estimates existing mandates boost premiums by more than 20%.

Oops. Maybe if we allowed people to buy only the coverage that they actually needed, more people could afford coverage.

Finally,

Some people will not comply: 47 states require drivers to buy liability auto insurance, yet the median percentage of uninsured drivers in those states is 12%. Granted, that number might be even higher without the mandates. The point, however, is that any amount of noncompliance reduces the efficacy of the mandate.

Let's assume that 12% of the U.S. populace ignores an individual mandate and doesn't buy health coverage. What's 12% of 300 million people? Oh, about 36,000,000 people. That's about the number of people in the U.S. that currently don't have healthcare.

I'm supremely skeptical that passing universal healthcare will do much to help Americans get better healthcare.