By Craig J. Cantoni
Jan. 19, 2010
Several industrialized countries have
mortality rates that exceed birth rates. Unless they change their social
welfare policies and immigration laws to encourage higher birthrates and
population growth, they will cease to exist in their current form in a few
decades. This is especially true for European countries that have a large and
largely illiberal Muslim population, which, because of higher birthrates, will
eventually outnumber the non-Muslim population. Even if these countries
somehow survive as liberal democracies, their social welfare costs will become
unsustainable, especially if the United States stops subsidizing
their national defense.
T. R. Reid glosses over this in The Healing of America. An advocate for
national health care for the United
States, he instead uses misleading
statistics and communitarian views of rights from such statist organizations as
the United Nations to make the case that Americans should adopt the health care
systems of other industrialized nations, including the dying ones. Like so
many advocates of national health care, he looks at the issue in a vacuum and
not in the larger context of what a smothering welfare-state security blanket
does to the psyche, values, industriousness, and survivability of a nation.
To his credit, Reid presents a balanced
overview of the history and workings of national health care, including the
many warts, such as long waiting times for treatment, bare-boned facilities,
rationing, unsustainable cost increases, and, in his words, the “shafting” of
physicians and other health care providers. For this reason alone, the book
should be read and kept as a reference by those who have an interest in the
health care debate.
Unfortunately, Reid either ignores an
important reason why the United
States appears to spend more on health care
and get less in return than other industrialized nations.
For example, although he correctly details
the dysfunctions, inefficiencies, sub-par health outcomes, and coverage gaps
with American health insurance/care, Reid gives no explanation of the primary
cause of these problems, other than to incorrectly imply that the cause is the
profit motive. As readers of these pages know, the primary cause is the
destruction of a true consumer market in health insurance/care at the hands of
the government. Seven decades of misguided tax, labor, and welfare policies
have created a Rube Goldberg contraption of cost shifting, third-party
payments, hidden prices, red tape, malpractice litigation, and rent-seeking
corporations that use their political clout to stifle competition. At the same
time, there has been a crowding out of private charity, personal
responsibility, and saving for the infirmities of old age.
If, as Reid suggests, the profit motive is
bad for health care, then wouldn’t it also be bad for other necessities of
life, such as food, shelter, and clothing? Shouldn’t profits be replaced by
socialism and a single-payer system across all life-sustaining industries?
Reid doesn’t address these questions. However, he does address the
philosophical issue of health care as a right.
Reid praises the Charter of Fundamental
Rights of the European Union, which, among other invented “rights,” grants the
right to health care, or to be more accurate, free
health care. Tellingly, he makes no distinction between positive and negative
rights and thus is not concerned that government coercion is used against some
citizens for the benefit of other citizens in order to fund national health
care and limit costs. Nor is he concerned that national health care violates
the right of self-ownership by giving the state control over the bodies of
patients and the labor of physicians. As a result, he doesn’t ponder whether
American health care can be improved without coercion or at least with far less
coercion than that exercised by other nations.
The book has the additional flaw of
comparing U.S. health care
costs and outcomes to Germany,
France, Great Britain, Switzerland,
Canada, Japan, and Taiwan. These nations are markedly
different from the U.S.
in racial make-up, levels of immigration, diets, size, and history. For
example, Germany, Switzerland, Japan,
and Taiwan are mostly
racially homogenous (France
doesn’t publish racial statistics). Switzerland, with a population of
only eight million, finds it much easier to maintain solidarity and enact
reforms than a multiracial nation of 310 million. Japan has low a low rate of heart
disease and diabetes due to genetics and diet. It also has restrictive
immigration laws that maintain racial purity and keep out people with AIDS and
other diseases. And none of the countries has absorbed as many unskilled and
uneducated immigrants in poor health as the United States.
On the last point, Reid holds up the other
countries as paragons of fairness and justice because of their national health
care, although the United
States has admitted a larger number of poor
immigrants to its shores than all of them combined. Coupled with its economic
freedom and class mobility, the U.S.
has given tens of millions of transplants the opportunity to rise above the
poverty, ignorance, and substandard health care of their homelands. But this
attribute has lowered the U.S.
in international rankings of health care and in the eyes of Reid and the United
Nations. Apparently, the U.S.
would have more international esteem if it were to have the immigration laws of
Yes, the American health care system
should be reformed, but American values and individual liberty shouldn’t be
sacrificed in the process. For sure, contrary to the advice of The Healing of America, the U.S. shouldn’t
emulate dying countries.
Mr. Cantoni is an author, a former
business executive in charge of employee benefit plans, and a longtime advocate
of health care reform and critic of employer-provided health insurance.